While cataract surgery is the most common outpatient surgical procedure and it is generally…read morewell-tolerated, it is not without its risks. Your physician should discuss the nature of the procedure and its risks. While some of the risks may be mitigated by the skill of the physician, some occur irrespective of the surgeon's ability.
I can tell you that as a physician, a little knowledge is a dangerous thing :-) While the procedure is pretty much considered pain free, psychologically, I had a hard time wrapping my head around having someone use a scalpel on my eye!
I wound up seeing (read interviewing) several ophthalmologists prior to finally selecting Dr. Dipaolo. Medicine is founded on both Art and Science. There are some intangible characteristics that in my humble opinion come into play in the selection of a physician, whether it is for Primary Care, a Specialist, or a Surgeon.
Pretty quickly during my visit and initial exam, I knew that Dr. Dipaolo was THE guy to entrust my eyes to. He is very personable, has a great sense of humor, and is attentive to detail. Part of the preparatory process of having cataract surgery is the taking of certain measurements necessary for the selection of the intraocular lens. Unlike other Opthomology offices I had been to where assistants take these measurements, he does them himself....not once....but as many times as he deems necessary to ensure accuracy.
The first cataract surgery simply removed the lens requiring the patient to wear very thick glasses. The first intraocular lens was produced in 1949 by Dr. Ridley. It has evolved substantially since that time.
The most common lens, the one that I selected, has a fixed focal length allowing me to see sharply at a distance but requires that I use reading glasses for reading. Presbyopia occurs in most people in their 40s as it did me. The natural lens loses its elasticity becoming more rigid and its shape can no longer change resulting in the inability to focus on near objects without reading glasses. So, I am ecstatic about being where I was at 40!
Some individuals choose to have mono vision. One eye gets a distant lens ad the other gets once for close up vision. Usually, these patients have had experience with mono vision having had contacts....one for distance in one eye and one for reading in the other. The brain learns to attend to one or the other automatically. For those who want the depth of field and greater clarity of binocular vision or have never done this previously, monocular intraocular lens replacement is not a good idea.
The regular lenses are covered by Medicare. There are also specialty or premium lenses that are not covered by Medicare. They cost an additional amount of money....from $3,500 to $5,500 per eye. Premium lenses come in a couple of ways. There is a multifocal lens that allows a patient to see both distant and near objects without glasses. There is a potential side effect where the patient may see halos which is the reason I elected not to go this route.
A toric lens is another premium lens that may be used for patients with moderate to severe astigmatism who would normally require glasses. It has to be placed very carefully and by its nature, adds a level of complexity over that of a simple monofocal lens. I have very little astigmatism so such a lens was really not necessary for me.
There is also another lens that mimics the ability of our natural lens to utilize the same muscles to change focus. My opinion about this lens having read up on it is that it is probably not particularly effective. There are also complications with this lens where it folds upon itself. When I asked Dr. DiPaolo what he thought about them, he told me that he was not impressed with them.
Some ophthalmologists will push for premium lenses. Dr. DiPaolo is not one of them.
If you require cataract surgery, your physician will prescribe drops for the eye that is being operated on. It is VERY important that you use these drops as directed both prior to and after surgery. One of them is an antibiotic, another is a nonsteroidal anti-inflammatory medication for both pain and inflammation, and the last one is a steroid anti-inflammatory.
Speaking of pain. Prior to the surgery, you will be given eye drops that dilate the pupil as well as a topical anesthetic. The anesthetic will also be instilled during the procedure. Immediately post-op for the first eye, at most I had perhaps a little bit of irritation but no real pain to speak of. For my second eye, I did not have any pain at all.
Remarkably, my eyesight was pretty clear immediately post-op. However, it is not unusual for a patient's vision to be a little blurry at first. This is due to inflammation and subsides over time.
Note: If you are a male who has taken any of these drugs for BPH, please tell Dr Dipaulo: terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral), and silodosin (Rapaflo)