Cataract Surgery

When is cataract surgery needed? When cataracts reduce vision so that normal activities become difficult, it is time to consider surgery, which is the only way to remove cataracts.

It is primarily the patient who determines when surgery is needed. Some patients have mild cataracts but major problems with glare and halos that make it difficult to drive a car at night or fly a plane, for example. If it is determined that these complaints are due to cataracts, surgery can be considered. Other patients may have more advanced cataracts but few complaints. For example, a patient who no longer drives and only needs to watch TV and read with a bright light may have little difficulty, so surgery would not be needed. The concept that the cataract is “ripe” or ready is no longer considered a valid indication for surgery.

What about safety and effectiveness? Today, cataract surgery with intraocular lens (IOL) implants usually takes less than an hour and results in vision improvement for most patients. Although any surgery carries risk, cataract-IOL surgery is uncomplicated and successful in more than 95 percent of patients.

Who does the surgery? An Eye M.D. (ophthalmologist) performs the surgery. It is important to discuss the surgery and the choice of an intraocular lens (IOL) implant to correct your vision with your Eye M.D. and to ask any questions you may have.

Eye exam with ophthalmologist using equipment.
  • Topical or local anesthesia is used so that the operation will be painless. You will not need to be concerned about keeping your eye open during the procedure. You may notice light or movement but will not be able to see the surgery as it is performed.
  • Phacoemulsification is the most effective and common cataract removal method in use today. After the eye is numbed with anesthetic, a small incision is made in the side of the cornea (the front window of the eye). A tiny ultrasound instrument is inserted and used to break up the cloudy lens, which is then suctioned out of the eye. In rare cases, another technique called extracapsular extraction of the cataract is required instead.
  • Next, an IOL is inserted to replace the natural lens. Usually, it is placed behind the iris, the colored part of the eye. Stitches are often not needed, but when used they dissolve naturally over time.
Here's an alt tag for the image: Eye surgery: implant insertion.
  • To determine your IOL prescription, your eye’s length will be measured by ultrasound (the “A-scan”), and the cornea’s curvature will be measured by a process called keratotomy. If you have had LASIK or other laser refractive surgery, provide your pre-surgery vision correction prescription to your Eye M.D., if possible. The record of this prescription is also called the “K card”.
  • Your Eye M.D. will review your eye health and overall medical history. Be sure to tell your doctor if you are currently or have ever used alpha-blocker medications such as Flomax®, Hytrin®, Uroxatral® or Cadura®. These medications can cause the iris to move out of its normal position, which can lead to complications during cataract surgery. You can still have successful surgery if your surgeon knows you have taken these drugs and alters his or her surgical technique. Also, tell your Eye M.D. about any other medications you are taking.
  • On the surgery day, you may be asked to skip breakfast. Before surgery, you’ll receive eye drops and perhaps medication to help you relax.
  • Your Eye M.D. will perform surgery on only one eye at a time. If both eyes need cataract removal and IOLs, the second procedure will usually take place within a few weeks. The interval allows your doctor to monitor your progress after the first surgery and make sure no complications arise, or to treat a complication in the unlikely event one does occur.
  • After surgery, the doctor may place a shield over your eye. After a brief stay in the recovery room, you can go home. Since you will not be able to drive after surgery, arrange for someone to take you home. You can resume most normal activities on the same day.

It is important to follow your Eye M.D.’s instructions to help your eyes heal and avoid complications.

Apply eye drops properly:

  • Tilt your head back.
  • Pull your lower lid away from the eye to form a pocket.
  • Let the drop fall into the pocket without touching the bottle to your eye or eyelid.
  • Close your eye for three minutes, then blink and close the eye again.
  • Wipe away unabsorbed drops and tears before opening the eye.
  • If your doctor has given you more than one eye drop medication, wait three to five minutes between applying each medication.
  • If prescribed by your doctor, wear an eye shield or eyeglasses to protect your eye during healing.
  • Do not rub or press the eye, as this can disturb healing and cause irritation.
  • Resume your normal activities, with the exceptions of driving and strenuous exercise. Most Eye M.D.s ask their patients to take it easy for the first few days, and to refrain from bending over, picking up heavy objects, and swimming. Use good common sense, and avoid any circumstances where the eye could be hit or injured. More vigorous activities may be resumed after a week or two, with the approval of your Eye M.D.
  • You will have follow-up visits with your Eye M.D. to ensure proper healing and good vision.

Dr. Raymond Girgis is a highly experienced cataract surgeon who offers his patients the most advanced techniques and proven technology. He has performed thousands of cataract surgeries and has been chosen to teach regional colleagues advanced surgical techniques.

Dr. Girgis and his staff will ensure that you receive the highest quality of care from the pre-operative evaluation, the surgical procedure, and the post-operative care. You will be treated with compassion, respect, and sensitivity. Exceeding total patient satisfaction is the minimum we strive to achieve. Come see the difference that thousands have experienced at the Center for Eyecare.