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Cataract Surgery: Is It Something to Fear?

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Cataract Surgery Is Scary To Some People

Is Cataract Surgery Something To Fear?

As much as we'd like to avoid it, we all face the possibility of some type of injury or medically necessary reason that could lead us to becoming candidates for surgery.

If you're anything like me, the idea of having ANY surgery can send shivers up and down your spine. Finding a skilled surgeon and one whom you trust and feel comfortable with is the key. I had arthroscopy for a knee injury several years ago and, although I was nervous, everything came out fine. I credit a great doctor and good two-way communication with him for getting me through it.

Now I'm facing a very different kind of procedure. I've been diagnosed with a cataract in my right eye and, if it continues to progress, I'll need to have cataract surgery. My first thought was could I have prevented this? Not likely.

There are many factors that can contribute to the development of a cataract, but that's not what this article is about. I've looked online for information about cataract surgery and there's a lot of statistics and procedural information available, but it didn't satisfy me or calm my fears. I decided to find out for myself. I called the vision center where I've been a patient for several years and was referred to an outstanding cataract surgeon, Dr. R. Wayne Bowman, M.D., of the University of Texas Southwestern Medical Center at Dallas, Texas. According to the Trusted LASIK Surgeons website, Dr. Bowman is considered to be "among the the top 1% of LASIK laser eye surgery, refractive, and cataract surgeons in the United States." A reading of Dr. Bowman's extensive list of credentials and qualifications have put me at ease and he was kind enough to agree to an interview with me.

Question 1: How to Find a Good Cataract Surgeon

Dr. Bowman - How long have you been performing Cataract Surgery and what is your best advice for finding a good surgeon?

I have been doing this for over 25 years. I think the best way to find a good surgeon is to go on the advice of friends and family. Lacking good advice there, one's internist can usually help.

In my opinion, I would, in general, avoid the people who advertise as they rely on this to bring in patients, rather than referral from other patients. I am against medical advertisement as it requires the doctor to do more cases to cover the cost of advertisement, creating a never- ending cycle.

When all else fails, one can contact a local medical school or county medical society. One has to be careful as the patient's problem is decreased vision which can come from a variety of causes and the cataract can be a red herring. A change in glasses, treatment of dry eye, or undiagnosed retinal disease may be the actual cause of the vision problem, rather than the cataract. One needs to make sure the doctor approach is not to operate first and diagnose later. Lastly, occasionally optometrists will have referral relationships with ophthalmologists.

Question 2: Could I Have Prevented This?

Is a cataract just an older person's disease and is there something I could have done in my earlier years to have prevented getting one?

A cataract is the clouding of the natural crystalline lens and there are numerous types and numerous causes. It can occur from birth throughout one's lifetime, so not just an older person's disease, but its incidence does increase with age.

Prevention is controversial. UV protection with sunglasses and antioxidants may help. Smoking clearly increases risk. Medications, such as steroids both orally and topically, can contribute to cataracts. Ocular trauma is also a risk factor, as is being highly near-sighted. Utimately though, most cases are genetic.

Question 3: Does Cataract Surgery Hurt?

Do I have to be awake during the procedure? I can't even go through the air puff test at my eye doctor easily!

Removing a cataract is surgery so there is a potential for pain as we must make an incision into the eye to remove the lens, but most people are amazed we can do it without pain.

There are a variety of ways of numbing the eye. I do most cases under Managed Anesthesia Care or MAC where we put the patient asleep with an IV medication and do an injection of local anesthetic around the eye. I think this offers the best combination of safety and comfort.

One can do the surgery under just topical anesthetic. High volume surgeons tend to do topical as turnover is faster and it costs the center less, but many surgeons genuinely prefer this method.

There is also a general anesthetic, but this carries the greatest risk to the patient and there is more post-op pain since no local anesthetic is used.

Usually, one just feels cold from the drops we put on the eye to keep the eye moist. Under the topical (anesthetic), there is a feeling of pressure.

At the end of surgery, I still inject antibiotics around the eye to decrease the risk of infection. In topical cases, this can't be done without severe pain so generally isn't, and one has to rely on topical antibiotics.

No one likes the air puff (test) and the IV can give you liquid courage.

Question 4: How Long Does It Normally Take?

How is the eye propped open and kept moist? Who is present in the procedure room and can a patient communicate to the surgeon if they're starting to feel uncomfortable?

We use a speculum to hold the eye open (i.e. think of two paperclips) and, as I mentioned, moisture drops are applied to the surface of the eye every few seconds to keep it moist. In our case there will be, at a minimum, the surgeon, the scrub nurse, the circulating nurse, and the anesthesiologist. Also, there may be a postgraduate fellow and a resident, but this varies.

The surgery generally takes around 10-15 minutes. Since most people are awake they can talk during the surgery and I frequently involve them in the conversation. I would be concerned if someone wasn't nervous before surgery. It would indicate they don't understand that, although it is one of the safest operations ever done, there is risk.

Question 5: Can I Take Anything Pre-Op to Relax?

What can a patient do to relax before the surgery?

We really don't want anyone to take any medication before surgery as this could impair their ability to cooperate and lie still, as well as legally sign the operative consent.

Wait until you are there, then it can be handled if needed. Remember the adrenaline with anxiety helps concentration and focus. Afterwards, we usually put a patch and shield over the eye after surgery until the next day when it won't be needed.

Question 6: After Your Cataract Surgery

Will the patient immediately be able to see better? What symptoms might a patient have post-surgery that he or she needs to let the physican know about?

Generally, people see much better, if not the next day, within a week. Another issue is the type of implant used. There are conventional monofocal, toric that correct astigmatism, and accomodating or multifocal. The type used depends on the person's eye, how they want to see, and their budget.

We give people a written sheet post-operatively, but pain, decreasing vision, flashes, floaters, a curtain or veil in the vision are the major points of concern.

A huge thank you to Dr. R. Wayne Bowman, M.D. for his valuable insight into this life-changing surgery

Important!

Important To Remember

Feeling better? Personally, I feel a lot better about the whole thing. Hopefully, you'll feel better about it too. Remember, communication is vital with your physician. Internet research of medical procedures is helpful, but should never replace the two-way communication you need to have with your own physician. Don't ever feel bad about asking questions. Find out what you need to know and then you, too, can be better informed about what to expect during cataract surgery.

Your Cataract Surgery Experience

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You and Your Eye Care Provider Can Work Together To Help Protect Your Sight

It's been said that the "Eyes are the Windows to the Soul." Your sense of sight is precious. Take care of your eyes. Regular eye exams are important to maintaining eye health. When you need surgery, whether it's for cataracts or you're interested in the LASIK procedure because you're tired of wearing glasses, explore all your options with a qualified and trusted ophthalmologist.
How can you be sure LASIK is right for you?
by UTSWNews | video info

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To sign up for a free vision correction surgery seminar and find out more about cataract procedures, contact the Laser Center for Vision Care at UT Southwestern Medical Center at 888-663-2020. You can also visit the website at: laservision@utsouthwestern.edu

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  • Reply
    Mark Z. Jun 22, 2011 @ 11:08 pm | delete
    Many people are indeed fearful of something they don't have any knowledge of. Especially when it comes to invasive procedures like a surgery. This lens should convince enough those who are scared of a surgery.

    laser eye surgery long island
  • Reply
    TeamSTM Jun 14, 2011 @ 8:40 am | delete
    Fear of the "Unknown" is always a little uneasy, after taking to a Doctor or someone who has been through this already does aften help. I like the way you have presented the information within this Lens!! :)
  • Reply
    nightcats Apr 1, 2011 @ 5:49 pm | delete
    I have recently had cataract surgery so this topic is near and dear to me. I am pleased to report that the procedures were a success and vision in both eyes is as good as it was before the cataracts developed.
  • Reply
    WinWriter Apr 4, 2011 @ 9:06 am | delete
    I'm so happy to hear it!
  • Reply
    WinWriter Nov 10, 2010 @ 5:02 pm | delete
    Glad you liked my lens. I was hoping it would be helpful to everyone. I just recently had to have my drivers license renewed and I was nervous. Fortunately, I passed. Looks like my cataract surgery will be next year.
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WinWriter

Welcome! I'm a former television reporter who used to live in wonderful Lafayette, Louisiana. I love researching and writing about various topics incl... more »

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