“What I Wish I’d Known About Cataract Surgery”: A Doctor Details What Patients Should Know About a Common Procedure

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What are the signs that show I need cataract surgery?

“There are several key signs that someone may need cataract surgery,” explains Dr. Levenson. These include:

• Blurry or cloudy vision that makes everyday tasks challenging.
• Trouble seeing in dim lighting or at night.
• Halos appearing around lights.
• A noticeable increase in light sensitivity and glare.
• Needing to update your eyeglass or contact lens prescription frequently.
• Difficulty driving, particularly at night.
• Requiring more light than before to read or do other activities.

He points out that the choice to undergo cataract surgery often arises when these visual problems start to seriously impact your everyday life and glasses or contact lenses no longer provide the necessary correction. It’s a decision you’ll make alongside your eye doctor, carefully considering both the benefits and the risks, he says.

To determine if cataracts are compromising your vision, a comprehensive eye exam with an ophthalmologist will be conducted, and they’ll evaluate your vision and inspect your eyes to decide if cataract surgery is the best course of action for you.

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What are the different types of cataract surgery?

“There are several types of cataract surgery available, and determining the best method depends on various factors specific to each patient. Phacoemulsification is the most commonly employed type,” says Dr. Levenson.

This method involves a tiny incision in the cornea, using ultrasound waves to break up the cloudy lens, then removing the fragments through suction, and finally inserting an artificial intraocular lens (IOL). He adds, “Phacoemulsification typically requires no stitches and patients usually return to normal activities, with excellent vision, within a matter of days.”

Often paired with phacoemulsification is laser-assisted cataract surgery. “This advanced technique uses a femtosecond laser to perform some steps of the surgery,” he says. It enhances precision in the incisions which can help reduce astigmatism, makes lens fragmentation easier, and potentially allows for more accurate IOL placement.

He also notes that the most suitable method for cataract surgery depends on several variables: The density of the cataract—as denser cataracts may benefit more from laser-assisted fragmentation; any preexisting conditions that might affect the surgical approach; the patient’s desired visual outcomes; and what insurance will cover. Some advanced techniques, such as laser-assisted surgery and specialty IOLs, are often not covered by insurance.

What type of lens should I choose?

“When we remove the cloudy human lens [the cataract], we need to replace it with an artificial lens.” Dr. Levenson explains that in his practice, he collaborates with patients to find the best lens to suit their daily needs and lifestyle. Here’s a breakdown of the options:

• Monofocal IOL: Great for seeing distances clearly. You’ll still need your reading glasses with this one.
• Multifocal IOL: These lenses have several focus areas, allowing for a wider range of vision—from reading a book to spotting a street sign, often without the need for reading glasses.
• Toric IOL: Specifically designed for those with astigmatism, these implants help sharpen your overall vision.

How long does it take for eyes to fully adjust after cataract surgery?

“Patients can usually resume normal activities within 24 hours after surgery, and vision is usually clear within a day or two after surgery,” explains Dr. Levenson.

While you might need to use anti-inflammatory drops for a few weeks post-surgery, most people are back to their regular routines—including working, driving, and exercising—within a week.

Since cataracts usually develop slowly, many patients are often amazed at how much brighter and more colorful everything looks in the days after their surgery, he adds.

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How successful is cataract surgery?

“In the setting of otherwise healthy eyes, cataract surgery is overwhelmingly successful,” states Dr. Levenson. “Over 98% of patients who have otherwise healthy eyes can expect to recover excellent vision from cataract surgery. Depending on the type of intraocular lens used, many will no longer require glasses.”

However, he adds that the situation can become more complex for patients who have additional eye conditions like glaucoma, macular degeneration, or diabetic eye disease. In such cases, the outcomes can be less predictable, and the complete restoration of all vision is less certain.

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How can cataract surgery affect other eye conditions?

Improved detection and monitoring

“Removing cataracts allows doctors to better examine the back of the eye, which can lead to improved detection and monitoring of other eye conditions like glaucoma, diabetic retinopathy, or macular degeneration,” explains Dr. Levenson. By clearing the lens, doctors get a clearer view, helping them spot and manage other issues more effectively.

Temporary worsening of some conditions

Cataract surgery isn’t without its challenges. “In some cases, cataract surgery may temporarily worsen conditions like diabetic macular edema or uveitis due to increased inflammation after surgery. However, this is usually manageable with proper treatment,” notes Dr. Levenson. It’s a short-term setback that can often be controlled with the right care.

Positive effects

Cataract surgery can also be beneficial for other eye conditions. According to Dr. Levenson, it might help reduce eye pressure in some glaucoma patients, and may also improve the effectiveness of treatments for diabetic retinopathy.

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What is the most common complication of cataract surgery?

According to the American Academy of Ophthalmology, a common complication of cataract surgery is posterior capsule opacification (PCO), also known as a “secondary cataract.” It occurs when the back of the lens capsule (which holds the new IOL in place) becomes cloudy after surgery, causing blurry vision.

This complication can occur weeks, months, or even years after the surgery. Fortunately, PCO can be easily treated with a quick, non-invasive laser procedure called a YAG laser capsulotomy, which restores clear vision.

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What are new advancements in cataract surgery technology and techniques?

One of the latest innovations worldwide is the TECNIS Odyssey by Johnson & Johnson. Dr. Levenson explains that this advanced IOL helps patients achieve exceptionally clear vision across all distances—whether they’re reading a book, driving, or just going about their daily lives, all while reducing disturbances in night vision. He shares that the majority of his patients are satisfied with their vision after surgery, often finding they no longer need glasses.

“Today, not only are cataracts curable, but with modern phacoemulsification and specialty intraocular lenses, we’re able to restore excellent vision to most patients,” he says. “We live in a time of miracle and wonder, and there’s no more direct manifestation of that than modern cataract surgery.”

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