When should I have surgery?
The treatment of cataracts is always surgical and although we know that protection from ultraviolet rays and a balanced diet can slow their advance, will not prevent its occurrence, much less improving vision.
The time to raise the surgery is based on two facts: (1) Loss of vision, when we have difficulty performing our normal life, especially driving. (2) Occurrence of complications such as increased intraocular pressure, counseling anticipate the surgery but still we have an effective vision.
Is it necessary a special preparation prior to surgery?
Modern cataract surgery does not require exceptional measures. We recommend a prior examination in cases other diseases such as hypertension, diabetes or cancer treatments; is preferable to avoid the phases of decompensation.
What type of anesthesia?
Currently we can completely avoid pain and anxiety. By a sedation, controlled by an expert anesthesiologist in this type of surgery, we can reduce the risk to almost zero and avoid the inconvenience of injections into the orbit or the eyelids.
Ultrasound remains the great ally in cataract surgery but it is true that the appearance of the laser is a revolution. We cannot yet say that the laser has replaced the ultrasound, but it does offer some important advantages. Personally I use the laser in complicated cases or cases that must implant a multifocal lens or a toric lens to correct astigmatism.
What type of intraocular lens (IOL)?
Although no full consensus, it is true that the multifocal IOLs offer a very good vision at all distances, far, intermediate and near. We can correct previous graduation (myopic, hyperopic), even astigmatic, and thereby eliminate the need for glasses after surgery. The surgeon must decide whether can be implemented.
Do both eyes on the same day or on different days?
We know that the visual and functional recovery of patients is faster and perform better when both eyes at the same time (bilateral surgery). There are still taboos against this practice (risk of infections and errors in the calculation of IOLs) but, all published studies show that doing things right, there are no more risk than surgery on separate days.
Where should operate?
The choice of center and the surgeon is critical and requires assessing the following criteria:
♦ A center with the best technology to detect risk factors and to establish the best surgical strategy in each case: the need for laser, possibility of bilateral surgery, possibility of implanting a multifocal IOL, and accurate calculation of IOL power.
♦ A surgical center that allows for micro-incision surgery that has modern ultrasound and facolaser technologies and to ensure patient comfort, aseptic conditions and sterility and to have a team of anesthesia for sedation techniques that avoid pain and anxiety to patients.
♦ A surgeon with proven experience, which dominates modern surgical techniques, to know what each patient needs and be able to resolve the possible complications after surgery. A good surgeon is one who can resolve exceptional situations and nobody knows before surgery whether it will be an exception.
How much recovery time?
If we have used a micro-incision technique, no sutures, and all went well, the recovery is very fast, no need eye occlusion and the same day it´s possible watch TV or read a newspaper (if a multifocal IOL was implanted). It is considered that after 1 week of surgery can be done relatively normal lives and need 2 or 3 weeks to swim or play sports.
GOLDEN RULE: Your vision should look fine on who you trust.