We’re With You Every Step of the Way

Surgery is typically recommended when cataracts interfere with your ability to perform daily tasks, such as reading, driving, working, or enjoying hobbies - see symptoms of cataracts above. Whether your cataracts have progressed enough to interfere with your activities of daily living, is somewhat subjective, and a ultimately up to you. Cataract surgery is an elective procedure. Your eye doctor can assess the progression of your cataracts and help determine if now is the right time.

We try to get you to be as glasses-free as possible after surgery. Another way to put this is that we will try to come as close to our refractive target as possible, to leave as little of a leftover prescription as possible. You may still require a small prescription to get the crispest vision, even if we come very close to a zero prescription. Certain variables out of our control may affect this outcome. All measurements, even with the most modern technologies available to us, have a small range of error, meaning there may be a small leftover prescription. In most cases, this leftover prescription is much smaller than what was present before surgery, and many choose not to wear glasses in such a scenario. Even those with multifocal lenses may need a pair of readers for the smallest print or in dimly lit settings. If you receive a monofocal lens, you should expect to wear glasses at distance and especially to read. If you receive a toric astigmatism-correcting lens, you will still need reading glasses, and possibly a very small prescription at distance. Hopefully, this prescription will be so small, you never feel the need to use it - the goal is to help you have satisfactory distance vision without glasses.

You will receive topical eye drops in the preoperative area to numb the eye. You will receive additional anesthesia inside the eye. In addition, to help remain calm, you will receive an IV for light sedation. Most report surgery is comfortable and easier than expected. It helps for you to let your surgeon know if you feel you need more numbing medication during surgery, as some people may require extra dosages to feel comfortable. Your doctors care very much about your comfort. With your collaboration, they will help ensure that your surgery is easy and comfortable for you.

You won’t see the surgeon “coming at you.” Many don’t even realize the surgeon is there because the surgeon sits to the side of the patient’s ear or at the top of the patient’s head. You will not be able to see what the surgeon is doing in the eye. Often, patients describe a “psychedelic light show.”

Surgery is performed under MAC anesthesia, the same category of IV anesethesia as is used for colonoscopies. Most patients end up somewhere between awake and talking during surgery to snoring, with most ending up somewhere closer to the awake and chatting end of the spectrum. Sometimes, oversedating patients can make surgery more challenging as patients may forget where they are or lose the ability to follow directions. This is why your anesthesiologist will carefully and precisely adjust the level of sedation necessary according to your perceived anxiety level. If you are feeling anxious during surgery, it helps to let your team know so they can adjust accordingly. General anesthesia is not usually necessary but may be recommended in specific situations, such as those with specific medical comorbidities or dementia, as the latter may not be able to remember where they are during surgery. Often, patients are slightly more alert during surgery on the second eye. We don’t exactly know why, but it may have something to do with the brain getting used to anesthesia or visiting the same destination again.

The eye will feel “scratchy” after surgery – it’s your eye’s way of saying, “hey, something happened to me.” This quickly improves by the next day, and the use of postoperative medication helps. It is common to experience dry eye after surgery, which may feel like foreign body sensation, mild light sensitivity, or tearing. This is why a preoperative evaluation is important – the more we can tune up any preexisting dry eye before surgery, the less it will have an impact after surgery. All patients will experience some dry eye, because the small incisions made cut through some corneal nerves, which signal the lacrimal gland to make tears. These grow back with time and symptoms of dry eye generally improve over the ensuing 6-12 months. With the overwhelming majority of patients, the symptoms are mild, and most do not report them.

Patients may resume most activities the next day, including going for a walk, shopping, cooking, and entertaining grandchildren. Doctor Feng does not give any restrictions about bending down except in rare circusmtances. It is generally recommended to avoid heavy weight lifting, heavy yard work, heavy duty cleaning, and makeup for a week, and to avoid swimming or hot tubbing for 3 weeks.

You can shower the next day after surgery. It is fine to let the water and shampoo run over your face.

Many people drive themselves to surgery the next day. It is legal to drive with one eye. However, you should use your judgment and do what you feel safe doing.

Cataract surgery is a highly safe and extremely commonly performed procedure. However, as with any surgery, there are risks, including but not limited to infection, inflammation, retinal detachment, refractive surprise or the need for additional procedures. These complications are rare, and your surgeon will take every precaution to minimize them.

In the early stages, stronger lighting and prescription glasses may help manage symptoms. However, if you have a visually significant cataract, surgery is currently the only effective way to remove cataracts and restore vision once they begin significantly interfering with daily life.