Frequently Asked Questions About Cataract Surgery

January 04, 2021

How can I prepare for my cataract evaluation?

  • A pre-registration link will be emailed and or texted to you prior to your appointment. Please take a few minutes to complete this prior to the day of your office evaluation.  This will help make your appointment as efficient as possible.
  • Watch our video that discusses the basics of cataract surgery and the options for lens implants.
  • If you wear contact lenses, please do not wear them for a few days before your office appointment (if you wear hard gas permeable contact lens, ideally you should not wear them for a month before your appointment).
  • If you have dry eyes, please use artificial tears the week prior to your office evaluation as it makes our diagnostic equipment more accurate.

When do I know my cataract is ready for surgery?

Cataract surgery is typically recommended when you can’t function well due to your natural lens becoming cloudy.  Common descriptions by patients are “everything is blurry”, “glare is really bothering me at night”, “I can’t read the ticker on the TV”, “I can’t drive at night anymore”, “I need to be right up to the road sign to see it”, “I just got new glasses but I still can’t see well”.

When does the surgery take place?

On the day you come to the office for a cataract evaluation, if you and your surgeon decide to proceed with cataract surgery, you will meet with a Kremer surgical coordinator to schedule surgery.  Each surgeon operates on specific days of the week.

Does cataract surgery hurt?

It is rare to have pain during cataract surgery.  For most patients, what bothers them most during cataract surgery is the numbing medicine.  The numbing drops sting and burn for a few seconds.

Will I see what’s happening during the surgery? 

Most patients are nervous about seeing instruments.  Luckily, you can’t see instruments during the surgery.  To perform cataract surgery, your surgeon looks through an operating microscope.  The microscope’s light is so bright that you can’t tell what’s going on around you.

Will I be asleep during my procedure?

You will not be under general anesthesia for your surgery.  You are given what is called “MAC” anesthesia.  This will make you relaxed, but you are still breathing on your own.  Some people do fall asleep because they are so relaxed.

Why one eye at a time?

At Kremer, if both eyes need cataract surgery, we typically perform each surgery 2 weeks apart.  One reason for waiting 2 weeks is to ensure you don’t develop an infection after surgery.  Infections after cataract surgery are very rare but can be severe.  We also operate one eye at a time to maximize the accuracy of our results, which translates to a patient as trying to achieve the sharpest vision possible for you.  The results of cataract surgery are very accurate to our intended vision goal about 80-90% of the time.  This means 10-20% of properly done cataract surgery does not achieve as sharp vision as desired.  If a patient’s vision is not as sharp as we hope after the 1st cataract surgery, we can make an adjustment to the focusing strength of the lens implant for the 2nd eye’s cataract surgery to try and get sharper vision for you.  Lastly, some patients may not need the 2nd eye done after the 1st surgery is completed.  If you feel after the 1st surgery that your daily activities are no longer impacted by your vision, you can hold off on the 2nd surgery.

Why does the 2nd surgery seem different?

Almost every patient says, “I don’t remember any of this from last time” at the 2nd eye’s cataract surgery.  While the surgery is the same, patients think it seems different.  The reason for this is that the anesthesia medicines that a patient receives for cataract surgery are designed to relax you, but also have an amnesia effect, which causes most patients to forget the details of the 1st surgery.

How much does it cost?

Our billing department will contact your insurance carrier for authorization prior to your surgery. You will be responsible for any deductibles, coinsurance, and or copays. Also, some options with cataract surgery such as upgraded lens implants and laser-assisted surgery are not covered by insurance and would be an additional out of pocket cost if you choose one of those options. Kremer Eye Center offers 0% interest payment programs for out-of-pocket costs.

Will cataract surgery help my floaters?

No, cataract surgery does not treat floaters. In fact, your floaters may become more noticeable following cataract surgery as you may have a clearer view of them.

Will cataract surgery help my dry eye?

No.  In fact, dry eye can get worse after cataract surgery.  The worsening of dry eye is typically temporary, but can take months to improve.  If you know that you have dry eye, please use artificial tears prior to surgery and in the weeks following surgery to try to avoid worsening of dry eye.  Make sure to wash your hands prior to instilling eye drops and wait at least 5 minutes between different eye drops so that each has a chance to work.

Can I keep using warm compresses?

If you typically use warm compresses on your eyelids as part of treatment for your dry eye, please temporarily stop using compresses after cataract surgery.  To minimize your chance of infection, you should touch the area around your eye as little as possible after surgery.  You can continue to use artificial tears to lubricate the surface of your eye.

What are my restrictions after cataract surgery? 

You want to avoid heavy lifting and strenuous activity the first week after surgery.  Avoid eye rubbing.  If you take care of young children, please do not let them touch your face to decrease the chance of infection.

When can I resume normal activities?

Most people can return to basic activities like watching TV and reading by the next day. Cooking is okay as long as you are not carrying heavy pots.  You can vacuum, but don’t carry the vacuum up and down stairs.  Walking for exercise or a stationary bike is okay.  If you chose a lens implant that reduces astigmatism, avoid bobbing head movements that could happen when using an elliptical machine.  Bending while gardening is okay, but don’t struggle to pull out a stubborn weed or pick up heavy bags of soil or mulch.  You should avoid heavy lifting or strenuous activities like tennis, bowling, pushups, squats, sit-ups, and driving a golf ball for 1 week.  Avoid swimming for 2 weeks after surgery.

Why do I have to avoid water from getting into my eye at first?

To minimize your chance of infection, we don’t want the bacteria on your skin getting pulled onto your eye.  When you shower, try to avoid having the water stream over your face.  You can use a washcloth to clean your face.

When can I go back to work?

Most people take off work the day of surgery and the following day.  If your job requires heavy strenuous lifting, consider taking off a week from work unless you can modify your responsibilities so that you don’t have to do strenuous lifting while at work.

When can I drive?

When you can drive after cataract surgery depends upon if your eye heals quickly or slowly, which is hard to predict.  It also depends upon if you have any other eye conditions affecting your vision and the clarity of the fellow eye.  You will not be able to drive the day of surgery due to receiving anesthesia medications.  While this answer is vague due to the factors discussed, most people can drive 1-3 days after surgery.

When can I wear makeup?

Please do not wear makeup to the surgical center. You should refrain from wearing makeup for the 1st week after surgery.

Why do I have to wear an eye shield after surgery?

You will be given a hard plastic protective eye shield after your surgery. To avoid rubbing your eye inadvertently, you should wear the protective shield over the operative eye when sleeping for the week following surgery. The edges of the shield should rest on your forehead and cheek, not putting pressure on your eye. The shield is taped in place with medical tape, which most drug stores sell.  If you have sensitive skin, consider using paper tape.

Can I eat and take my medication the morning of surgery?

Do not eat or drink the morning of surgery. However, please take essential medicines (blood pressure medications, anti-seizure medications, COPD medications, Parkinson’s medications, thyroid medications, etc.) with a sip of water.

What type of clothes should I wear for cataract surgery?

Different surgical centers have different requirements. Some require you to change into a hospital gown, others do not. We recommend you wear comfortable, loose fitting clothes in case you are asked to get changed into a hospital gown.

What should I do with my hearing aids?

Please wear your hearing aids to the surgical center as you will need to communicate with the nurses and staff.  Typically, the hearing aid on the surgical side is removed for the actual surgery, but can remain on the non-surgical side.

Do I need to stop a blood thinner?

No, you can remain on a blood thinner for cataract surgery.  The exception is if your surgeon is also going to do a Trab, Tube shunt, or Xen surgery at the same time as your cataract surgery.  If you are not sure, please ask your surgeon.  Your primary medical doctor should be made aware of any changes to your daily medications.

What should I do for glasses after only 1 eye is fixed?

This is always a great question as almost every patient’s need for glasses changes after cataract surgery.  However, the answer is not always straight forward as it depends upon how strong a pair of glasses you originally needed.  If you have a weak glasses prescription, sometimes popping the lens out of the frame on the side that had cataract surgery is best.  If you have a strong prescription, popping a lens out can make things worse.  Some people decide not to wear their glasses if they see better without them after surgery.  Sometimes the best option is to temporarily wear a contact lens on the eye that has not yet had cataract surgery.  However, the contact lens should be removed a few days before surgery so that your risk of infection is not increased.

Tell me about the lens implant.

The implant is a synthetic lens designed to provide focusing for your vision.  It is made of either an acrylic plastic or silicone material and is constructed to be a life-long implant.  The lens implant is designed to be placed in the eye’s capsule, which has no nerve fibers, making it so that you cannot feel the implant.  However, when the implant is new to your eye, about 10% of people get undesired visual symptoms such as flickering or seeing a dark crescent from the edge of the implant.  Over time, these undesired visual symptoms tend to lessen as your brain adjusts to the lens implant.

Can cataracts come back?

Once a cataract is removed, it does not come back.  However, about 30% of patients will develop an opacity or cloudy spots on the capsule that holds the lens implant.  This can happen months to years after cataract surgery and can be cleared with a quick laser procedure called a YAG capsulotomy.  If you end up needing a YAG capsulotomy, it is covered by medical insurance.

What are the major risks of cataract surgery?

While very rare, severe complications from cataract surgery can occur even when it is properly performed:

  • Infection. The risk of infection is about 0.1%.  Infections after cataract surgery typically occur in the week after surgery and its main symptoms are pain, redness, and decreased vision.  Should any of these symptoms develop after cataract surgery, seek medical care immediately as the sooner an infection is treated, the better the prognosis.  To minimize your chance of infection, please wash your hands often and avoid touching the skin around your eye.
  • Retinal detachment. The risk of a retinal detachment is about 0.03%.  People who are near-sighted are at greater risk.  Symptoms are typically a lot of flashes and floaters initially and then a curtain being pulled across your vision.  If a retinal detachment occurs, you need to be promptly evaluated by a retina specialist.
  • Retinal swelling. The risk of retinal edema is about 1%.  Typically, it develops weeks after surgery and causes blurry vision.  Those at greatest risk are diabetics, people with prior eye inflammation, prior retinal problems, and individuals who do not use their postop eye drops properly.  This is treated with anti-inflammatory eye drops or an injection of medication.

What % of patients are happy they had cataract surgery?

About 95%.

What is my vision like after cataract surgery?

Everyone’s eyes heal at a different pace.  Typically, the day of surgery has fluctuations between blurry and clear vision.  Starting the next morning, the vision tends to gradually improve.  Most of the improvement occurs in the week following surgery but can continue to improve for up to 6 weeks.

What happens if I blink during the surgery?

After instilling a numbing eye drop, an eyelid device is placed that prevents blinking during cataract surgery.

I’m nervous for surgery.

If you are nervous about having cataract surgery, you are not alone.  Many people are apprehensive about having surgery on their eye.  However, millions of people each year undergo cataract surgery and the surgeons at Kremer Eye Center are very experienced.  After going through cataract surgery, most patients say it was easier than anticipated, likely due to the fact that a patient can’t see what’s happening during the surgery.  In addition, the relaxing medicine you are given also makes the experience more tolerable.

What can I expect the day of surgery?

You will receive a phone call the day before surgery with your arrival time.  Do not eat or drink the morning of surgery (the exception is taking essential medications with a sip of water).  When you check in at the surgical center, you will need a valid photo ID and your medical insurance card.  If the surgical center calls you in advance to fill out your medical information online, please complete this.  In the pre-op area, you will meet with the nurses and the anesthesiologist.  Multiple people will ask you which eye is having surgery and which surgery you are having.  You will then be taken to the operating room where you will receive numbing eye drops, sterilizing eye drops, and relaxing medication.  When your surgeon performs your surgery, you will not see what is really happening; most patients notice interesting colors and lights from the operating microscope.  When the surgery is complete you are taken to the recovery room before a family member or friend drives you home.  Often after surgery your vision is blurry and starts to improve the next day.

Eye drop routine

Most patients are prescribed antibiotic and anti-inflammatory eye drops.  The drops are typically started a few days prior to surgery and a Kremer surgical coordinator explains how to use the drops as it changes each week after surgery.  Your initial prescription typically has refills so when you need another bottle, please contact your pharmacy.  If your surgery is approaching and you do not have your drops yet, please contact either your pharmacy or your surgical coordinator so that you can start your drops prior to surgery as requested.

Before placing a drop, please wash your hands and place 1 drop onto your eye at a time.  If you have never used eye drops before, there is a learning curve and you may want to practice with artificial tears.  After the eye drop is placed, either keep your eyes open for a few seconds or gently closed, but do not blink rapidly as that would push the drop out, not allowing it to work.  If you use multiple eye drops, please wait at least 5 minutes between different bottles so that each has a chance to work.

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