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Eye and Vision Care

Cataract Surgery - How Quickly Changing....

06/15/2010

Question:

I am a healthy 65 Y.O.W.M. Both my eyes are about -13. Although my vision is clear, driving at night seems a little darker/dimmer than prior yrs. I was astonished when my Doc decided to do a cataract exam and more surprised when he said I had a medium level of cataracts in both eyes. He said with my "bad" eyes, he would recommend just correcting my eyes to near 20/20 with the implant (i.e., rather than using the multi-focus lens). Two questions: 1) He said that the lens he will use will get me very close to 20/20 but that the lenses come like shoes (only so many sizes available, not my specific Rx. Why is that and is it likely to change in a year or two whereby you can get your EXACT Rx with the implanted lens, or is that way off? 2) Are all offices using pretty much the same procedures; in other words do larger offices have better, more up-to-date eqpt than the smaller office practitioner? Thanks a lot for any light you can shed on this! Btw, how many days after the procedure can I bend over to do gardening work. Tx again!

Answer:

Since I am not an eye surgeon, I do not feel completely qualified to answer your specific questions.

But as an optometrist who has over 35 years of co-managing cataract patients with ophthalmologists, I can tell you that very few patients have perfect vision after cataract surgery. This is because of variations in surgical techniques, unwanted residual refractive errors like astigmatism, changes in pupil size in light and dark environments, and the fact that your eye may heal differently than another patient's. Having said all of this, most patients (over 95%) do achieve close to 20/20 after their cataract surgery and are happy with the results.

With your -13 lens power, you have a lot of myopia (nearsightedness) that needs to be compensated for with an intraocular lens (IOL). If your cataract surgery leaves you with a small amount of uncorrected refractive error (either "plus" or "minus"), glasses may need to be worn when you need very sharp acuity (ie, night driving). Also, if your eye surgeon does not implant a multi-focal IOL or suggests monovision (one eye corrected for distance, the other for near), you will need to have reading glasses for good near vision.

As far as large vs small practices are concerned, the type of setting in which a doctor practices is not as predictive of success as is the number of procedures he/she has performed successfully. Generally speaking, in all surgical disciplines, a busy surgeon is better than one who only does a few cases.

Finally, if your eye heals well without any complications, you should be back in the garden within two days of your operation. 

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Response by:

Robert D Newcomb, OD, MPH, FAAO Robert D Newcomb, OD, MPH, FAAO
Professor Emeritus of Clinical Optometry
College of Optometry
The Ohio State University