5 TIPS BEFORE CATARACT SURGERY

5 Tips Before Cataract Surgery in Winnipeg

So you are waiting for cataract surgery in Winnipeg.  You have seen your optometrist.  Is there anything you can do to improve the outcome of your surgery?

Here are 5 things you can do to take charge to ensure successful cataract surgery.

1. Know Which eye

I know this seems pretty obvious, but it is surprising how many people are not aware if they have cataract in both eye and if they do, which eye is going to be have surgery first.   Cataracts will often happen at the same time in each eye, but one eye will typically be worse than the other.

Typically, surgeons will choose to do surgery on the worse eye first and then a few weeks later do surgery on the other eye.

Some surgeons will choose to do bilateral treatment, meaning surgery one both eyes at the same visit.

Before you leave your surgeon’s, consult appointment make sure you know if he is doing unilateral or bilateral treatment. AND if it is unilateral, which eye he will be treating first.

2. Treat Your Dry Eye Disease

Dry eye disease can be important factor in cataract surgery.    Almost 20% of people near the age of 65 have dry eye disease and it is much more common in women.

Dry eye disease is a situation where the eyes don’t produce as many tears or they produce a poorer quality tear.    The bottom line is that this chronic dryness causes the cornea to dry and damage the top epithelial cells.  This produces an uneven corneal surface, blurred vision, irritation and other symptoms.

There are 3 ways that dry eye can affect your surgery.

1. Before surgery the surgeon will be doing some precise measurements of the corneal curvature in order to calculate what power of lens implant, they will use. if the corneal epithelial cells are damaged due to dry eye disease it can give poor or inaccurate readings resulting in calculations that may be less reliable.
2. Faster healing. Your eye will have to heal after cataract surgery.   If the corneal cells are already damaged due to dry eye, your eye will be slower to heal than if you have a healthy cornea.
3. Better outcomes: If you have dry eye disease your vision will tend to be blurrier and be more irritated…as a result you will not benefit from your cataract surgery as much as you could.

My recommendation is that you ask your optometrist to evaluate you for dry eye disease and if you have it ask for treatment options.  It is important to do this months before you see the surgeon because sometimes dry eye disease treatment can take months.  Basically, the healthier your eye is going into surgery the faster recovery will be and you will have less complications.

3. Clean your eyes

What is the thing your scares your surgeon the most?   Endophthalmitis.

What is endophthalmitis;  it is an infection that occurs inside the eyeball after surgery.  And it’s scary because it can result in losing your vision.  It is the worst complication in cataract surgery but fortunately it is rare….it affects only about 1 person in 1000.

But there are things you can do to reduce the risk…and the main one is keeping your eyes clean before cataract surgery

There is a really common condition called blepharitis…it is reported that up to 50% of people over 65 have sings of blepharitis.   Blepharitis is a chronic mild bacterial infection of your lids from the normal bacteria that lives on your lids.   Basically there is bacteria that is supposed to be there……

Blepharitis can cause irritation to your eyes and can cause dry eye…remember number 2…but it also puts you at higher risk for endophthalmitis

If you have blepharitis you need to clean your eyes regularly before surgery.

When you are asking your optometrist about dry eye…ask them if you have blepharitis as well and how you can treat it.

4. Know what you want your final vision to be.

Primary goal:  the primary goal of cataract surgery is to get rid of the cloudy lens.

Secondary goal: the secondary goal is a refractive procedure…..so when they replace the lens that need put a different acrylic lens in your eye….and that lens needs to have a power…..but if you wear glasses the surgeon can incorporate your glasses prescription into that lens implant…and thereby attempt to make you whatever prescription you want……

So if you are a -4.00 they could make you -4.00 after surgery or they could make you at -2.00 or -1.   Or +1 or zero prescription.

This is an attempt not a guarantee.

This also doesn’t fix your focusing….so you will need readers

5. Other eye conditions

Most people who develop cataracts do so later in life when they’re likely to have other health problems as well. For that reason, cataract surgeons often find themselves operating on patients with problems such as corneal disease (things like fuchs’ dystrophy or keratoconus, etc), glaucoma, macular degeneration, diabetic retinopathy or uveitis/iritis—among other possible issues. These conditions can complicate cataract surgery in significant ways. Cataract surgery can also be made more complex as a result of previous surgeries such as a vitrectomy, a glaucoma shunt implantation, a trabeculectomy or scleral buckling.   So, make sure that your surgeon knows if you have other eye conditions.

Michael Nelson, OD FAAO

Waverley Eye Care Centre

Winnipeg, MB