Monday, August 29, 2011

Cataract Surgery Cost and Medicare

Question: I have a question about the cost of cataract surgery and Medicare. If I am having basic cataract surgery why would there be a charge of $300 per eye. I have Medicare and a supplement.


Answer: It is impossible to know exactly what is generating the out of pocket expenses for your Cataract Surgery as it will depend on any copays or deductibles you might still be responsible for to the surgery center or, depending on the type of anesthesia used it could be an anesthesia charge or other miscellaneous charge assessed by the facility or a provider that does not fall 100% under the coverage you have. Although you have a supplement it is also possible that your supplement has a threshold, copay or deductible as well leaving you responsible for the $300 charge.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Eyeglass Prescription

Question: I have a question about cataract surgery and eyeglass prescriptions. My 74 year old dad just had cataract surgery 3 days ago. He has not yet seen any improvement with his vision. Should he be wearing his prescription glasses? He says he needs to wear them so he can see and be able to get around.
Answer: Depending on what prescription your father's Cataract Surgeon was aiming to achieve it is possible that your father may not actually need to wear the preoperative eyeglass prescription for that eye at all. It is possible but not likely that the preoperative eyeglass prescription is correct after having a lens implant. If your father is not observing any improvement in his distance vision it would be worthwhile call the surgeon and asking what level of vision he should be achieving at this time. Without knowing more about the preoperative vision and the health of the retina we cannot speculate about what his level of vision should be at this time although it is not at all unusual for patients to see pretty well after 2-3 days of their Cataract operation.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery, Twitching & Black Line

Question: I had cataract surgery in May this year. Over the past few weeks I have experienced terrible twitching of that eye on a very regular basis. I tried putting more drops in as thought it may be due to dry-eye, but these have not helped. I also notice a black line occasionally when I look in certain directions and feel I have something in my eye. Can you help please?
Answer: From your symptoms you may describing a number of different things. The twitching you report may or may not be related to your Cataract Surgery. The fact that you notice a black line maybe related to a visual phenomenon some patients experience with certain types of Lens Implants called "dysphotopsia" or if it is accompanied by any sense of floaters or flashes could be a symptom of a vitreous detachment, which is benign and self limiting, or less common-a tear or a retinal detachment. Most of these phenomenon are self limiting, including the optical symptom of dysphotopsia, however since there is a small outside possibiity of a retinal probelm it would be worthwhile to schedule a followup visit with your Cataract Surgeon to confirm that what you are experiencing is not a serious problem.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery after Retinal Detachment

Question: I have had a retinal detachment and have a cataract that needs to be removed. Will cataract surgery work for me?


Answer: Cataract Surgery after a Retinal Detachment is possible and can provide good results with certain caveats. First it is important to know whether the Retinal Detachment you experienced included a detachment of the Macula or center of vision. If it did, then it is important to know the level of best corrected visual acuity you achieved after your Retinal Detachment surgery in order to determine the risk/benefit ratio of Cataract Surgery in your case. Second, your Retina must be anatomically stable and well attached without the presence of other risk factors for another detachment, or those risk factors will need to be treated is they exist. The determination of the status of the Retina and the risk of another detachment from the Cataract operation will be determined by your Retina Surgeon in consultation with your Cataract Surgeon. Once they have discussed their opinions then together they can recommend whether a Cataract removal is safe and will be effective 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. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, August 25, 2011

Cataract Surgery Complication with Black Eye

Question: I have a question about cataract surgery problems and complications. My mother has undergone phacoemulsification for cataract surgery. Since her eye surgery the eye is red and area around eye is black.What is this type of complication?


Answer: If your mother had Cataract Surgery whereby the Cataract Surgeon used an injection for anesthesia, it is quite possible that the injection caused some bleeding in the eyelid around the eye perhaps even "bruised" the tissue so as to give it a "black" appearance. Assuming that your mother is seeing well and has no discomfort or pain then this will resolve on its own shortly. If she is uncomfortable or has any vision complaints you should contact your Cataract Surgeon immediately.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Lens Implant Confusion

Question: Two cataract surgeons are confusing me about choosing a lens implant. I had cataract surgery last November with a lens implant for distance vision. Now the eye doctor suggests Crystalens® for the cataract in the other eye, but another cataract surgeon says to have both eyes corrected for distance. I am very lost and in need of help.


Answer: Crystalens® is a type of Lens Implant that is used to correct distance vision and provide clarity for a greater range of intermediate or "arm's length" vision as well as help for near vision after Cataract Surgery. The choice of a Lens Implant for vision correction after Cataract Surgery really depends on what types of things you like to do in your daily activities-AND whether you would like to be able to do them without being totally dependent on eyeglasses. Since your first eye was corrected only for distance vision after the Cataract was removed it is highly likely that you would need to wear eyeglasses to see up close and for tasks that require arm's length vision. The Cataract Surgeon who suggested Crystalens® for the second eye is doing so with the thought that this will help you somewhat with arm's length and near vision without eyeglasses. If you are comfortable having to wear eyeglasses for arm's length and near vision tasks then your simplest solution is to have the second eye corrected for distance and just wear the glasses. If you want to reduce your dependence on eyeglasses after the second eye Cataract Surgery, one option is to consider having a presbyopia correcting lens implant like Crystalens®-however, the full benefit of these lenses is NOT typically experienced unless they are implanted on BOTH eyes. If you are in certain need of having greater arm's length vision after Cataract Surgery on the second eye another option could be using a monovision correction whereby the second eye is corrected for intermediate and near vision-however you should not consider this unless you sure that you have a real need for arm's length clarity without eyeglasses. The decision you make should be after considering what you want to achieve-specifically whether you need to be free of eyeglasses for those arm's length tasks. Then your Cataract Surgeon can help you make the right decision.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, August 19, 2011

Choosing a Lens Implant

Question: I have a question about choosing a lens implant for cataract surgery. I am 64 years old, in good health, have cataracts and an astigmatism. How do I determine the most appropriate IOL for my situation?


Answer: Choosing a Lens Implant for vision correction after Cataract Surgery is a decision you AND your Cataract Surgeon make together after careful clinical evaluation of your situation AND after a careful discussion about your lifestyle and how you use your eyes. It is NOT a decision YOU make alone and requires that the Cataract Surgeon or their staff take the time necessary to review your daily routine and relate that to the various distances and range of vision correction that is important to you. Some people spend most of their day doing things that require clarity for near tasks-some for far tasks....some for a variety to tasks. By reviewing this with each and every patient top Cataract Surgeons can make a recommendation about what type of Lens Implant the patient should consider in order to meet their personal vision correction goals.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, August 16, 2011

High Risk Cataract Surgery

High risk Cataract Surgery for patients with orthopedic, neurological, respiratory or cardiac problems can now be performed with the patient seated comfortably in an upright position according to a report in the Journal of Cataract and Refractive Surgery. By using techniques of advanced Cataract removal including phacoemulsification, eye drop topical anesthesia and movable operating microscopes, Cataract Surgeons can accommodate the various types of breathing problems and spinal discomfort that might be a difficult for those in need of a cataract operation and Lens Implant.

Lens Implant IOL Dislocation Risk

The risk of Intraocular Lens Implant (IOL) dislocation after Cataract Surgery is quite low according to a study reported by the American Journal of Ophthalmology in June 2011. By reviewing 14,000 Cataract operations the researchers determined the rate of lens implant dislocation to be 0.1% 5 and 10 years after Cataract Surgery, 0.2% 15 years after Cataract Surgery, 0.7% 15 years after Cataract Surgery and 1.7% 25 years after Cataract Surgery. The slightly greater rate of patients having Cataract Surgery 25 years ago may be attributed to the types of IOLs and the eye surgery technique used at that time. These factors have undergone considerable changes and improvement since that time.

Lens Implants Most Often Implanted Devices

Intraocular Lens Implants (IOL) for Cataract Surgery are the most frequently implanted medical devices in the U.S. according to data from a study by financial news and opinion company 24/7 Wall St. More than 2.5 million artificial lens implants (IOL) are implanted annually as part of Cataract Surgery to treat Cataracts in the U.S. This far outpaces all other types of implanted medical devices. Overall eye and ear devices are the most implanted medical devices in the U.S. with second place going to ear tubes with 715,000 procedures performed yearly. Cataract Surgery with advanced lens implants to correct nearsightedness, farsightedness, astigmatism and presbyopia-the age related focusing problem account for expenditure estimated at between $8 billion and $10 billion per year.

Cataract Surgery Complications Decline

Cataract Surgery complications declined by approximately 20% in the most risk prone group of Medicare patients treated between 1994-1995 as compared to those having Cataract Surgery between 2005-2006 according to a study in the June 2011 Ophthalmology journal that evaluated some 220,000 patients. It is interesting to note that one half of one percent (0.5%) had a severe complication and that these were typically associated with a prior diagnosis of proliferative diabetic retinopathy or who were having another intraocular eye surgery procedure on the day of their Cataract Surgery. Among the least risk prone group of patients having Cataract Surgery the complication rate declined by 48%. The authors concluded that it would be important to find ways to reduce the severe adverse events in high risk groups as research goes forward.

Macular Degeneration Risk & Belly Fat

Abdominal "belly fat" may increases the risk of Age Related Macular Degeneration (AMD) in middle-age men but may have the opposite effect in women, according to researchers reporting on a study in the March 2011 American Journal of Epidemiology. AMD is a leading cause of blindness in older people, and treatment options are limited. An Australian study on Abdominal Obesity followed 21,287 from their 40s to mid-80s and found that each 0.1 increase in the waist/hip ratio was associated with a 13% increased chance of developing early-stage AMD and a 75% increased chance of the more severe late-stage AMD, but only in men. Abdominal obesity actually reduced early AMD risk in women by 7% to 11%. There were 2,694 early and 122 late cases of AMD in the study, which followed the incidences of AMD from 2003 to 2007. The researchers suggest that abdominal fat releases estrogen and other chemicals that may contribute to inflammation associated with AMD while the inverse association in women could reflect a genetic resilience to disease seen in older people called the survivorship effect plus the protective effects of long-term estrogen exposure, they said. However, specific information about the onset and duration of obesity wasn't considered and the AMD was only measured at follow-up, so the progression of the disease wasn't tracked.

Monday, August 15, 2011

Cataract Surgery Medication & Corneal Abrasion

Question: Can medications used during Cataract Surgery cause cornea abrasions?


Answer: While unusual, it is possible that in certain patients with especially dry eyes or otherwise compromised corneal epithelium-the delicate top layer of the cornea-a slight erosion of the surface might occur due to the irrigating solution used or perhaps due to preservatives that might be used in certain medications. When it does occur it can be bit uncomfortable but usually goes away in a short period of time. It may be more likely-and patients should be cautioned-NOT to touch the dropper tip of any eye drop to the surface of the eye when placing drops in the eye as this in fact can cause a corneal abrasion and can contaminate the bottle of drops. If there is any doubt about the proper technique for instilling eye drops after Cataract Surgery be sure to ask your Cataract Surgeon or their staff to help you or a caregiver learn the best technique.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Complications and Cataract Surgeon Choice

Question: I am uncertain as to whether to continue with my Cataract Surgeon as I had a complication. My Cataract operation for the left eye resulted in a tear in the posterior capsule with parts of the old lens escaping the capsule. My Cataract Surgeon did not repair the tear prior to inserting the new lens implant. The pressure in this eye rose to 56 and my surgeon scheduled a vitrectomy with a Retina surgeon to reduce the pressure. Should I consider a different surgeon for the right eye?


Answer: Although not terribly common, a tear or rupture of the posterior capsule during Cataract Surgery and Lens Implant procedure does happen every so often. This complication can happen for a number of reasons and does not necessarily suggest a poor technique or lack of capability on the part of the Cataract Surgeon. The "capsule" that surrounds the crystalline lens where the cloudy material that forms the Cataract exists is actually a very thin, fragile membrane. Certain eye anatomical features as well as the type of Cataract can make this membrane or capsule even more fragile. The decision not to perform a vitrectomy at the time of the Cataract operation may have been made based on the ability to visualize the completeness of the removal of all of the cloudy lens material and reflected the best judgement at the time of surgery. All of these considerations aside-it is never inappropriate to make the choice of an eye surgeon based on your personal comfort and confidence level in the particular individual. If you do not feel confident in his or her abilities then you should consider the choice of another surgeon who is considered the best Cataract Surgeon in your area. It is never inappropriate to have a second opinion or consultation in order to assess your confidence level.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Lens Implant for Reading

Question: I have a question about a Lens Implant for reading after Cataract Surgery. Two weeks ago my 65 year old husband had Cataract Surgery in which a Lens Implant was put in so he could see distance. He is scheduled to have the second eye corrected in a week. He asked the Cataract Surgeon if it was possible to put a reading lens in the other eye . The Cataract Surgeon said yes but left it up to him to decide. What are the pros and the cons for doing this? I have never heard of this. I have the same lens Implant in both eyes and just have reading glasses for computer and close up reading.

Answer: You are describing a technique called Monovision. Monovision correction is a technique of vision correction that has been used for many years to correct distance, near and intermediate vision with contact lenses and Laser Vision Correction such as LASIK. It has also been used by Cataract Surgeons to help patients achieve simultaneous correction of distance, intermediate and close vision in selected situations. Typically in Monovision correction, your dominant eye is corrected for clear distance vision and your non-dominant eye is corrected is corrected for intermediate and/or close vision. With proper patient selection through careful testing and evaluation the patient satisfaction rate is in the 80% range and so it is growling in popularity among there best Cataract Surgeons.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery with Toric Lens Implant for Monovision

Question: I have a question about Cataract Surgery with a Toric lens Implant for Monovision. I had Cataract Surgery on right eye 2 weeks ago and now have 20/20 distance vision. However, I need "readers" for close vision. I have astigmatism in both eyes and had to have a Toric Lens Implant. The difference is amazing-crisp distance without blurred vision! Now I have to make another decision. I my Cataract Surgeon today and he said he could correct the left eye so I could read without glasses-I spend a lot of time on computer. I am scheduled for 2nd surgery the end of August. Would you say most people that choose this option are happy with their decision?

Answer: Based on your particular lifestyle need of spending a lot of time on the computer your cataract Surgeon offering you the option of Monovision Cataract Surgery-in this case with a Toric Lens Implant (IOL) to correct your astigmatism. For many patients Monovision correction is an excellent way to help them see things at intermediate distances such as the computer as well as read without being totally dependent on "readers". If your cataract Surgeon has carefully evaluated you for Monovision, the general patient satisfaction level for this type of correction typically is in the 80% range which is quite good. It does require some extra testing and discussion but is becoming more and more popular among top Cataract Surgeons.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, August 8, 2011

Torn Lens Implant?

Question: My new lens implant is torn. I was given two different stories by my Cataract Surgeon. The first was that it was torn when it was unfolded and the second was that the technician may have torn it. This was two months ago. I was promised 20/20 vision and am far from it after using expensive eye drops 4 times each day and countless trips to the Cataract Surgeon. What should I do?


Answer: It is very difficult to offer much advice as your description of what you have been told is a bit unclear. First, it is HIGHLY unlikely that the Lens Implant is torn. While it is not impossible, it would be quite rare. If the Lens Implant was in fact torn and it was adversely impacting your vision, it is probable that the Cataract Surgeon would have recommended a Lens Implant Exchange whereby the alleged torn Lens Implant was exchanged for an intact one. What is more likely to have happened is that the capsule of the crystalline lens was torn during your Cataract Surgery. The lens capsule is the membrane that surrounds the crystalline lens where the cloudy material or the Cataract existed. The lens capsule is typically left in place and is often used to support the Lens Implant. The capsule of the crystalline lens is a very thin and delicate structure that even with the best efforts of the Cataract Surgeon can sometimes tear or become damaged. This does make the surgery more complicated and difficult but generally with proper post operative management the ultimate results can be quite good. Your best course of action is to first ask your Cataract Surgeon to clarify what exactly the situation is in terms you can understand. If you are not comfortable with the explanation it is always acceptable to get a second opinion from a top Cataract Surgeon in your area.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Prostate Medication & Cataract Surgery

Question: I am taking Avodart which is for enlarged prostate. It is different from Flomax®. Can it pose problems with Cataract Surgery?

Answer: Patients who suffer from an enlarged prostate are often treated with a class of medication called and "alpha-blocker". Alpha blockers come in two types-"selective alpha blockers" and "non selective" alpha blockers are called that because they are VERY selective in their muscle relaxing effect on the bladder AND on the Iris-which makes it more difficult to perform Cataract Surgery. Non selective alpha blockers are less selective in their effect, as the name implies, and thus cause less or little difficulty performing Cataract Surgery. Medications like Flomax® and Rapaflo® are selective alpha blockers and medications like Uroxatral ®and Hytrin® are non selective alpha blockers. Avodart is a COMPLETELY DIFFERENT CLASS of medication for an enlarged prostate (BPH) called an "alpha reductase inhibitor". It does not cause the concerns that alpha blockers cause.

Anyone taking any type of medication for an enlarged prostate should inform their Cataract Surgeon. Taking any type of medication for BPH does not preclude you from having cataract Surgery but alerting your cataract surgeon will allow them to take any necessary precautions or modify their surgical technique so that you get the best possible 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 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. Contacting us via e-mail or any other means is not a substitute for medical care.

Lens Implant Problem?

Question: I had Cataract Surgery about 3 months ago in my left eye and then the following month on the right eye. The left eye was very bad and my surgeon asked my husband and myself if I had taken a blow to the face or head that would have caused this to develop so quickly..No I didn't. Everything was fine until last week when I went swimming and jumped in the water---when I got out I noticed a new floater that was shaped like a backwards "c" and was very dark compared to the other floaters that I have had for years. I have a relative who works for an eye doctor and called her. She said to get the the Cataract Surgeon because the very end part of the implant DOES have a piece on it like a backwards "c". My surgeon said that it had NOTHING to do with the surgery and that it could happen to anyone at my age (64). I also told him that if it is dark I have flashes of light from the left part of my left eye. He said that it would go away in 6 weeks . It is still the same after 2 weeks. Should I go to get another opinion? Is it possible that a piece of the implant became loose and is floating?


Answer: It is highly unlikely that the Lens Implant became dislocated and floating for many reasons-not the least of which is that would GREATLY disturb your vision and would be completely visible to your Cataract Surgeon. it is not possible to say for sure but the symptoms you are complaining of are consistent with a Vitreous Detachment and/or a Retinal Tear which may have occurred with the Vitreous Detachment. Assuming that your Cataract Surgeon thoroughly examined your Retina when you presented him or her with these complaints then they would see either of these problems. Now...jumping into a swimming pool may have caused this to happen if it caused a firm blow to your head or face...which could have happened. The floater symptoms and the flashes typically do in fact go away after some time without any treatment whatsoever if it is a Vitreous Detachment. However this can take more than 6 weeks in some cases. if you are uncomfortable with the diagnosis and explanation given to you by your Cataract Surgeon then it is not inappropriate to seek a second opinion with a top Cataract Surgeon to be reassured.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, August 2, 2011

Lens Exchange after Cataract Surgery

Question: I am a 53-year-old male who had cataract surgery in one eye in March 2011. Prior to the surgery I was near-sighted in both eyes, about -2.75, with some astigmatism. I discussed the replacement lens with one of the doctors, and we decided they'd try to get the vision as close to "perfect" in that eye as possible. Four months after surgery, I am now far-sighted in the eye with the replacement lens, +1.25. Because of this, I no longer have the option of wearing glasses, and must now wear contacts. This can be extremely inconvenient at times for various reasons, including the fact that my seasonal allergies can make it uncomfortable to wear contacts. I'm thinking of asking my surgeon if we could redo the surgery to replace the lens so I am not far-sighted in that eye, so that I have the option of wearing glasses. Would a second surgery be advisable? Would it be unreasonable for me to expect them to "fix" this free of charge? It seems like a bit of a mistake on their part to leave me +1.25 with the new lens when I'm -2.75 in the other eye. Thanks for your help.


Answer: While the precision of the calculations for Lens Implants with Cataract Surgery is generally quite good, occasionally due to some unpredictable factors the actual result is not as planned. In your case the unplanned residual refractive error and magnitude of the inequality between eyes necessitates wearing a contact lens correction in order to achieve good vision correction. There are three options that are available to assuming your eyes are healthy. You can continue to wear the contact lens correction as you are doing but that does not seem satisfactory. You can also discuss having a Lens Exchange with your Cataract Surgeon in order to get closer to a more symmetrical refractive error in each eye which would allow you to wear glasses to see clearly at distance. This is done with some regularity with patients who have this type of situation. Last, you can discuss with your Cataract Surgeon the possibility if having a LASIK Surgery procedure in the -2.75 D eye with a planned overcorrection so that both eyes were +1.25 and would necessitate the wearing of glasses for both far and near.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Eyelid Puffiness after Cataract Surgery

Question: Since my Cataract Surgery for both eyes I have a puffiness under my eyes that I did not notice before the surgery. Is this a possible side effect of the surgery?

Answer: Actually many people who have Cataract Surgery suddenly notice that their eyelids appear more puffy-however it has nothing to do with the surgery. It is much more likely that you might not be wearing eyeglasses that obscure the direct view of the eyelids coupled with the more careful inspection and observation of your eyelids that causes you to think that there is "more puffiness". Unless you are aware of discomfort, redness, itching or discharge it is probably not really more puffy and in any even not related to your Cataract Surgery. If there is any question be sure to bring it to the attention of your Cataract Surgeon so that he or she can examine the eyelids.

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. Contacting us via e-mail or any other means is not a substitute for medical care.