Is cataract surgery an inpatient procedure?
No, it’s typically an outpatient procedure. You will be there for about 2-3 hours total but the actual procedure takes less than 15minutes.
Am I asleep while you are taking out the cataract?
It’s twilight sleep, where you receive intravenous sedation but you do not have general anesthesia. With general anesthesia, a tube is placed to control your breathing and administer anesthetic gas, and the recovery is longer. With cataract surgery, topical anesthetic is placed before we start, and additional medication is placed in the eye, while the sedation drugs go in through the IV. It is similar to the medication used in a colonoscopy.
Does my insurance cover the surgery?
Generally, yes. With so many different policies, our billing coordinator will speak with you on the day you schedule your appointment, so you will know what your out of pocket expenses will be. Medicare covers the hospital portion and 80% of the allowable fee for the surgeon, as well as 80% of the allowable costs for the anesthesia professional. Some new technology lens implants are associated with extra costs. If the new lenses are appropriate for you, we will thoroughly discuss the cost and benefit with you. Insurance can be confusing, but we’ll walk you through it.
Is my eye actually taken out to operate on it?
No, an eyelid retractor is used to create enough exposure to get at the cataract. Don’t worry, you won’t feel it. Once the retractor is removed you’ll be able to blink normally since we don’t use injections around the eye or lids.
Do I have to stop my blood thinner before surgery? My internist and cardiologist don’t want me to stop it.
Because there are no injections around the eye, and no incisions through tissues that contain blood vessels, cataract surgery with topical numbing agents and IV sedation is bloodless. There is no need to stop your blood thinners, even warfarin (Coumadin). We have done hundreds of cases for people on all kinds of blood thinners (anticoagulatives), and it is not a problem.
Do I need to take antibiotics by mouth before the surgery? I have a prosthetic heart valve (or an artificial joint).
Cataract surgery is considered “clean” surgery by the infectious disease specialists and prophylactic antibiotics are not considered necessary.
Do I need a driver?
Yes. You should not drive for 24 hours after your surgery and this includes the day of surgery.
What are the limitations on activity after cataract surgery?
There are few limitations. On the day of your surgery, you should not drive. Also, do not swim for at least two weeks after surgery. We recommend limiting bending at the waist and lifting objects greater than 10lbs for one week. We also recommend that you shield the operated eye for three days after surgery when sleeping.
Will my eye hurt?
Most people have no pain and very little light sensitivity. In some cases, patients have noted some mild discomfort, often describing it as “something in my eye”. However, most people usually don’t take anything for it. The morning after surgery, most people are very comfortable. We typically don’t prescribe pain medication after surgery because in our experience, most people don’t experience major discomfort that would require medication.
What about changing my glasses?
Your current glasses prescription will no longer be accurate after the surgery. If needed, we will have our opticians temporarily remove the lens from your current glasses on the surgery side. Medicare will cover a large portion of the frames and lenses after each eye surgery. We will update your glasses a few weeks after surgery.
How soon will I see better?
Colors and contrast are noticeably better by the morning after surgery. You should continue to see improvement over the next couple days.
How soon can I shower?
We recommend avoiding showering until we see you for the one-day post-op visit. After that appointment, you can shower.
What is the worst thing that could happen?
Risk of infection, (currently estimated at 1:3000 to 1:8000 cases) while it is highly unlikely to occur, can cause vision loss. Therefore, prevention is key. We guard against infection by: asking you to use a disinfectant eye scrub three days before surgery; use an antibiotic eye drop one day before and for 10 days after surgery; not rubbing the eye. We also use standard solution of povidone-iodine prep in the operating room (OR) before your surgery, both in and around the eye. At the end of surgery, an antibiotic solution is placed within the eye itself. Our track record for avoiding infection and that of our ORs is outstanding. The most common sight-threatening complication is retinal detachment, 1.5% of cases overall but more common in younger patients, nearsighted patients (longer eyes), and males. Retinal detachment might require additional surgery for repair.