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Cataract surgery

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A cataract is a clouding of the eye's natural lens, most often due to aging. This clouding can cause blurry or dim vision. Cataract surgery involves removing your cataract and replacing it with an artificial lens implant to help improve your vision.

Cataracts are one of the most common causes of vision loss, especially as we age. Surgery is the only way to take care of cataracts. You can't stop cataracts from happening with lifestyle changes or take care of them with medication.

Cataracts tend to become a problem slowly and don’t affect people until they're in their forties or fifties. At first, you may not notice any vision changes with cataracts. Cataracts can start to cause problems in daily life as vision worsens over time.

Patients with symptoms of vision loss or changes should make an appointment with an ophthalmologist. 

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FAQ

  • As with any surgery, there are some concerns. The most common concerns include:

    • Infection (less than one in 1,000 cases)
    • Swelling of the cornea and retina after surgery that goes on for a long time (less than 5%  of cases)

    This type of swelling usually happens with patients with pre-existing eye problems or an extremely dense cataract.

    Your surgeon will tell you about concerns with your eye or eyes at your consultation. Antibiotic (drug that helps fight germs that make you sick) and steroid eye drops are used to help stop and take care of these two possible problems.

    Very rarely, loss of vision or the need for a second surgery can happen. Overall, the chances of these types of problems happening are extremely low. Most patients report they are satisfied and that they see better after cataract surgery.

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  • If wearing glasses doesn't bother you, you'll enjoy excellent vision after cataract surgery. If you have traditional artificial lenses, you'll need to update your glasses about one month after surgery.

    Premium artificial lenses are available if you don't want to wear glasses after cataract surgery. Your medical insurance won't cover the cost of advanced lens technologies, such as presbyopia correcting or toric artificial lenses. There will be extra fees.

    What are the different advanced lenses used?

    Intraocular lens (IOL or a lens inside the eye) implants should improve vision and lessen your need for glasses after surgery. These kinds of implants also offer a better range of focus. After the cataract is removed, the IOL implant is permanently placed in the eye.

    Toric lens implant

    A patient with a high level of astigmatism (an eye problem that causes blurred vision) and cataracts may want to have a toric lens implant. The toric lens implant will lessen or completely take care of astigmatism as a part of cataract surgery.

    Presbyopia correcting lenses

    Presbyopia correcting lenses may lessen a patient’s dependence on glasses at a range of distances, including using the computer, reading, dining, cooking and driving.

    If you have significant astigmatism, you may want to have a toric artificial lens. Your doctor will tell you what type of lens will work best for you based on your lifestyle and eye exam.

    Monofocal lens

    A monofocal lens is an intraocular lens (IOL) with a fixed focus for one distance. Monofocal IOLs can be selected for near, a medium amount of distance or distant focus, but only one of these three can be selected.

     

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  • Insurance companies and Medicare will pay for cataract surgery and the implantation of a traditional artificial lens.

    If you want a premium artificial lens, your employer's flexible spending account (FSA) or health savings account (HSA) may offer tax advantages for these services. We also offer payment plans.

    If you have any questions about your insurance coverage, please call our Business Services department at 1-425-258-3900. Give them the cataract surgery CPT code: 66984.

    Lastly, call your insurance company with the total estimate and they should be able to tell you your estimated out-of-pocket costs for cataract surgery.

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Before surgery

  • Cataract surgery rarely causes any bleeding inside the eye. There is no need to stop blood thinners. Ask your eye doctor if you are having a different type of eye surgery that isn't a cataract surgery, such as retina, glaucoma, eyelid or cornea surgery.

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  • It's important to not to eat anything after midnight the night before your cataract surgery. You can take a small sip of water to take any pills as normal. A nurse will call you two days before your surgery to give you further directions.

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  • Please don't wear makeup on the day of surgery.

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  • Yes. Take all your usual medications the morning of surgery with a sip of water. If you have diabetes, you'll be given special directions about insulin when you speak to the nurse two days before surgery.

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  • You will use prescription eyedrops for one month after your cataract surgery. You will get directions and prescriptions for your eyedrops at your appointment before your surgery.

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Day of surgery

  • Your surgery will be performed at The Everett Clinic Kemp Surgery Center located on the first floor of the Gunderson Building.

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  • Even though the surgery usually takes 20 to 30 minutes, you should plan to spend two to three hours at the surgery center. Extra time is needed to dilate your eyes (widen your pupils) and prepare you. After surgery, you will be monitored and given more directions.

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  • Wear a loose shirt or a shirt that buttons in front. Don't wear jewelry.

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  • Patients are usually very relaxed from the sedation. Your eye is numbed with eyedrops, so you won't feel any sharp pain. You may feel fluid to keep your eyes moisturized or slight pressure. Most patients are surprised how comfortable they are and report little pain.

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  • The surgery is done with sedation (IV) anesthesia. You may doze off, but many patients are in a "twilight state" or sleepy and very relaxed for the surgery. Most of the time, patients remember very little from the surgery itself due to the anesthesia medication.

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  • We use a gentle device that will support and keep your eyelids open for the surgery.

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  • Most patients report seeing a kaleidoscope (variety) of colors and lights.

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  • Minor pain or headaches after surgery are usually taken care of with Tylenol® or acetaminophen. This generally resolves the day after surgery. It's common to have some "sandy" or "scratchy" feelings mostly the first day of surgery.

    Artificial tears (a type of eye drops) or resting with your eyes closed can help soothe feelings of slight irritation. Prescription eye drops can sting after the surgery. Usually this stinging is over less than 24 hours after surgery. 

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  • Most cataract surgeries use small self-sealing incisions. Sometimes your surgeon may decide to use a temporary suture (only needed for a short time). This suture is removed in the clinic at a later date.

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  • No, only one eye will have the surgery at a time. The second eye can have the surgery about two to four weeks later, after the first eye has had time to heal.

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After surgery

  • You'll wear an eye shield after cataract surgery for one week to be used only when you sleep. This is to stop you from accidently rubbing your eyes in your sleep.

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  • Vision is usually blurry during the first few days after surgery. For most patients, their vision clears up significantly by their follow-up appointment one week after surgery.

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  • This varies among patients. Many patients can return to work the day after cataract surgery, depending on their job. Most patients take the day of surgery and the day after surgery off work.

    If you do return to work, you won't be able to lift anything over ten pounds or bend over from the waist down for one week after surgery.

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  • Most patients can go back to normal daily life the day after cataract surgery, including walking, reading, cooking and watching TV.

    Please remember, there are some restrictions:

    • Don't lift anything heavier than 10 pounds
    • Don't strain or do any deep bending at the waist
    • Don’t do any strenuous exercise (a lot of physical movement)
    • Don't use eye makeup for one week
    • Don't go swimming or go in water for four weeks after cataract surgery 
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  • You won't be able to drive for 24 hours after surgery. Following the first day of surgery, if your vision is clear enough, you may drive later that day.

    Be ready to have someone else drive for you if your vision is not sufficiently clear and you don't feel safe. Please ask your surgeon at your appointment after your surgery for guidance.

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  • High altitude and air travel pose no problems after cataract surgery. We usually prefer that you stay in town for at least two weeks after your cataract surgery in case you have any problems. 

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  • Don't wear any eye makeup until one week after cataract surgery.

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  • You can shower and wash your face after cataract surgery. Be sure to gently close your eyes to stop any water splashing into your eyes.

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  • Cataracts don't grow back. The artificial lens implant is made of a clear acrylic plastic that will last your lifetime. In some cases, several months or years after cataract surgery, a clouding of the posterior capsule behind the intraocular lens implant may happen.

    Fortunately, a painless, in-office surgery with lasers called a YAG capsulotomy can clear the clouding in a few minutes.

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