When You Need Cataract Surgery

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When You Need Cataract Surgery

The timing of cataract surgery is generally a personal choice depending upon your level of tolerance for blurry vision. In cases of retinal disease, such as diabetic retinopathy and macular degeneration, there are few other concerns that may affect the timing of surgery.

Cataract surgery is needed when your vision is not as good as you’d like, and, your eye doctor feels that the elective procedure would help.  In cases of diabetic retinopathy and macular degeneration, there may be other factors that weigh in to the decision of having cataract surgery.

Cataracts are usually elective surgery.  While insurance does cover most cataract surgery, there are a few criteria for having the operation.  Most of the criteria are based on certain vision measurements taken at your eye doctor’s office.  Your visual acuity, with or without glasses, may simply be bad enough to qualify you for surgery.  Sometimes your daylight vision is fine, but you may suffer from significant glare when driving at night with oncoming headlights.  In addition to vision, your doctor simply needs to affirm the presence of a cataract and likelihood of improvement with surgery.

There is no hurry to having surgery.  Unlike a piece of overripe fruit, you really have lots of time.  Choose a time when you are ready for surgery and is convenient for the rest of your friends or family; whoever may be helping you.

There is no strain on the other eye.  Don’t worry about overworking the other eye while waiting for cataract surgery.  There really is not such thing.

Patients with diabetes have some additional concerns regarding the timing of their surgery.  If you have a history of diabetic retinopathy, make sure that the diabetic retinopathy is stable at the time of surgery.  The only way to assess stability is with a dilated eye exam with your doctor or retina specialist.

While the timing is not that crucial in cases of macular degeneration, the expectations of the operation should be reviewed with the doctor.  By definition, patients with macular degeneration already have decreased vision from their retinal disease.  Make sure you and your doctor are on par with your expectations after surgery.

What Does This Mean? Cataract surgery can be a life changing event.  In most cases, there is likely to be full restoration of vision.  The timing of cataract surgery is basically up to you, based upon your own tolerance, or intolerance, of blurry vision.

If you have cataracts, or suspect that you do, I would recommend an examination soon with your eye doctor.  Use this visit as a fact finding mission, you’ll be surprised how much there is to learn about cataract surgery.  You don’t have to commit to surgery.

Take your time to schedule the surgery.  Make sure you are ready.

If you have retinal disease, such as diabetic retinopathy or macular degeneration, make sure you and your doctor are “on the same page” about the timing and expectations of the surgery.

“Randy”

Randall V. Wong, M.D.

Retina Specialist, Ophthalmologist
Fairfax, Virginia

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Comments
  • JulieW September 2, 2012 at 6:04 pm

    A few questions about cataract surgery.
    1. Can one ever wait too long to have (c/s) cataract surgery?
    2. I have already had a tractional retinal detachment and vitrectomy. Is there still a chance that I could have another detachment from cataract surgery or not so much having had a vitrectomy?
    3. Is there a chance of getting better vision after c/s than what I test at with having the cataract? Vision has gone from 20/30 to 20/150 in 7 months and w/ correction I am now at 20/40 where 7 months ago I was at 20/30.
    4. Do you know the pros and cons of gettting a lense that is near-sighted (so I won’t have to wear glasses to read)? My ophthalmologist doesn’t do or recommend them so I want to get a 2nd opinion from his associate.

    Thank you for your time. ‘your site has a lot of valuable information.

    • Randall V. Wong, M.D. September 3, 2012 at 9:56 am

      Dear JulieW,

      1. No not really. Technically the cataract can cause problems if it becomes white (gives you a white pupil), but this is very, very unusual in the U.S. and other developed countries.

      2. Yes, there is, but unlikely. There are sometimes signs of recurrent tractional detachment before cataract surgery.

      3. Yes.

      4. Personal preference. I do know that many surgeons prefer performing bilateral cataract surgery using the “premium” IOL’s within a short period. I’ll stress that this is not the case for the traditional “monofocal” lenses.

      Randy

  • cheryl April 11, 2013 at 7:03 pm

    My vision is very blurry in my left eye that had the vitrectomy for floaters. There are some small residual spots left over. I had long distance vision before but now with my left eye I can see close up. My last visit my eye pressure was at 30 and I am taking Combigan eye drops twice a day for the left eye. My right eye was 17 IOP.

    When is it safe to get the cataract surgery? How experienced are most Opthamologist with doing cataract surgery after having a vitrecomy and the difficulty level of the surgery.

    Thanks for answering.
    Cheryl

    • Randall V. Wong, M.D. April 23, 2013 at 9:09 am

      Cheryl,

      Cataract surgery can really be done almost anytime following vitrectomy. Most cataract surgeons who work closely with retinal specialists are accustomed to operating on people with your circumstances. Cataract surgery is usually not too difficult without the vitreous.

      r

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