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Frequently Asked Questions
Cataracts
What is a cataract?
What causes cataracts?
Is there a way to prevent cataracts?
When do I need surgery?
What are some of the problems with delayed surgery?
Where is cataract surgery done?
How is the surgery done?
How long before I can resume normal activities?
Will I need glasses after surgery?
What are the complications of surgery?
How will I see after surgery?
How many cataract operations have you done?
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What is a cataract?
Cataract is the clouding of the lens inside the eye. The effect is similar
to that of looking through a ground glass. Things look fuzzy and reading
is difficult. There may be glare while driving at night. Characteristically,
these changes start slowly and progress over months or years.
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What causes cataracts?
There are many causes of cataracts. The most common cause is aging of
the eye. Both eyes are usually affected but often to a different degree.
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Is there a way to prevent cataracts?
There is no way to consistently prevent cataract development. Several
vitamins have been shown to reduce cataract formation but their protective
effect is very limited. Avoiding excessive exposure to UV light by using
glasses and sunglasses with UV filters may help a little.
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When do I need surgery?
Generally, you need surgery when the cataracts have advanced to a point
where your vision interferes with your life style. As long as you can
do what you want to do, you do not have to have surgery.
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What are some of the problems with delayed surgery?
Because of your cataracts, you may not clearly see steps, toys or similar
objects on the floor. You are much more likely to misstep, fall and suffer
serious injuries from the fall, including hip fracture.
Excessive delay of surgery causes the cataract to harden. Fragmenting the hard cataract with ultrasound may be difficult, increasing the chance of complications. Sometimes the incision has to be enlarged and the benefits of the modern "Small incision - No stitch" surgery are lost.
While you need not rush into surgery, you should not procrastinate just
because of fear. When you think that you are not seeing as well as you
would like, or as well as you think you should for your safety, it is
time for surgery. Today, cataract surgery is very easy on you. It is painless,
and the results are very satisfying.
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Where is cataract surgery done?
Most of our cataract surgery is done in the Southgate Ambulatory Surgery
Center. The Surgery Center is highly efficient because it has been set
up mainly for cataract surgery. An American Board Certified anesthesiologist
is on the staff. Nurses and other support personnel have extensive experience
in cataract surgery, assuring a smooth and safe process. To you this means
less upheaval, less anxiety and a short stay in the Surgery Center. Most
patients check in, undergo surgery and are home within two hours. Patients
who had one eye operation at a hospital and the other at the Surgery Center,
much prefer the Surgery Center.
We also operate in the Seaway, Heritage, Wyandotte and Riverside hospitals.
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How is the surgery done?
On the vast majority of patients we use the most current surgical method
of cataract surgery. It is the "Clear cornea - Small incision - No stitch"
method. There are no shots to the eye. After mild sedation, eye anesthesia
is achieved with eyedrops. An ultrasound probe is introduced through a
1/8-inch, self-sealing puncture. The ultrasound breaks up the cataractous
lens and the fragments are aspirated. Then, an artificial lens made of
plastic or similar material is introduced into the eye through the same
small incision. The lens is positioned and secured in place by the anatomical
structures within the eye. No stitches are used to keep the lens in position
or to close the incision through which the operation was done. Most patients
do not even need an eye patch at the end of surgery. The operation is
essentially painless and takes about 15 minutes.
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How long before I can resume normal activities?
Most patients leave the operating room without an eye patch and are able
to see with the operated eye immediately. They are not allowed to drive
until the next day. Most normal activities may be resumed one day after
surgery. If any of your planned activities are unusual or physically intense
and stressful, discuss your plans with us before engaging in such activity.
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Will I need glasses after surgery?
Yes, usually to read small print. Currently, nearly all lenses implanted
in the USA are monofocal. This means they focus at only one particular
distance (focusing distance depends on lens power). If your lens gives
you perfect distance vision, you will have to use glasses to read. If
your lens gives you perfect reading vision, you will have to use glasses
to see clearly at distance. Many patients are happy with an in-between
power that gives them adequate distance vision while allowing them to
read larger print without glasses. We carefully measure the lens power
and try to accommodate patient wishes. However, there are many variables
in patient preferences, and in eye anatomy and surgery. Perfect results
cannot be guaranteed. Another problem are patients with astigmatism. Current
implants do not correct astigmatism. Bifocal-like lens implants are under
development but there are still unresolved problems with the lens design.
The surgical procedure for implanting bifocal lenses is about the same
as for current lenses. As soon as design problems are resolved we plan
to start implanting bifocal and multifocal lenses.
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What are the complications of surgery?
The most serious complications are severe bleeding inside the eye and
infection inside the eye. Severe intraocular bleeding is said to occur
once in 500 operations. In my experience with the current small-incision
surgical method bleeding is much more rare than that. Serious infection
is said to occur once for each 1,000 operations. In my own experience
it is closer to once in 2,500 operations. Less dramatic complications,
with no major vision loss, are said to occur in about 3% of operations.
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How will I see after surgery?
The vast majority of patients notice great improvement in vision sharpness
and in color perception. Years ago we did a study of 200 consecutive patients
undergoing cataract surgery. All patients whose only eye problems were
cataracts regained sufficient vision to allow them to resume driving.
Patients who, in addition to cataracts, had diabetic eye problems or macular
degeneration showed less complete vision recovery. The extent of improvement
in these patients was limited by the vision loss suffered because of diabetes
or macular degeneration.
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How many cataract operations have you done?
Over 15,000.