The following questions are from actual patients and taken directly from one of many “Live” cataract seminars hosted by The Eye Institute each year.  A calendar of events will be displayed on our website in the Fall as a  guide to when and where you may attend these informative learning events. 

Q: Do you put patients to sleep before this cataract surgery?
A: Typically, you are not completely asleep. You will be sedated, relaxed enough to feel comfortable. We will customize the anesthesia. We essentially tailor it to each person—some people need more, some less, some none at all. If you’re more nervous, we can use more medications.

Q: Do you use injections to numb the eye?
A: We use topical drops, no injections.

Q: What if I have an allergy to certain anesthesia medications?
A: We have a wide variety of anesthetic options.

Q: What if I have allergies or dry eye problems? Will that affect the cataract procedure?
A: You will want to take care of such issues prior to surgery because inflammation will slow the healing process. We can direct you to a specialist who can help you take care of certain issues and then do the cataract surgery.

Q: Will the replacement lens in the eye scratch if I have a dry eye problem?
A: No, the lens is actually inside the eye itself, not on the surface.

Q: I use eye drops, will I have to use them after surgery?
A: If you have to use a lubricating drop before the surgery, you’ll most likely have to use it after as well.

Q: Can I potentially have both a ReSTOR® and a ReZOOM® lens?
A: Yes, each lens has certain properties to it that make it better for certain things, and depending on your lifestyle, sometimes we’ll choose to use one of each type of lens, to give you both the intermediate and the close-range vision, as well as distance vision. It’s very frequent that we’ll use both the ReSTOR and ReZOOM lens, one in each eye.

Q: Do you operate on both eyes at one time?
A: No, we do one eye one day, the other several days or a week later, usually.

Q: Do these replacement lenses last forever or do you have to replace them?
A: All of the lenses we use are made of an acrylic or silicone polymer, so they will last longer than all of us. Not forever, but at some point in the future, when you don’t need those lenses any longer, they’re still going to be there. Lenses don’t have to be switched or replaced.

Q: I only have trouble with my vision close up, like for fine print. I have no problems driving at night or with distance. Is there an implant for that purpose?
A: Absolutely. There are a variety of ways to do that, whether we choose to focus both eyes up close to make you see well, or by using one of the other types of implants. We can tailor the vision we give you for what you want and need for your lifestyle.

Q: Do implants come in different sizes?
A: Yes, implants come in different sizes and different powers. The implant is made specifically for you depending on the measurements of your eyes.

Q: How long does the cataract surgery take?
A: The whole procedure, start to finish, in Dr. Weinstock’s hands, usually takes about 6 minutes.

Q: What if the implant doesn’t unroll properly or is defective?
A: The doctor will be able to see defects. At the time of the procedure, right now, it’s very easy to go in, take that implant back out, and put a perfect one in.

Q: Is one type of implant more difficult to insert than another?
A: They’re all very similar. They’re all made very similarly and they insert similarly. There are different sizes, so some need a larger incision.

Q: How will a corneal scar affect the cataract procedure?
A: From a procedural point of view, it really does not have an effect, but having a cataract taken out won’t solve a vision problem that you’re experiencing from a corneal scar.

Q: Is this cataract procedure called the “no-knife” procedure?
A: No-suture. You have to open up the eye, so technically speaking you have to have something sharp to get in there. There’s no such thing as no-knife.  There has to be some kind of a blade used.

Q: Is this surgery a once-in-a-lifetime deal?
A: Yes.

Q: What can go wrong?
A: Bleeding, infection, swelling of the retina, retinal detachment, there are all sorts of things, a laundry list a mile long from scratchiness in the eye for a couple of days to blindness. There is risk, just as with any surgery, but the risk is extremely low. The risk of going blind is one in 10,000. It’s a very delicate procedure, but in the right hands, with the right experience, doing it repetitively, it becomes very routine.

Q: Who’s at risk?
A: People with high prescriptions, high glasses, history of previous retinal surgery, history of macular degeneration, glaucoma, myopic degeneration, astigmatism…there are so many different eye conditions and all those are very individual, specific situations. That’s why you want to find a doctor that’s going to take into account all of the little nuances of your particular eye and your particular conditions. Dry eye, glaucoma, all these things affect the outcome, all these things affect the surgery, all these things affect what lens is the right lens for the eye. There is no way to determine that in a group, the only way is to meet individually, get a history, figure out what’s going on, then make some intelligent decisions about what to do.

Q: Why do some people have a laser procedure after cataract surgery?
A: The capsule from which the cataract is removed and in which the lens is placed can often get “milky” or hazy after the surgery. Sometimes this happens within 6 weeks of the surgery, sometimes it takes 6 years.  The doctor can see that film and do a quick, approximately 10-second laser procedure in the office that puts a hole in that film so the vision clears up. This is called a YAG laser.

Q: What kind of maintenance is required after cataract surgery? Will I need to use drops?
A: You’ll use drops four times a day for 4 to 6 weeks to prevent any rejection, swelling, inflammation or infection.

Q: What is the likelihood of swelling of the retina?
A: Swelling of the retina happens about 5% of the time, and 95% of the time it goes away if you use the drops as directed.

Q: What if I have keratoconus?  Can I still have cataract surgery?
A: Dr. Weinstock often does surgery on people with keratoconus. The patient will still not have perfect vision because of the irregular shape of their cornea. The cataract procedure does not help to improve the shape of the cornea.

Q: What is the downside of the Crystalens?
A: The surgery is exactly the same, no matter the lens, whether a standard or Crystalens is implanted. The patients that have those lenses that understand the shortcomings of lenses --like those with the ReZOOM and ReSTOR who know they’ll have a little glare and halos at night and that night driving might not be the sharpest, but that they’ll be able to read without glasses during the day, for instance—those patients who understand that and choose that--they love it. The Crystalens patients, as long as they understand their Crystalens may not flex all the way up for fine, fine print and are ok with distance and middle and some light reading vision, they love it.  The unhappy patients are the ones that are expecting a miracle and to never wear glasses again, and its not that perfect. They’re disappointed.  So I do my best to get them out of glasses, I can’t control everything.  But all of these lenses, in the right situation, if chosen properly and if the eye is healthy, and the patient is a good candidate for that lens, they will all lead to an improvement in their quality of life.

Q: Is distance vision with the Crystalens as good as with the ReZOOM?
A:  It’s better. The Crystalens has better distance vision.  It has great distance vision but has the benefit of flexing, to get you some close vision as well. So it’s a step up from the standard lens. The ReZOOM and ReSTOR, because of the bifocal, decreases the quality of distance vision just a little.  So the ReZoom and the ReStore are not good for airplane pilots, its not good for truck drivers, its not good for people that golf and want to see the ball hit the green.  It’s good for people who do a little bit of everything, especially a lot of reading; a little compromise on the distance, but really good reading.

Q: Is Crystalens covered by Medicare?
A: No, the Crystalens is more advanced and not covered by Medicare. The standard lens is covered by Medicare. The Crystalens is considered cosmetic by Medicare because the goal is to try to get you out of glasses, just like LASIK.

Q: How many cataract procedures does Dr. Weinstock perform in a normal year? And how many years has he been doing cataract surgery?
A: Dr. Weinstock performs several thousand cataract procedures a year. He has been performing cataract surgery for about 9 years.

Q: What if I move during the procedure? How do you prevent this?
A: Clamps hold the eye open during the cataract procedure. A piece of tape is placed over your head to prevent movement.

Q: Is there an age factor when it comes to how well the muscles work? (required to flex for the Crystalens)
A: Not that we’ve found yet. It’s kind of like the mouth muscles you use for talking. There might be a little bit of an age factor, but it might be more a function of the use of the muscles.
Question for patient (Jean):

Q: How much are you aware of while he’s operating?
A: Nothing. I saw a bright light. There’s no pain.