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Cataract Surgery

DISCLAIMER! The information on this website is general information for someone who may need cataract surgery. Please discuss with your surgical provider your concerns and questions about the procedure. Your personal health information may differ from the information presented here.

Portland Oregon Cataract Surgery

Cataracts occur when the part of your eye known as the crystalline lens becomes cloudy, or less transparent. Cataracts do not go away on their own; rather, they tend to progress over time and often result in decreased vision, faded colors, or increase in the amount of glare. These challenges can quickly interfere with daily life, making it difficult to drive, read, and perform other essential tasks. 

Fortunately, cataract surgery is a safe, painless, and fast procedure that can effectively treat cataracts and restore your vision. In fact, the cataract surgery success rate is higher than 90%. 

Our experienced team of ophthalmologists in Portland, Oregon research and perform cutting edge, cornea-related work. Cataract surgery is one of our areas of specialty, so contact us today to learn more or schedule an appointment.

Cataract Symptoms

Initially, cataracts may only affect a small part of your eye’s lens, so they can be difficult to notice. However, as the cataract develops and grows over time, it will cloud more of your lens and affect the light passing through, so symptoms will become more noticeable. 

Some of the primary symptoms of cataracts include: cloudy vision, blurred vision, fading or yellowing of colors, sensitivity to bright light and glare, increase in the amount of glare, seeing “halos” or rings around lights, double vision in a single eye, increased difficulty reading or with vision at night, frequent changes in eyeglass prescriptions, and related symptoms. 

As previously mentioned, symptoms tend to get worse over time as cataracts grow, so don’t delay in seeking professional help if you notice any of these symptoms. If you experience drastic or sudden changes to your vision, you should see an eye doctor immediately.

Types of Cataract Surgeries

Below are the two most common types of cataract surgery: 

  • Phacoemulsification Cataract Surgery: This is the traditional method of performing cataract surgery, which uses an ultrasound probe to break up or emulsify the lens for removal. The surgeon makes a tiny incision in the front of your eye, or cornea, in order to insert the small ultrasound probe. 
  • Laser-Assisted Cataract Surgery: With this method, the surgeon uses a laser to make the corneal incision. A camera/ultrasound device is placed over your eye to map its surface and guide the laser. This type of cataract surgery usually requires meeting certain medical conditions and medicare guidelines. 

With both of these types of cataract surgery the damaged lens is replaced with an artificial lens, known as an intraocular lens (IOL). In most cases no stitches are needed for either type of procedure.

Preparing for Cataract Surgery

Fortunately, cataract surgery is not as scary as it might sound. It’s a relatively safe and low-risk surgery, and only a very small percentage of patients experience complications. It’s also one of the most common medical procedures in the United States. 

A week or two before the surgery itself, your ophthalmologist will have you come in for painless ultrasound testing to measure your eyes so that they can select the proper replacement lens. You will likely be advised not to eat or drink anything for 12 hours prior to the cataract surgery, and may be advised to stop certain medications that can cause interference. In some cases, you may be prescribed antibiotic eye drops prior to the surgery. Other than that, there isn’t much for you to worry about before the surgery, but be sure to follow your doctor’s instructions carefully.

Understanding the Procedure

As far as surgeries go, cataract surgery is quick and painless. The surgery will be performed while you are awake, but eye drops and local anesthesia will be administered to numb the eye. In some cases, patients will also be given a sedative. The surgery itself entails removing the lens with cataracts and replacing it with an implanted artificial lens. It typically takes less than an hour or so for the surgery and it’s normally an outpatient procedure, meaning you can go home that same day.

Cataract Surgery at NW Cornea Institute

The Operation

Because cataract surgery can usually be accomplished in only 5 to 10 minutes, the surgery is performed under topical, anesthesia unless you have a strong personal preference for General anesthesia (General anesthesia is when you are asleep during the surgery.). With topical anesthesia, we place strong anesthetic drops on your eye so that there is no pain with the surgery. You are awake, but we can also have the anesthesiologist give you some medicine in your vein to make you fell less anxious. Topical drop anesthesia has nearly no risk and is even safer than going to the dentist.  The surgical procedure will take about 10 to 15 minutes to perform from start to finish. I generally talk to you during the surgery to let you know each stage of this short procedure and how you are doing.  Before you know it, the surgery is over:

Immediately after the surgery, your vision will be dark until your eye recovers from staring into the bright ‘light of the microscope. We do not patch the eye, but simply place a shield over it to protect the eye and remind you not to rub it  Within about 30 minutes after the surgery, you will. notice that your vision is improved and you can see through the holes of the shield.  You will be kept another hour after surgery in the Ambulatory Procedure Center prior to discharge. Surgery is usually done as an outpatient procedure at the hospital and you ate sent home with the shield on your eye that same afternoon. You should have minimal discomfort after surgery, and standard over-the-counter pain medications can be taken if necessary.  You may also be given other pill medications to take for the eye if indicated; Keep the eye shielded until your doctor sees you the next day. Just pull the shield down to put in the eye drops, starting immediately after surgery until you go to bed that night.

Immediate Post-Op

Instructions: we request that you try to stay relatively inactive for the first 24 hours. You are quite free to stand up and walk around for going to the bathroom or to sit up for eating meals as much as necessary in that ‘first 24 hours after surgery and it is not a danger to your eye to do so. However, do try to rest, whenever possible, in bed or a chair or on the couch, just kind of relaxing until I see you the next day. You are permitted to bend over and tie your shoes, but generally limit your activities immediately after surgery. The morning after your surgery, you can get up, take the shield off, and you can even take a shower, wash your hair, etc. Just try not to put too much pressure on the eye.

Post-Op Visits Schedule

You will return to see your doctor the next day. The shield will be removed and your eye will be examined. You will be placed on antibiotic and steroid drops to prevent infection and to help with healing. This first visit will only take about 15 minutes and is primarily done to check the pressure and to be sure that the eye has done well after the trauma of surgery. If all looks good the first day after surgery, we generally don’t need to see you again until 2 to 4 weeks later, and it is at that time that your eye has stabilized enough to get your glasses for reading or distance or whatever. Most patients can see in the distance well enough in those first few weeks after cataract surgery that just plain old over-the-counter reading glasses work reasonably well. If the other eye also has unacceptable vision due to cataracts, then your second eye surgery can usually be done within a few weeks of the first surgery.

(from NW Cornea Surgeons)

Cataract Surgery Recovery

After the surgery is complete, your vision should improve in just a few days as you start to heal. With a brand-new, crystal-clear lens, colors should begin to appear brighter too. You may notice some slight discomfort immediately after the surgery, which is normal, but you should avoid touching or pressing on your eye. You will likely have several post-op appointments with your eye doctor to ensure everything is healing and improving as it should be. Depending on your doctor’s recommendations, you may be instructed to wear an eye patch while you heal, or be prescribed medication or eye drops to prevent infection. Though you should feel better and notice improvement quickly after the surgery, the full recovery process may take around 8 weeks or so in total.

Medication Dosage and Schedule for NW Cornea Patients

(Note: you can use your various drops at the same time, just separate them from each other by about 5 minutes, so they don’t wash each other out.)

Vigamox:

Begin using this drop every TWO HOURS immediately after surgery until you go to bed that night. Sleep through the night and then the dosage is FOUR times a day (breakfast, lunch, dinner and bedtime) from the day after surgery until it runs out, usually (or as directed by your physician) within about 2 weeks after surgery.

This drop (Vigamox) is an antibiotic and keeps your eye from getting infected.

Prednisolone Acetate 1 %:

(a milky white drop) – SHAKE WELL BEFORE USING Begin using this drop FOUR times a day (breakfast, lunch, dinner, bedtime) from immediately after surgery until it runs out, usually about 4 weeks.

This drop (Prednisolone acetate 1 %) is what keeps the inflammation down after surgery, so it is important that you DO NOT stop taking this medication unless advised by your corneal doctor.

Nevanac:

Begin using this drop THREE TIMES a day (Breakfast, Lunch, and Dinner) starting immediately after surgery until it runs out,(Or as directed by your physician) usually after about 4 weeks.

This drop is a non-steroidal anti-inflammatory (like ‘Advil’ for the eye) and can not only reduce discomfort but also reduce inflammation of the retina that can rarely occur after routine cataract surgery.

Artificial Tears:

Use these drops if your eye feels dry or uncomfortable. They are only lubricants (do not have medicine) and do not have to be used unless desired.

Please use any other eye medications that you were using prior to your surgery.  Use them on the day of surgery and start them again the morning after surgery when the patch is removed.

Activities

Immediately after surgery, we like you to be resting as much as possible for the first 24 hours (see comments previous page). You can bend over to tie your shoes, but try to avoid any real exercise in the first 24 hours.

The day after surgery, the shield is removed and does not need to be used again in most cases. No protection is needed during the day, but if you normally wear glasses for the other eye, go ahead and wear them.

Normal activities are permitted even the first post-op day after you see Dr. Terry and he takes the shield off.  You can shower, wash your hair and do normal activities like shopping etc. However, you are at risk for infection for the first two weeks after surgery, so do not do activities like gardening, cleaning out stalls or attics etc.  Just use common sense and it will be fine.

Finally, avoid activities that may lead to taking a direct hit to the eye (eg. playing with small children, wrestling with animals, etc!).

No sports activities of any kind for one week after surgery. No swimming under water for three weeks, but doing water exercises (head always out of water) is fine after one week. Absolutely avoid any sports where you might get hit in the eye (tennis, racketball, etc.) for at least 3 weeks, and if you must play, ALWAYS wear protective eyewear.  I do!!

Vision Expectations

Almost immediately after surgery, most people notice that the vision is better, with brighter lights, colors, and pretty good vision through the central pinholes of the eye shield.

When the patient wakes up the next morning, that is when the vision really starts to become apparent. However, some patients will have some corneal swelling after cataract surgery or other minor problem, and so their vision may take 2 or 3 days to settle in. The vision is pretty much stabilized at about 2 to 3 weeks after surgery when glasses for reading or other activitie are usually prescribed.

Infections after  Cataract Surgery

Infections are EXTREMELY rare after cataract surgery, with some estimates at about 1 case in 2 to 3 thousand. Nonetheless, that is the one risk we all worry about.  That is why we put you on antibiotics after surgery and why we want you to know how to tell if the eye might be infected.

How do I know if I am having a serious infection after cataract surgery?

I often ask my patients if they know what “RSVP” means … and they all tell me that it basically means “Call me back” … Well for an eye that just had surgery, RSVP means:

R: the Redness is increasing

S: the Sensitivity to light is increasing

V: the Vision is decreasing

P: the Pain is increasing (not just ‘scratchy’,  but real serious pain)

There is generally nothing  ‘subtle’   about these symptoms if they are due to infection.

If you have these symptoms occurring with the surgery eye, then it may be a sign of infection, and if so, you need to “RSVP” your doctor (me) and let me take a look at the eye.  Infection is most common in the first week after cataract surgery.  Never hesitate to at least call us if you have any concerns about RSVP.

Cataract Surgery Cost

As of 2020, the average cost of cataract surgery paid out of pocket was $3,500 per eye, for a traditional phacoemulsification procedure. Laser-assisted cataract surgery tends to cost more because more advanced technologies are used. Luckily, Medicare or private insurance will usually offset the costs. Medicare will often cover 80 percent or more of the total cost of the procedure and treatment. Contact us and talk to your insurance provider for a more specific and accurate price estimate.

Cataract Eye Surgery FAQs

How Do You Know if You Need Cataract Surgery?

If you experience any of the following cataract symptoms, contact an eye doctor to see if you might need cataract surgery: cloudy vision, blurred vision, fading or yellowing of colors, sensitivity to bright light and glare, increase in the amount of glare, seeing “halos” or rings around lights, double vision in a single eye, increased difficulty reading or with vision at night, frequent changes in eyeglass prescriptions, or related symptoms. 

Does Medicare Cover Cataract Surgery?

Yes, Medicare will often cover a large percentage (often more than 80%) of the cost of cataract surgery. 

How Painful is Cataract Surgery?

Cataract surgery is usually a quick and painless procedure! Your doctor will most likely administer a local anesthetic to numb the eye before the procedure itself, which will help to minimize any discomfort. 

How Long Does it Take to Recover from Cataract Surgery?

You should notice improved vision within just a few short days following the procedure, though it may take up to 8 weeks for the eye to completely heal. 

What is the Average Age for Cataract Surgery?

Although cataracts may begin to develop in your 40s, they often will not noticeably impair vision until you’re closer to your 60s. Most cataract surgeries are performed on patients between the ages of 60 and 80 years old. 

What Kind of Sedation is Used for Cataract Surgery?

Cataract surgery typically involves the administration of a local anesthetic in addition to sedatives administered by an anesthesiologist or nurse anesthetist.

What Happens if Cataracts Are Left Untreated?

Cataracts tend to worsen over time and can ultimately lead to total vision loss if left untreated. They can also become “hyper-mature,” which makes cataract surgery more difficult, so don’t delay if you notice any cataract symptoms.

How Do You Prepare for Cataract Surgery?

Generally, your eye doctor will perform ultrasound testing a few weeks prior to measure your eyes and select the proper replacement lens. You will likely be advised not to eat or drink anything for 12 hours prior to the cataract surgery. Your eye doctor will explain how to prepare for cataract surgery in more detail. 

Portland OR Cataract Surgery Specialists!

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