Cataract Surgery

Evaluation for cataract surgery:

Cataract surgery is an operation to remove your eye's natural lens when it is cloudy. The purpose of the lens is to bend(refract) light rays that enter the eye to help you see. Your own lens should be clear, but with a cataract, it is cloudy. Having a cataract can look like looking through a foggy or dusty car windshield. Things become blurry, hazy, or less colorful.

The only way to remove a cataract is with surgery. At Berkeley Heights Eye Group, Dr.ToddO. Leventhal, M.D. will evaluate the eye to determine whether surgery is appropriate. If the cataract interferes with daily activities, Dr. Leventhal will recommend proceeding with surgery.

Preparing for cataract surgery:

During cataract surgery, the cloudy part of your natural lens is removed and replaced with a clear artificial lens. That lens is called an intraocular lens (IOL). Dr. Leventhal will talk to you about lOLs and how they work.

Dr.Leventhal will measure your eye to determine the proper focusing power for your IOL. Also, you will be asked about any medications you take. You might be asked not to take some of these medicines before surgery.

You will be prescribed eye drop medications to start before surgery. These medicines help prevent infection and reduce swelling before and after surgery.

You will need to get a preoperative clearance for cataract surgery. Our surgical coordinator will work with you to help obtaining medical clearance from your primary care doctor.

The day of surgery:

Dr. Leventhal will ask you to refrain from eating solid foods at least six hours from surgery. Cataract removal surgery with Dr. Leventhal will be done at Surgicare in Watchung, New Jersey. The following procedures will be performed:

1. Your eye will be numbed with topical drops. A board-certified anesthesiologist will monitor you and provide sedation as needed.

2. Dr. Leventhal will look through a special microscope. He will create tiny incisions (cuts, created by blade or laser) near the edge of the cornea. He uses these incisions to reach the lens in your eye. Using very small instruments, he will break up the lens with the cataract to remove it. He will then put a new lens into place.

3. Usually, Dr. Leventhal will not need to stitch the incisions closed. These “self-sealing” incisions will close by themselves within 24 hours. A shield will be placed over your eye to protect it over the first night. This shield will be removed the day following surgery.

4. You will need to rest in a recovery area for about 15-20 minutes. Then you will be ready to go home.

Recovery from cataract surgery:

1. You will continue eye drops during the post-operative period. Be sure to follow the doctor's directions for using these drops.

2. Avoid getting soap or water directly in the eye for the first two days following surgery.

3. Do not rub or press on your eye. Most patients will not have any physical restrictions following surgery.

4. You will have post-operative appointments one day and three days following surgery. At that point, Dr. Leventhal will go over the drop regimen and advise you when it is safe to resume exercise, drive or do any activities.

Risks of cataract surgery:

• Infection
• Pieces of the natural lens remaining in the eye. This requires additional surgery to remove.
• Ongoing swelling
• Swelling of the retina (the nerve layer at the back of the eye)
• Detached retina (when the retina lifts up from the back of the eye). This requires additional surgery to repair.
• Damage to other parts of the eye
• Pain that does not improve with over-the-counter medicine.
• Blurred vision
• Seeing halos, glare, and dark shadows
• Vision loss
• The IOL implant may become dislocated, moving out of position
• This list is not meant to be all inclusive

Cataract surgery will not restore vision lost from other eye conditions, such as macular degeneration, glaucoma, or diabetic retinopathy.

During your initial cataract consultation, Dr. Leventhal will discuss the risks and benefits of cataract surgery.

Posterior Capsular Opacification:

It is not unusual for vision to become blurry weeks, months, or years after cataract surgery. This could be referred to as “posterior capsular opacification (or PCO).” It's also called “secondary cataract.” If you develop cloudy vision following cataract surgery, Dr. Leventhal might suggest a laser procedure. The laser creates an opening in the cloudy capsule and is called a posterior capsulotomy (or a YAG laser capsulotomy).

This procedure helps restore clear vision.

Cataract surgery costs:

Cataract surgery costs are covered by Medicare if you are Medicare eligible. Private insurance usually covers cataract surgery as well. Payment will be subject to applicable deductibles and coinsurance requirements of each particular plan.

Medicare will cover your costs if your vision tests at a certain level of acuity or clarity. Private insurance plans may have similar vision requirements. If your surgery is covered you may still have some costs. There is also a separate facility fee through Surgicare or Overlook Hospital. Also, special types of IOLs will cost more. Choosing to have cataract surgery before your vision has deteriorated will cost more.

If you don't have private insurance, our office will work with you to reduce and manage the cost of cataract surgery. Additionally, many employers offer flexible spending accounts that can help.