How Do I Decide Whether To Have Surgery?
Most people have plenty of time to decide about cataract surgery. Your doctor cannot make your decision for you, but talking with your doctor can help you decide.
Tell your doctor how your cataract affects your vision and your life. If any of the statements below apply to you, share them with your doctor.
- I need to drive, but there is too much glare from the sun or headlights.
- I do not see well enough to do my best at work.
- I do not see well enough to do the things I need to do at home.
- I do not see well enough to do things I like to do (for example, read, watch TV, sew, hike, play cards, go out with friends).
- I am afraid I will bump into something or fall.
- Because of my cataract, I am not as independent as I would like to be.
- My glasses do not help me see well enough.
- My eyesight bothers me a lot.
You may also have other specific problems that you want to discuss with your ophthalmologist.
What Should I Know About Surgery?
Your doctor will discuss the options with you before choosing the best kind of cataract removal and lens replacement for you. He or she will also explain how to prepare for surgery and how to take care of yourself after it is over.
At Eye Center of Central Georgia, our surgeons perform small- incision, no-stitch cataract surgery. The outpatient procedure is performed onsite in our Ambulatory Surgery Center, where we specialize in ophthalmic surgical procedures. You will need a friend or family member to take you home, and to drive you back the next day for your post-operative appointment.
It takes several weeks for an eye to heal after cataract surgery. Your ophthalmologist should check your progress and make sure you have the care you need until your eye recovers fully.
Removing the Lens
There are three types of surgery to remove a cataract:
- Extracapsular surgery: The eye surgeon removes the lens through a slightly larger incision than in phacoemulsification, leaving behind the back half of the capsule.
- Phacoemulsification (Pronouned FAY-co-ee-mul-sih-fih-CAY-shun): In this type of surgery, the surgeon softens the lens with sound waves and removes it through a needle. The back half of the lens capsule is left behind. The incision is very small and allows for rapid healing. This is the most common way we use to remove cataracts.
- Intracapsular surgery: The surgeon removes the entire lens, including the capsule. This method is rarely used.
- Replacing the Lens: A person who has cataract surgery usually gets an artificial lens at the same time. A plastic disc, called an intraocular lens, is placed in the lens capsule inside the eye. Other choices are contact lenses and cataract glasses. Your doctor will help you to decide which choice is best for you.
Can a Cataract Return?
A cataract cannot return because all or part of the lens has been removed. However, in about half of all people who have extracapsular surgery or phacoemulsification, the lens capsule becomes cloudy. This cloudiness of the lens capsule, if it occurs, usually develops a year or more after surgery. It causes the same vision problems as a cataract does.
The treatment for this condition is a procedure called YAG capsulotomy. The doctor uses a laser (light) beam to make a tiny hole in the capsule to let light pass. This surgery is painless and does not require a hospital stay.
Most people see better after YAG capsulotomy, but, as with cataract surgery, complications can occur. Your doctor will discuss the risks with you. YAG capsulotomies should not be performed as a preventative measure.
Is Cataract Surgery Right for Me?
Most people who have a cataract recover from surgery with no problems and improved vision. In fact, serious complications are not common with modern cataract surgery. More than 95 percent of patients with otherwise healthy eyes see better after cataract surgery. But no surgery is risk-free. Although serious complications are not common, when they occur they could result in loss of vision.
You will be able to make the right decision for yourself if you know the facts. Ask your doctor to explain anything you do not understand. There is no such thing as a "dumb" question when it comes to your health.
Here are some questions you might ask:
- Do I need surgery right away?
- If not, how long can I wait?
- What are my personal risks?
- What benefits can I expect?
- If I choose surgery, which type is best for me?
- Which lens replacement is best for me?
- What are the chances of developing cloudiness in the lens capsule after cataract surgery?
- What are the benefits and risks of YAG capsulotomy?
You may wish to write down other questions to ask your doctor to help you make an informed decision about treatment.