A cataract is simply a clouding of the lens inside the eye that occurs with age. We refer you for surgery when vision quality reduces to the point where eyeglass correction no longer gives clear vision, or if glare becomes very noticeable.
Q: What can I expect with cataract surgery?
A: Cataract surgery is the most commonly performed surgery in North America. Your preliminary visit will involve a consultation with the surgeon to assess the severity of the cataract. If you decide to proceed, there are a number of measurements that are then performed and your surgical date booked. Surgery is done on an outpatient basis at a cataract surgical facility used by your ophthalmologist for this purpose. It is usually a painless and relatively quick surgical procedure involving eye drops to numb the eye, followed by extraction of the cloudy lens through a small incision in the front window (cornea) of the eye. Extraction is performed using a small handheld ultrasonic tool that liquefies your cataract and extracts it through a vacuum. This process may also involve use of a laser to help break up the cataract into smaller pieces. Once the old lens is extracted, implantation of a new plastic lens is done using a small syringe containing a foldable lens. The procedure is usually complete in 15 minutes and you are patched up and sent home. You can usually see very well the next day, and are fully healed after a few weeks of eye drops. We will generally see you at the 2 week point to ensure things are healing well, and again a month later to assess your vision and the possible need for glasses.
Q: Should I pay the extra money for the lens implants that Alberta Health does not cover?
A: Since the surgeon can choose the power of your implant to match your distance correction, you may only need glasses for reading and fine detail after surgery. Alberta Health will cover a basic implant to correct any nearsightedness or farsightedness but they do not correct astigmatism. If you have astigmatism, you can get the basic lens, but you may still need glasses after surgery to correct the astigmatism for sharp vision. You can opt to pay extra to get the lens implant designed to correct the astigmatism, giving you a high chance to achieve optimal distance vision. You will still likely need glasses for reading. There are also multifocal lens implants designed to correct both near and far vision. Results are variable on these lenses, and some patients notice a loss of clarity at distance and/or increased glare from the optics of these implants. Glare from these lenses is impossible to fix without another surgery to extract and re-implant new lenses. Some patients are satisfied with the results of these private pay lens implants, but there is no guarantee.
Q: Can cataracts grow back?
A: A full lens cataract cannot grow back after removal. However there are remnant lens cells often left behind after cataract extraction that try to regrow. This causes a clouding of the membrane behind the plastic lens implant, impairing the vision in a way similar to a cataract. For this reason, it is often named a “secondary cataract”. Treatment of this cloudy membrane is very straightforward and does not involve outpatient surgery. It is a 2-minute procedure performed in-office using a microscope mounted YAG laser. This laser is precisely focused on the membrane and fired multiple times to cut a hole. This low risk procedure restores clear vision. There are sometimes remnant floaters for a few days, but these almost always settle out of the vision. Rarely does your eyeglass prescription change, but you must be monitored at our office for possible inflammation or pressure increase in the weeks following the procedure.