Cataract Surgery & Lens Implants at 80

Question: Is it practical for me at 80 years to pursue Cataract Surgery and Lens Implants for astigmatism? I do take medication for enlarged prostate.

Answer: If you have Cataracts and the decrease in vision they cause negatively impacts your being able to do the things you want to do safely and comfortably, there is no reason that you cannot have Cataract Surgery and Lens Implants as long as your general health is good and the overall health of your eyes-especially the Retina and Macula, is in reasonable shape. If you have a significant degree of astigmatism then having a toric lens implant-if recommended by your Cataract Surgeon would be a good choice for your vision correction at distance after the Cataract removal. Be certain to advise your Cataract Surgeon of the exact medication that you take for an enlarged prostate as well as any other medications you might be taking as these could require that he or she modify the actual cataract procedure in order to get you the best results.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Double Vision after Cataract Surgery

Question: I recently had cataract surgery on both of my eyes and had lens implants as well. The first surgery went very well but the second surgery left me with double vision. I have found out that I have a prism, but never had double vision. My doctor said there was nothing he could do and told me I would have to always wear glasses.
Answer: It is not obvious from your question whether you were wearing a prism in your glasses before your Cataracts were removed. If you have a long term history of wearing a prism, then you may very well need to continue to wear the prism in eyeglasses. If, you were not wearing prism, and if the onset of the double vision has been recent, then you need to find out why. It is possible, but not likely that Cataract Surgery for the second eye caused you suddenly develop diplopia or double vision, but rather the diplopia is due to some underlying cause that needs examination and diagnosis. Again, if prior to Cataract Surgery you had a prism prescription to compensate for a muscle imbalance then having Cataracts removed would still require that you wore the prism. You best course of action is to consider a second opinion with a top Cataract Surgeon to evaluate whether there is anything that might be slightly out of line with the Cataract Surgery, the Lens Implant or perhaps the Retina that could be contributing-or whether there is some other underlying issue.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Streak of Light after Cataract Surgery

Question: I've had cataract surgery and two IOLs implanted The left in July 2011 and the right in October of 2011. I have experienced a "streak" of light in the vision of my left eye ever since the implantation. It runs at a 45 degree angle through any concentrated light source and is particularly bothersome at night, making night-driving difficult and dangerous. Can this be corrected?

Answer: Without actually examining the eye and vision after your Cataract Surgery and Lens Implants it is not possible to be certain, but there are several possibilities to be considered, as the cause-each with somewhat different methods of resolution. One possibility is that you have some degree of uncorrected astigmatism. This should easily tested by your Cataract Surgeon and a resolution demonstrated with some trial lenses in the office if it is actually the problem. Another, somewhat remote possibility is an optical irregularity in the Lens Implant itself. This would be quite unusual. A more likely cause is a very fine crease in the posterior capsule of the crystalline lens that is typically left in place to support the Lens Implant after Cataract Surgery. A very fine crease can produce exactly what you are describing. If this is the case your Cataract Surgeon can perform a YAG Laser Capsulotomy which is a quick laser procedure to create an opening in the capsule along the visual axis-typically the results are immediate and achieved without pain, discomfort or recovery time.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

No Bifocals after Cataract Surgery

Question: I am a candidate for cataract removal and I have myopic astigmatism. After cataract surgery I still require bifocal glasses?


Answer: If you wish to be less dependent or even independent of bifocal glasses after Cataract Surgery there are some options that might be suggested by your Cataract Surgeon if they are appropriate. There are three possible options for correcting your near and far vision after Cataract removal. First, you might be a candidate for Monovision Astigmatism Correcting Lens Implants (IOL). Second you might be a candidate for Presbyopia Correcting Multifocal Lens Implants (IOL) such as the AcrySof ®ReSTOR® Multifocal Lens Implant (IOL) or the Tecnis® Multifocal Lens Implant (IOL). Third, you might be a candidate for Accommodating lens Implant (IOL) such as the Crystalens® Lens Implant (IOL). Whether one or more of these options is appropriate will really depend on your lifestyle and expectations as well as the information gathered by your Cataract Surgeon during your examination and consultation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Lens Implant Surprise

Question: I had cataract surgery and a lens implant on my right eye 2 months ago. Before surgery, I was farsighted in this eye. Now I am profoundly nearsighted and need glasses for any distance vision at all. The distance vision is markedly worse than before the surgery. What could have caused this? Was the "wrong" IOL implanted? Was the IOL the right one but displaced from the original site in the capsule? Any other possibilities?


Answer: The measurement and computation of the Lens Implant (IOL) power for Cataract Surgery is actually quite complex and depends on the interaction of many factors. Most likely what has happened here is a "refractive surprise" in that the measurements and calculations performed during your Cataract examination, for whatever reason, did not fall within the statistical norms of the calculation. This resulted in "surprise" with regard to the refractive outcome. In you case it does not sound as if it is even close to being satisfactory and thus you need to discuss the options with your Cataract Surgeon. These may include a Lens Implant Exchange or even a LASIK Surgery procedure depending on the overall health and condition of your eyes. In any event, if you are not happy with the result it is time to discuss this with your doctor.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tecnis® Multifocal Lens Implant Glare & Halo

Question: On Aug. 26th I had a Tecnis® Multifocal lens implanted in my left eye. My cataract surgeon also did limbal relaxing incisions as both eyes have substantial astigmatism. The glares and halos are so bad that driving at night feels dangerous. My eye doctor assures me that most patients who experience that find that once the second eye is done, their brains adapt and it's no longer an issue. I'm afraid that if mine doesn't, I will not be able to drive AT ALL at night until I have both removed. We've already talked about going to monovision lens implants and have used contacts to mimic it as best as possible. However, my cataract surgeon says that because I already have the Tecnis® Multifocal in place, it's impossible to get a true monovision test. So, I would really appreciate your thoughts on:


A: The likelihood of the glares/halos becoming non-problematic once the second eye also has the Tecnis® in place;
B: The idea of using monovision IOLs instead, with the right eye having a toric lens implanted to correct the astigmatism.

Answer: Multifocal Lens Implants, including the Tecnis® Multifocal Lens Implant, use complex optical designs to achieve their vision correction properties. For that reason they do indeed require a varying degree of “neuroadaptation” in order for patients to get “used to the vision”. Depending on each individual patient’s “neuroplasticity” this adaptation process can take little time or even a few months. You are approaching 4 months and do not seem to report a notable improvement in sensitivity to the symptoms of glare and halo. Typically, for complete neuroadaptation to occur it does require implantation in both eyes. So, the information being provided to you by your Cataract Surgeon is quite consistent with the experience of others. So, while “conventional and experiential wisdom” would suggest proceeding with the right eye with a Tecnis® Multifocal, it does sound like in your case this would NOT be a prudent path based on the severity and persistence of your complaints. You do not state whether your left or right eye is your dominant eye and this could impact the relative success of monovision Lens Implants. The most conservative approach is to correct the right eye with an astigmatism correcting toric lens implant for full distance correction. Then depending on the residual symptoms of glare and halo, and the degree of satisfaction with your near vision at that time either leave the left alone or possibly have a lens exchange to replace the Tecnis® Multifocal with a single focus lens implant. Again, the conservative approach would be to avoid monovision as you have already demonstrated a less than optimal “neuroplasticity” and monovision does also require adaptation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Lens Implants for Congenital Cataracts

Question: I have a question about congenital cataracts and lens implants. I was born with cataracts in 1978. The protocol for cataract surgery at that time was to remove the lens as well as the capsule. I am currently wearing aphakic contact lenses bringing corrected vision to 20/30. Is there any lens implant surgery available for me? And if so what is the risk?


Answer: Indeed in 1978 you would have most likely had an "intracapsular" Cataract extraction which would have removed the entire lens capsule as well as the cloudy lens material-the Cataract. Today, the typically the lens capsule is left in place in order to support the placement of a Lens Implant. However, the lack of a lens capsule does not preclude you from having secondary Lens Implant IF your eyes are otherwise healthy and in "good anatomical" shape. Depending on the condition of the Vitreous, Iris and other structures it is often possible to have a "secondary lens implant", either an the Anterior Chamber Lens Implant (IOL) in front of the Iris or a Posterior Chamber Lens Implant (IOL) sutured in place in the posterior chamber. The choice and the position of the lens will depend on the anatomy and the condition of the eye as stated previously. As with any intraocular surgery there is always risk, however most likely less risk than the Cataract Surgery itself. The complications of Cataract Surgery and Lens Implants are pretty infrequent. That said, you should consider taking the next step and schedule a consultation with the best Cataract Surgeon you can find and after a thorough examination and consultation, they will be able to advise you of the most appropriate course of action to consider.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Removal in Only Eye

Question: I have only one functioning eye and it now has a cataract. I'm considering the removal of a cataract in my right eye. I rarely drive at night anymore and distance vision is a real problem. My concern is that my right eye is my only functioning eye. I understand there are always risks. Should I have it removed?


Answer: The concern and anxiety you express regarding having Cataract Surgery in your only good eye is reasonable and expected-and likely shared by most top Cataract Surgeons. You are correct in that with any surgery there is always the risk of complications, no matter how small. It would not be inappropriate to seek referral from your primary care physician as well as friends regarding finding the best cataract Surgeons in your area and scheduling a consultation with 1-2. Discuss your concerns and inquire what they will propose to endure that you will have an uncomplicated Cataract removal and Lens Implant procedure. Something you should know however is that the longer you wait and the more dense the Cataract becomes-the more difficult it can be to operate on and the greater the potential complication rate. So-if this is something you need to do or are seriously considering, you should proceed and not allow the Cataract to become too dense.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Vision Correction after IOL Removal

Question: What is the best method of vision correction when an IOL must be removed some years after cataract surgery?

Answer: If a Lens Implant must be removed-and it is specifically in one eye only-it is entirely possible that the IOL can be exchanged and replaced with another IOL of a different type if the eye is otherwise healthy and the internal structures are intact. This would by far be the best choice if it is an option. If this is not an option due to anatomical or other considerations then the next best choice would be to use a contact lens for the vision correction in one eye. Eyeglasses after Cataract Surgery are only a choice if both eyes are to be corrected and even then these are likely to provide many limitations in terms of vision quality and field of vision. In any event, the removal of a Cataract is almost always best managed optically by a Lens Implant and it would be important to fully discuss the options with your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery with Toric Lens Implants for Severe Astigmatism

Question: I have severe astigmatism and I am scheduled for cataract surgery. Will the lens implant for astigmatism really improve my vision?


Answer: If your cornea is healthy, and the astigmatism is "regular" allowing your vision to be well corrected with eyeglasses, depending on what you mean by "extreme" the answer is most likely yes. With careful measurement and calculation in conjunction with the proper diagnostic testing, the use of Toric Lens Implants (IOL) to correct astigmatism-even rather significant degrees of astigmatism-is quite successful. The vast majority-even those with 4-6 diopters of preexisting astigmatism-report be able to be independent of eyeglasses for seeing clearly at distance after Cataract Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Toric Multifocal IOL Lens Implants

Researchers reporting in the September 2011 Journal of Cataract and Refractive Surgery found that implantation of toric multifocal IOL's in patients with cataract and corneal astigmatism provides good distance and near visual outcomes and spectacle independence. The investigation in the Netherlands looked at patients with cataract, corneal astigmatism and a motivation for spectacle independence. Each patient underwent cataract surgery and implantation of a toric diffractive multifocal IOL. In 90% of the eyes enrolled in the study a residual refractive astigmatism of −1.00 D or less was achieved however moderate glare, halos and star burst symptoms were present in approximately 50% of patients. The authors concluded that toric multifocal IOL implantation enables patients with significant levels of corneal astigmatism to achieve distance and near spectacle independence.

Crystalens® Lens Implant Side Effects & Complications

Question: I am a candidate for cataract surgery and am thinking about the Crystalens implant. However, I've read some horror stories in reviews by people who have had this particular implant, ie, spiderwebs, flashing lights, poorer night and color vision. My questions are: 1) are these problems typical with Crystalens; and are there other accommodating IOL technologies to consider, even if it means waiting a few months?


Answer: First, as authors of peer reviewed digital content for ophthalmology we are constantly shocked by the state of web publishing in which patients, competitors and unknowing content sources are able to simply write unedited, unverified and simply incorrect material and post it as "meaningful" reviews that you and others are apt to take or even consider as factually correct. It is a real shame that Google Places, Bing, Insider Pages, Vitals and thousands of other "review sites" allow reviews to be posted regarding medical practice sites, physicians and medical devices as if they were reviews of restaurants or bowls of pasta. Medicine and the associated outcomes of the practice of medicine are subject to considerable degrees of complexity and influence by factors that "reviews" simply just cannot contemplate.

Second, while it is commendable that you are doing research and have become interested in "selecting" a lens implant-we pose the following question to ALL patients-do you have the breadth of understanding or the appreciation measurement nuances and surgical skill required that TOGETHER with a specific type of lens implant can produce certain results-OR are you looking at selecting a Lens Implant by "reviewing" manufacturers "marketing hype" or online chit chat? Medical devices, especially implantable medical devices, provide their reported outcomes and results when used by experienced and skilled physicians for patients who have been selected as good candidates for THAT DEVICE by that physician.

It is NOT the other way around-like buying running shoes-where the user or patient decides if the device or product sounds good and then goes and buys it.

The Cataract Surgeon and the Cataract Surgery procedure used by that eye surgeon have a huge impact on the results of the Cataract removal itself as well as the implantation and functioning of the Lens Implant. Further, the preoperative condition of the eye and its internal structures-independent of a type of Lens Implant-also impact results and outcome. These are just some of the reasons believing ANYTHING you read in "reviews" about surgery procedures, devices or products is IRRELEVANT.

With apologies for the long windedness of this response, here is what you need to know about your question. The side effects you noted i.e spider webs, flashing lights, poorer night and color vision are NOT reported any more frequently with Crystalens® than with any other type of Lens Implant including Multifocal Lens Implants. In fact what you are describing may very well be side effects of the Cataract Surgery itself and NOT have anything to do with any type of Lens Implant.

That said, near vision presbyopia correcting lens implants from different manufacturers are fabricated in varying optical designs-some are accommodating like Crystalens® whereas others use complex optics to achieve their "multifocal" effect. Each one has its own set of "tradeoffs" and compromises. Through a careful evaluation, measurements and consultation with a top Cataract Surgeon THEY should be able to discuss your particular lifestyle needs and vision correction goals after Cataract Surgery AND based on the eye examination, suggest one or more types of Lens Implants that can help you get to those goals.

Lens Implants are not like running shoes-you can't pick a brand and then go in and get "sized". They function differently and require matching the performance, optical characteristics of your eyes, your lifestyle and activity requirements. Finally, if you really think you want an accommodating Lens Implant and are concerned about what you are seeing in "reviews", there will be other accommodating Lens Implants available in the coming months or years that may or may not be better than Crystalens®. Only time will tell. In this sense you would be wise to use "best car buying practices" and NOT buy the first model year!

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Shiny Dot on Pupil after Cataract Surgery

Question: I have had successful cataract surgery in both eyes. Since then I notice a shiny dot on my pupil that looks like a small sequin and is present in both eyes most of the time. Sometimes it is quite noticeable and somewhat disconcerting. It seems to reflect light. Other people have the same experience. What is it?

Answer: It is very common after Cataract Surgery for patients who had Lens Implants made from certain acrylic materials to report a shimmering dot like reflection in their pupil. While it is visible if you look at yourself, and possibly noticeable by others, it in no way actually impacts vision or clarity. It is really a simple property of the acrylic Lens Implant material and is completely benign.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Removing a Wrong Lens Implant

Question: If the wrong lens implant was inserted during cataract surgery can it be removed after a year?

Answer: Removing or explanting or exchanging a Lens Implant a year after Cataract Surgery is possible but depends on a number of factors and often requires an extraordinary effort and technique by the Cataract Surgeon. It is odd that a Lens Implant would be deemed "wrong" after such a long period of time but it is possible. Factors that could complicate a lens implant removal or exchange after a year might include the placement of the lens itself and whether it was fibrosed in place, whether a YAG Laser Capsulotomy had been performed as well as whether the vitreous had been violated in any manner and the overall health of the cornea. If any of these conditions exists it might be worth seeking a consultation with a Corneal Specialist who is also a top Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Pressure on Eye after Cataract Surgery

Question: What damage might be caused by putting pressure on eyeball two days after cataract surgery? A misplaced lens or retinal tear have been ruled out by examination. But the image is blurred especially at a distance and there are ghost images and even double vision in that eye.


Answer: While it is simply impossible to tell without a thorough examination, there could be an almost limitless number of remote possibilities that could occur. If there has been a "pressure" related event that causes any type of inflammation with or without associated swelling of the Macula, it could cause Cystoid Macular Edema which occurs in a small number of patients after Cataract Surgery. Likewise, if there is residual induced corneal edema this too could cause these symptoms. Further, and very unlikely there could have been damage to the posterior capsule, intentionally left in place to support the Lens Implant, causing it to prematurely fibrose leading to symptoms like these. However, these are purely conjecture as there are many possibilities that can only be determined with a careful examination by your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Near-Intermediate Vision Correction & Cataract Surgery

Question: I'm now contemplating cataract surgery and have decided that I want mini-Monovision, rather than multifocal lens implants. I would also not like to have a big correction disparity between each eye - e.g., maximum 1.25 D. My goal is to attain very good vision for the following kinds of "near-intermediate" activities: Sitting at a table playing cards, shaving, seeing the dashboard of my car, searching through drawers, looking at my cell phone, reading a menu, walking down the aisle of a market, and reading the labels on cans (at least the larger type). As a trade-off for very good "near-intermediate" vision, I would be willing to sacrifice some sharpness in distance vision - perhaps 20/40? Here's my thinking: It seems that if I was corrected for very good "near-intermediate," I could probably go without glasses about 90% of the time --needing them only for really sharp distance (e.g., driving, tennis), and readers for the fine print. My questions are: Is it possible to get the type of good near-intermediate vision I'm seeking, and still be 20/40 for distance? If so, what would your target correction be (with a maximum of 1.25 D difference between the eyes)?


Answer: First, you are asking the right questions to help you identify the most acceptable choices and compromises for your vision correction after Cataract Surgery. Monovision Cataract Surgery requires careful measurement of the near and intermediate working distances your desire clarity for as well as identifying the specific tasks. While you have identified the tasks, the actual working distances of those tasks can vary greatly by your personal physical stature and size. For example if you are 5'4'' tall with medium length arms you will require different working distances than someone 6'2" tall with long arms. Next, the achievement of the results you are requesting could also depend on several other factors including but not limited to the type of Lens Implant to be used and whether it is a spherical or aspheric design, your pupil size as this contributes to your ultimate depth of focus, the amount and type of spherical aberration in your eye as well as your overall tolerance and threshold to "defocus." Now, in order to consider these factors, if you have not already done so, it would be wise to be sure that you had a complete refractive Monovision evaluation as part of your Cataract consultation at which time detailed measurements could be taken and analyzed AND it might be possible to provide you with trial contacts to demonstrate the defocus and working distances that could be achieved. This kind of trial will really depend on the degree of cataract formation you presently have. In general, the scenario you describe is achievable but does require careful measurement and testing in order to select a proper target correction-AND may require specialized testing for the actual Lens Implant selection. To obtain this level of testing and precision we would suggest you choose an eye surgeon who is both a Cataract Surgeon and a Refractive Surgeon and thus fully equipped to deal with the precision of the measurements and the testing required to achieve your personal goals here.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Eyelea for Macular Degeneration Help

The FDA has offered additional help for patients with Wet Age Related Macular Degeneration (AMD) by approving a first-in-class drug called Eyelea (aflibercept). Eyelea is called a VEGF Trap-Eye that is a protein drug that soaks up the vascular endothelial growth factor molecules that promote the unhealthy growth of new blood vessels under the Retina. According to the FDA-approved labeling for aflibercept, the drug is indicated for the treatment of patients with neovascular Age-Related Macular Degeneration (Wet AMD) and may be given by intravitreal injection as frequently as 2 mg every four weeks, but additional efficacy was not demonstrated with this schedule compared with the eight-week interval. As with other drugs that are VEGF inhibitors, there is a potential risk of arterial thromboembolic events, defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause) with the incidence of such events in the aflibercept trials occurring in 1.8% of patients.

Glaucoma & Risk of Erectile Dysfunction (ED)

Researchers reporting in the October 2011 publication Ophthalmology reported on a novel association between Erectile Dysfunction (ED) and Glaucoma in patients who were previously diagnosed with Open Angle Glaucoma (OAG). Open Angle Glaucoma (OAG) is known to be associated with certain systemic metabolic and cardiovascular disorders, and these systemic and metabolic disorders share common risk factors with Erectile Dysfunction (ED). However, few studies have investigated the association of ED with OAG. A nationwide study in Taiwan aimed to estimate the association of ED with prior OAG by using and found that patients with ED were more likely to have prior OAG than controls, indicating a novel association but requiring additional study to fully understand the clinical significance of the findings.

Cataract Surgery, Lens Implant & Eyeglass Lens Changes

Question: After cataract surgery would you have to have a change of eyeglass lens or lens implant at some time latter as you get older?


Answer: Once you have Cataract Surgery and a Lens Implant, generally, unless you develop some other type of eye disease that impacts the refractive error of your eyes-such as a corneal disease or diabetic macular edema-it is not likely that your optical prescription will change too much. In any event the nature of the optical changes that might occur rarely necessitate a change of Lens Implant but could require a small change in an eyeglass lens prescription over time as the eye changes corneal curvature or other parameter.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Complications from Cataract Surgery

Question: I seem to have a lot of complications from my cataract surgery. I had cataract surgery on my right on July 1, 2011 with a lens implant to correct my far and near vision. I have been back to the eye doctor 8 times complaining that my vision has not improved and actually it has worsened. He used the laser to remove the part of the capsule and that has not helped. Now I am seeing floaters and funny shapes in my vision. I went to see the doctor this past Friday and he says he noticed that there is some swelling of the Retina and he has given me some new drops and says come back in a month. Why is it that after spending $7000 I can't see? Should I be looking for another doctor?
Answer: While Cataract Surgery and Lens Implantation are among the most frequent and most successful types of eye surgery one can have, there is always the risk of side effects and complications that can result from the surgery itself or simply just from the condition and health of the eye-unrelated to the surgery. Although it is impossible to know exactly what is going on with your eyes and vision you are describing some things that we know can sometimes occur. First, you describe the need to be treated with a laser to "remove" part of the lens capsule. In as many as 30% of the people having routine Cataract Surgery, the posterior lens capsule-normally left intact to support the Lens Implant-does become cloudy or opacified. This is treated with a procedure called a YAG Laser Capsulotomy in which an opening in placed in the capsule with a laser in order to allow light to readily pass through to the back of the eye. While not every patient requires this, it is not uncommon and represents one of the most common complications of Cataract Surgery. However, the YAG Laser treatment is quite effective in restoring vision in almost every instance of posterior capsular opacification. The fact that you are experiencing floaters may or may not be related to the Cataract Surgery. You are possibly describing a vitreous detachment that may have occurred spontaneously or in conjunction with the Cataract removal.

IF you have a vitreous detachment that is causing the floaters they will self limit over time and will likely no longer disturb your vision. But it takes time and your Cataract Surgeon will want to be sure that there are no associated tears in the Retina contributing to the floaters. Another complication that are possibly describing is the presence of Cystoid Macular Edema which is a painless swelling of the Retina that can cause blurred vision and distortion. it is thought to be due to post operative inflammation and may occur in about 1% of the patients having Cataract Surgery. While the pre and post operative drops that are normally prescribed are usually sufficient to manage the inflammation, sometimes they require an additional or alternative more powerful anti-inflammatory eye drop to reduce the inflammation and the swelling. Although it is difficult for you to be the recipient of what seems like so many complications, they are all familiar and known complications of Cataract Surgery-albeit unusual. However, they are also pretty much manageable over time with careful observation, testing and treatment. That said, it is never inappropriate to get a second opinion in order to confirm the diagnosis and treatment as well as the prognosis. If it would make you more comfortable you should either find the best Cataract Surgeon in your area or even find a Retinal Specialist who can give you an opinion regarding your individual situation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Brain Bleeding

Question: Can Cataract Surgery cause a brain hemorrhage or brain bleeding?

Answer: Cataract Surgery and Lens Implantation is actually not known to be associated with a complication of brain hemorrhage or bleeding. While not inconceivable as there are certainly complications that do rarely occur, it would be a very remote possibility that such an event could occur as a result of a Cataract removal, rather than as a result of other health conditions present in someone having Cataract Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cost of Multifocal Lens Implants

Question: What is the average out of pocket cost for the Multifocal Lens Implants? Also, is there any indication that Medicare will approve this type for payment?

Answer: There are some points of clarification that should be made regarding the cost and fees associated with Multifocal Lens Implants for Cataract Surgery. First, the correction of near vision and presbyopia-the age related near vision focusing problem is NOT a covered service under Medicare. Given that the Obama administration and Congress need to cut trillions of dollars in spending-and physician fees and services are in the cross hairs of the target-it is unlikely that ANY current non covered services will become covered services in the future and in fact it is probable that more and more of the costs of Cataract Surgery and Lens Implants will be both directly and indirectly increased for patients. Second, when considering the fees and costs of Multifocal Lens Implants, it is important to understand that the actual cost of the Lens Implant is actually only one component of the fee charged to patients. The fees for a Multifocal Lens Implant typically reflect the actual cost of the implant plus additional fees for other non covered services associated with the measurement and calculation of the more complex Lens Implant including but not limited to Corneal Topography to measure the shape of the Cornea, Corneal Pachymetry to measure the thickness of the Cornea, Ocular Coherence Tomography (OCT) to confirm the integrity of the Macula and the Retina, perhaps aberrometry, additional biometry measurements to confirm the lens power calculations which may also include as necessary the cost of astigmatism correction such as Limbal Relaxing Incisions (LRI) or a Laser Eye Surgery procedure such as LASIK. This additional testing and its interpretation as well as the "as needed" necessity for the additional procedure is most often "bundled" into the fee charged to patients. In general to cost of these services plus the Multifocal Lens Implant itself can range in cost from $2000-$3500 per eye depending on location and the scope of what exactly is included in the fee.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery Measurements & Contacts

Question: How long should you go without hard contacts before a true measurement for cataract surgery can be taken?


Answer: There is no hard and fast rule for the discontinuation of contact lens wear in order to take measurements for Cataract Surgery and Lens Implants (IOL) as it can vary greatly depending on the cumulative length of time the contact lenses have been worn for, the health and shape of the cornea and the individual patient ocular rigidity. However, as a practical matter during your initial examination and consultation the shape, topography and thickness of your cornea can be measured giving some indication of the degree of change induced by your contact lenses-if any! It may be necessary to have you discontinue them for some time and recheck the stability and reproducibility of the measurements after a few weeks. Once there are two consistent sets of measurements the final calculations can be performed. Sometimes this can take as few as two weeks and sometimes-if there is considerable distortion in the shape of the cornea-it can take a couple of months. Be patient and follow your Cataract Surgeon's instructions carefully.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sedation & Anesthesia for Cataract Surgery

Question: I have a question regarding anesthesia and sedation for cataract surgery. I am scheduled to see an ophthalmologist for cataract surgery. My daughter-in-law works in the office and when I asked her what they use for sedation she said they give you "happy pills". I have an cervical essential head tremor and cervical dystonia and I am claustrophobic, so I hope they will use a deeper sedation so they will not have to deal with my head shaking. Can you help answer this question for me? Thank you for your help.

Answer: While the most common types of anesthesia and sedation for Cataract Surgery might be eye drops and a tablet to help you relax, top Cataract Surgeons evaluate the needs of each and every patients as individuals in order to determine the best approach to sedation and anesthesia. That is to say that they have a wide choice of how to make patients most comfortable and provide a quick, safe Cataract removal for patients based on their individual situation. Trust your Cataract Surgeon to discuss your needs and make the appropriate choices with and for you.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Astigmatism, Glare & Halo after Cataract Surgery

Question: After cataract surgery that was to correct both near and far vision I am having trouble with far vision and have terrible glare and halos when driving at night. I have an astigmatism in that eye and my distance vision is not good. My near vision has improved. It has been suggested that I have a laser treatment in that eye to get rid of the astigmatism. The after affects of laser seem to say I would still have halos at night and perhaps blurry vision as I have now. Would this be a treatment that I should consider or are the possible side affects not worth it.


Answer: Unfortunately your question leaves out a number of key details that would allow us to offer a direct response so we will try to respond in general terms. First, if you had preexisting astigmatism before your Cataract removal it certainly would need to be corrected during or after your Cataract Surgery in order for you to get the best possible vision. Astigmatism for people with Cataracts can be corrected by using an astigmatism correcting toric lens implant, by using a secondary procedure called Limbal Relaxing Incisions (LRI), by having a Corneal Laser Eye Surgery procedure such as LASIK or by wearing eyeglasses with the correction for the astigmatism. You have to correct the astigmatism by one of these methods if you want to get the best vision correction after Cataract Surgery. Although you do state that as part of your Cataract Surgery your vision was to be corrected for both far and near, you do not state whether that was done with Monovision Cataract Surgery or a Near Vision Presbyopic Correcting Multifocal Lens Implant or an Accommodating Lens Implant.

Depending on the type of Multifocal Lens Implant, there may be predisposition to cause glare and halo side effects-in many cases these complaints resolve as patients adapt to the vision with the Lens Implant. In some cases patients do not adapt to the glare and halo and the Lens Implant needs to be removed-but this is only in a very small percentage of instances. Nonetheless, you do NOT get good vision with Near Vision Presbyopic Correcting Multifocal Lens Implant or Accommodating Lens Implants if there is uncorrected astigmatism.

Further, the glare and halo could be caused by a number of other factors that would require careful examination. So, you have to have the astigmatism corrected AND you have to discuss the annoyance of the glare and halo with your Cataract Surgeon as this may simply be due to adaptation and self limiting or may have another cause that needs to be addressed. If after discussing the situation in depth with your Cataract Surgeon you still do not feel comfortable, it is completely appropriate to get a second opinion prior to electing another surgical procedure. If you seek a second opinion you might want to make sure that it is with someone who is BOTH a Cataract and Refractive Surgeon and thus has the breadth of experience in both surgery areas of Surgery and LASIK Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Heavy Lifting after Cataract Surgery

Question: If a person who had cataract surgery was told not to lift heavy objects but did, not thinking that it was that heavy, what would happen to their eye to let them know that they damaged their eye?


Answer: Most Cataract Surgeons tell patients to avoid heavy lifting or really excessive exertion of any type in order to prevent a short burst of pressure from building up in the eye or suddenly shifting or changing the position of the eye's delicate tissues during the healing process. While it would be unusual, depending on the time period of the exertion after the surgery, there is a range of adverse effects that can result including some leakage from the incision, traction on the vitreous gel in the back of they eye, dislocation of the Lens Implant and even a remote possibility of a Retinal Detachment. However, all of these are pretty unusual without a great deal of exertion. In most instances there would be some vision compromise that could be noticed. If you are the least bit concerned it would be worthwhile calling your Cataract Surgeon and scheduling a follow up visit just to make sure everything is stable.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Repeating Cataract & Lens Implant Surgery

Question: Can cataract surgery be performed more than once per eye and implant a new intraocular lens?


Answer: Cataract Surgery entails removing the cloudy crystalline lens inside the eye and replacing it with a permanent clear artificial lens. Once the cloudy material is removed it does not regrow and thus does NOT need to be repeated. In some instances the membrane or "lens capsule" that is left in place to support the placement of the Lens Implant can become cloudy and requires an opening be created using a YAG Laser-however it does not require that another Cataract be "removed'. Thus-the answer to your question is that there is no real need to have a repeat of a Cataract operation. There is in some percentage of cases the need for a YAG Laser Capsulotomy. Regarding the need to replace a Lens Implant-modern Intraocular Lens Implants (IOL) last a lifetime and do not "wear out". Unless there is a problem with some other eye problem or condition there is no need to replace a well functioning IOL. Infrequently there may be a need to exchange an IOL in the short period after Cataract Surgery if there is a need to obtain a better optical result although for the most part this is unusual.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Age Limit for Cataract Surgery

Question: Is there an age limit for Cataract Surgery? At 92 should my friend have Cataract Surgery. He in lots of pain and takes drugs for pain.


Answer: There is no real age limit for Cataract Surgery. If a Cataract has progressed to a point of interfering with either the quality of one's life or the safety of an individual, and these aspects can be improved by a Cataract operation-it should be strongly considered. There are some practical matters that the Cataract Surgeon would need to carefully consider such as the health of the Retina in particular the Macula as at 92 years old there is a meaningful possibility that the onset of Age Related Macular Degeneration (AMD) has at least commenced and may impact the setting of expectations for the results of the surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery after Macula Detachment

Question: Can cataract surgery improve vision after a macula detachment? I had a retinal detachment in my left eye two years ago that included a macula detachment. The best level of visual acuity achieved since the detachment is about 20/200. I can read with this eye easily, from fairly close up. My retinal surgeon says my retina is stable. Are there cases in which a lens implant resulted in significant vision improvement despite the macula detachment?


Answer: The fact that you had a Macula Detachment and that you report the BEST level of visual acuity since the Retinal Detachment repair is 20/200 suggests that Macula function was impaired by the detachment. However, the fact that you can read is a positive prognostic sign for overall visual improvement if NOT central vision after a Cataract is removed. If the presence of a Cataract is causing a significant reduction of light transmission to the Retina and Macula this could cause a disproportionate loss of contrast sensitivity and associated functioning. HOWEVER, if the BEST corrected visual acuity after the Retinal repair was 20/200 AND THERE WAS NO PREEXISTING CATARACT, the likelihood of a significant improvement beyond that level is small. This does not mean that removing the cataract would not help with overall functioning particularly in reduced contrast situations. This requires thorough and careful evaluation with the best Cataract Surgeon you can find in your area who can offer the full scope of diagnostic and prognostic testing in your individual situation. it would worthwhile to consider this when you are ready.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract & Ovarian Cancer Risk

There may be a relationship whereby women who develop Cataracts are less prone to developing Ovarian Cancer according to researchers. It is widely recognized that the major health benefit of exposure to Ultraviolet (UV) Radiation from the sun is the production of Vitamin D, which is helpful in protection against several human cancers, including Ovarian Carcinoma. On the other hand, Ultraviolet (UV) Radiation from the sun is a recognized risk factor for Cataract development. Researchers reporting in the November 2011 publication Cancer Epidemiology, Biomarkers & Prevention studied 709 women with primary invasive ovarian carcinoma and 1101 controls to examine the association of Ovarian Carcinoma risk with a history of Cataract. Some interesting findings were that older age, a history of Type 2 Diabetes and skin cancer were significant risk factors for developing a Cataract.

Further, a history of Cataract was reported by 14% of cases and 17% of controls and was significantly associated with a reduced Ovarian Carcinoma risk. These findings add indirect evidence to the hypothesis that lifetime Vitamin D exposure may be inversely associated with risk of Ovarian Carcinoma. Additional studies are needed to further investigate the potential behavioral and biological factors that might influence association of cataracts with ovarian cancer.

Cataract Surgery with Fuch's Dystrophy

Question: I have Fuch's Endothelial Dystrophy and am having Cataract Surgery with astigmatism surgery on my left eye. What type of things should I be on the lookout for or should I even have the astigmatism part of the surgery done?


Answer: Fuch’s Dystrophy is a slowly progressive disease of the cornea in which the innermost layer of cells in the cornea, called the endothelium, tend to decrease in functioning and die, which makes the endothelium less efficient in maintaining the proper level of corneal hydration/dehydration through its normal metabolic pumping activity. This results in the cornea swelling and distorting vision and may be accompanied by glare, night vision problems, haloes and photophobia. You do not state what type of "astigmatism surgery" you are having with the Cataract Surgery. Presumably you are referring to the use of an astigmatism correcting toric lens implant and not Limbal Relaxing Incisions (LRI). The choice of a Toric Lens Implant rather than a Monofocal Lens Implant is generally not considered to pose any additional risk for a patient with Fuch's Dystrophy. One consideration is that although there are many experienced and excellent Cataract Surgeons, you may wish to consider have your surgery performed by a Cataract Surgeon who is also a Corneal Specialist. In this way, should it become necessary by using advanced corneal transplantation procedures that allow transplantation of the deep corneal layers called “endothelial keratoplasty” or “posterior lamellar keratoplasty” techniques it is often possible to help patients resume normal activities and lifestyles with minimal symptoms.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery & Macular Pucker

Question: Can Cataract Surgery cause or result in Macular Pucker or Wrinkled Retina?


Answer: A Macular Pucker or Epiretinal Membrane can occur due to changes in the Vitreous whereby cells converge in the Macular area creating a tight transparent layer that can cause the Retina to "pucker" like a piece of "cellophane wrap" when it is under tension. This may result in a "bowing" or "bending" of vision.

It is remotely possible that Cataract Surgery could lead to a spontaneous Vitreous Detachment-which is generally benign-which could then lead to a Macular Pucker. What is much more likely is that a fine Epiretinal Membrane existed before the Cataract Surgery and after the Cataract Surgery if a tiny amount of Macular Edema (swelling) was present it could have gotten trapped by the Epiretinal Membrane and caused the pucker. Some Cataract Surgeons order an Ocular Coherence Tomography (OCT) test routinely before the surgery in order to be sure there are no fine membranes present-and some do not as it is often not covered by insurance or Medicare when there is an otherwise "normal" Retinal exam and many patients complain about the added out of pocket expense.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataracts and Medicare Coverage

Question: Are there any requirements for Medicare to cover cataract surgery to remove my cataracts?

Answer: In general, if you have a Cataract that is visually significant in that it disturbs your visual acuity to worse than 20/40 or causes you problems with glare so that your vision is worse that 20/40 with the glare, Medicare will cover the cost of the Cataract operation including a portion, in not all, of the Cataract Surgeon Fee, the Cataract Surgery Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your Cataract Surgery. Usually if there is a fee for the pre surgery office examination, consultation and IOL measurement you will responsible for a co-pay or a deductible. Should you require a pre surgery physical with your medical doctor, you might have to pay that physician's co-pay as well. In addition, if you require anesthesia, you may be responsible for the anesthesia co-pay and/or deductible as well.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Alzheimer's Disease

Cataract Surgery for patients with mild Alzheimer's Disease not only improves vision but also can offer improvement in cognitive ability, mood, sleep patterns and other behaviors according to researchers reporting at the 2011 Annual Meeting of the American Academy of Ophthalmology in Orlando, Florida. In the first study of its kind to specifically assess whether Cataract Surgery could benefit Alzheimer's patients, researchers selected participants who had a debilitating Cataract in at least one eye and were appropriately treated with Cataract Surgery and Intraocular Lens Implantation (IOL) to replace the eyes' natural lenses in order to provide vision correction. The Alzheimer's patients were assessed for mood and depression, behavior, ability to function independently and cognitive abilities at one month before and three months after Cataract removal. Cognitive status, the ability to perceive, understand and respond appropriately to one's surroundings, improved in 25 percent of patients. Depression was relieved in many of them, and the level of improvement was similar to what commonly occurs after Cataract Surgery in elderly people who do not have dementia. No changes were found in patients' level of autonomy, that is, their ability to function independently. In addition, sleep patterns improved and night time behavior problems decreased in most study patients. Other studies have shown that when cataracts are removed, levels of the sleep-regulating hormone melatonin become normalized. In future the researchers will study what factors, specifically, led to the positive effects so they can boost the quality of life for Alzheimer's patients, their families and caregivers.

Crease after Cataract Surgery

Question: My daughter has recently had cataract surgery but still has blurred vision. She has been told by the cataract surgeon that this has been caused by a 'creasing' when the lens was implanted. Is this normal and what is the remedy and prognosis ?


Answer: Typically, when a Cataract is removed it requires that the Cataract Surgeon remove the cloudy material of the crystalline lens while leaving in place the thin lens "capsule" as a support in order to effectively place the Lens Implant in a stable position. From time to time the lens "capsule" can get a small "crease" in it which will almost certainly blur the vision. As the eye heals, say over 3 months after the Cataract Surgery, the "capsule" becomes fibrotic and can change configuration. Sometimes this eliminates the crease by itself. More often, the Cataract Surgeon will perform a YAG Laser Capsulotomy which is a painless laser procedure using eye drops to numb the eye, in order to create an opening in the creased capsule along the visual axis. This procedure takes a few minutes and almost always provides a huge improvement in vision within a few minutes!

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