Cataract Surgery: Frequently Asked Questions
I put together the questions my patients ask most often. If you don't see yours here, please bring it to your visit. That conversation is where we make your plan together.
Will I need glasses after cataract surgery?
Most likely, yes, at least for some things. Standard cataract surgery is designed to remove the cloudy lens. It is not designed to eliminate glasses. You may hear about a friend who "doesn't need glasses anymore," but everyone's eyes and expectations are different. With BASIC SURGERY, glasses are typically still needed for both distance and reading, often as bifocals or progressives. Even when distance vision improves a lot, reading glasses are usually still needed. If your vision after surgery matters a great deal to you, tell me so. We can talk about options that may reduce how often you need glasses.
What are my surgery options?
I offer three paths:
BASIC SURGERY: standard cataract surgery with a basic lens implant. It is usually covered by insurance, apart from your co-pays and deductible.
ADVANCED CUSTOM: adds an optimized lens implant and ORA measurements during surgery, and includes refractive enhancement up to 1 year after your original surgery. It has an out-of-pocket cost.
ADVANCED CUSTOM PLUS: uses a multifocal or extended depth of focus lens with ORA, and includes refractive enhancement up to 1 year after your original surgery. It has a higher out-of-pocket cost.
The Surgery Options page compares them side by side. Within each path, I still tailor the plan to your eye.
What is laser-assisted cataract surgery?
In laser-assisted surgery, a specialized laser performs some steps of the operation that are otherwise done by hand. These include making the opening in the lens capsule, softening the cataract and, in some eyes, treating astigmatism. For some patients, this may help improve the result. Laser-assisted surgery is one option, not a requirement. Many people have excellent results with the traditional approach. Whether it makes sense for you depends on your eyes and your goals, and we decide that together, case by case.
What is ORA?
ORA stands for Optiwave Refractive Analysis. It measures the eye during surgery, after the cataract is removed. In-office measurements are taken before surgery, and the eye can change slightly once surgery begins. ORA gives me updated information about lens power and astigmatism at that moment, which may help me fine-tune your result. I was the first surgeon in central Ohio to use ORA.
Does my insurance cover everything?
BASIC SURGERY is usually well covered by insurance, apart from your co-pays and deductible. Please check your own plan. Advanced technology, such as laser-assisted surgery, ORA and premium lens implants, is generally not covered, because insurers consider it beyond what is medically necessary. That is why ADVANCED CUSTOM and ADVANCED CUSTOM PLUS have an out-of-pocket cost. Before you decide, we will go over what insurance typically covers and what you would pay yourself.
What is astigmatism?
Astigmatism means the cornea, the clear front window of the eye, is curved unevenly. A cornea without astigmatism is shaped like a basketball. One with astigmatism is shaped more like a football. Astigmatism can stretch and blur what you see, and in stronger cases it can cause ghosting or double images.
How do I know if I have astigmatism?
Most people have at least a little astigmatism, and small amounts usually don't affect vision much. I measure the front of your cornea before surgery to plan your treatment. The back surface of the cornea can also add astigmatism ("posterior astigmatism"), which is harder to measure in the office. ORA measurements taken during surgery may help account for it.
How is astigmatism treated?
Astigmatism can be treated during cataract surgery with a special lens implant known as a toric lens. It can also be treated by reshaping the cornea, either by hand or with a laser. Which approach fits you depends on your measurements.
What is lens optimization?
How sharp your vision is after surgery depends partly on how well the lens implant matches your eye. A lens that is a little too strong or too weak can make vision less sharp, and a good match can also help with glare and seeing in dim light. ORA helps me check and fine-tune the lens choice during surgery.
Am I a candidate for advanced options?
Many eyes are good candidates, but not all. If you have another eye condition, such as macular degeneration, the extra benefit of advanced technology may be limited, and a simpler plan may make more sense. I'll give you my honest recommendation after examining your eyes.
I'd like to depend less on glasses. What are my options?
That's a common goal. There are two main approaches. A multifocal or extended depth of focus lens (part of ADVANCED CUSTOM PLUS) is designed to give a wider range of vision, from distance to near. Monovision sets one eye for distance and the other for near. Either may reduce how often you need glasses. Neither is designed to eliminate glasses completely.
Is a multifocal lens right for me?
Multifocal lenses can widen your range of vision, but they involve trade-offs. They are not covered by insurance. Most people with a multifocal (trifocal) lens notice some halos or starbursts around lights at night. In the FDA study of the PanOptix lens, about 6 in 10 patients reported halos at 6 months, and about 1 in 10 said they were bothered quite a bit or more. For many people these become less noticeable over the months after surgery. A small number find them bothersome enough to consider exchanging the lens. If you drive a lot at night, we'll weigh this against the benefit of needing glasses less often. We'll talk about whether your eyes and lifestyle are a good fit.
Will I still need glasses with a multifocal lens?
Many people need glasses less often, but some still use them for very fine print, dim light or night driving.
Is monovision right for me?
Monovision isn't for everyone. Some people can't get used to one eye seeing far and the other seeing near. It tends to work best for people who have already used monovision with contact lenses. It can also affect depth perception, and glasses may still be needed for some activities, such as driving.
What is a refractive enhancement?
Every eye heals a little differently. A refractive enhancement is a follow-up procedure to fine-tune your vision if the result isn't what we planned, or if it shifts as you heal. Most patients don't need one. Refractive enhancement up to 1 year after your original surgery is included in ADVANCED CUSTOM and ADVANCED CUSTOM PLUS. It is not included in BASIC SURGERY.
What is a YAG laser treatment? Is it included?
Months or years after cataract surgery, the thin membrane that holds your lens implant can become cloudy. This is sometimes called a "secondary membrane." A quick in-office YAG laser treatment can clear it. YAG treatment is not included in any of the three packages.
Will BASIC SURGERY improve my distance vision?
It can, but with BASIC SURGERY, glasses are typically still needed for both distance and reading. Cataract surgery is meant to treat the cloudy lens. It is not designed to eliminate glasses.
This page is general information, not medical advice for your eyes. We'll talk about your own situation at your evaluation.
My focus is your vision · Aaron C. Mack, MD · Canyon Eye Associates · 245 Taylor Station Rd, Columbus, OH 43213 · (614) 866-9134 · www.ohiocataractmd.com