Talking With Your Doctor About Cataract Surgery


Mary Elizabeth Dallas

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When having cataracts interferes with your day-to-day life, your eye doctor may say it's time for surgery. The operation would give you an artificial lens to replace the cloudy one. Blurry or double vision should go away. But surgery is a big step. You need to have a long talk with your doctor about what's involved. A thorough discussion with your doctor will help you feel better about your decision whether or not to have surgery. 

Here are some questions to help get that conversation started.  

Do I have options for the type of cataract surgery?

The simple answer is yes. Not all surgeries are the same. And the type of new lens you get will affect how well you see after the surgery.

First, there are three ways to remove cataracts:

  • Femtosecond Laser Cataract Surgery: Your doctor uses a special laser that completes several steps of the procedure. After that, your doctor revers to a typical phacoemulsification technique. This approach can reduce the risk of presurgical refractive errors.
  • Phacoemulsification: Your doctor will use ultrasound waves to break up the central lens nucleus in your eye. The doctor then uses suction to remove the broken lens through a small incision. Another name for this type of surgery is small-incision cataract surgery.
  • Extracapsular surgery: Your doctor will make a larger incision and remove the cloudy lens material in one piece. 

Ask your doctor which type of cataract surgery would be best for you. And if you want to know more about the operation, don't be afraid to ask.  Your doctor can give you as many details as you want to hear. 
The second step is implanting a new lens. You have options here too.  

Once the cataract is gone, your doctor will replace your natural lens with an artificial intraocular lens. The new lens will be clear and made of plastic. You won't feel it. You might need to wear glasses or contacts after your cataract surgery. Or you might not. For example, a multifocal lens lets you see near, intermediate and distance vision in one implant. The type of lens is something you should ask your doctor about before surgery. 

Also be sure to talk with your doctor about costs. Different types of intraocular lenses may have different insurance coverage and out-of-pocket costs.

What is my risk of cataract surgery complications?  

Cataract surgery is generally safe and effective. And most people with otherwise healthy eyes experience better vision after the surgery. Still, all surgeries have risks. You should ask your doctor how likely they are for you. Also ask whether there's anything you should do to lower your risk. For instance, do you need to stop taking any medications before the surgery? What might you need to do afterward to prevent problems?

Possible complications of cataract surgery include:

  • Bleeding
  • Glaucoma (elevated intraocular pressure)
  • Incomplete removal of lens contents, requiring a second procedure to retrieve lens remnants
  • Induced astigmatism
  • Infection
  • Inflammation inside the eye
  • Retinal detachment
  • Swelling in the eye

What else do I need to know?

Some people see very well just one day after the procedure. For others, this may take up to eight weeks. Ask your doctor about what you can expect before, during and after your surgery. Use this checklist as a guide. 

Questions to ask before surgery:

  • Is there any harm in waiting to do surgery later, or do I need it now?
  • Are there advances being made in cataract surgery that would make it a better idea to wait?
  • Will I need to stop any of my medications?
  • Could any of the medicines I take complicate surgery?
  • Do I have any other eye conditions that could affect my treatment?
  • Is there anything I need to tell my family or caregiver?

Questions to ask about the surgery:

  • How long will it take?
  • Will I be in any pain?
  • Will local anesthesia keep me awake but numb? Or will I be asleep under general anesthesia?

Questions to ask about recovery:

  • How soon can I go home?
  • How should I care for my eye?
  • Should I avoid any activities?
  • When can I drive again?
  • How soon will my vision improve?
  • How will my symptoms change?

Final tip: Take notes and ask for detailed instructions.

It's important to have a good long talk with your doctor about cataract surgery. But in a way that's only the first step. You still need to make sense of the information. Do you understand what your doctor told you? If anything confuses, worries or concerns you, let your doctor know. 

It’s a good idea to take notes during your talk. Write down what the doctor tells you. It often helps to bring a close friend or family member for support (and to help you remember what was said).

Finally, ask your doctor for printed information about cataract surgery. And ask for written instructions about anything you should or should not do before and after cataract surgery.