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Cataract Surgery

Cataract Surgery in Raleigh, NC

Have you been told you have a cataract? Want to know more about your treatment options? The experienced cataract surgeons at Raleigh Ophthalmology have performed thousands of cataract surgeries and are excited to help you achieve better vision!

At your initial consult, you will meet with your cataract surgeon, who will assess your cataracts’ severity and discuss how your vision affects your quality of life and your daily activities. This will help your surgeon determine if you are a candidate for cataract surgery and how they can customize the procedure to meet your specific needs.

At Raleigh Ophthalmology, we are excited to offer the latest, state-of-the-art treatment options to our patients. Your cataract surgeon will discuss with you the type of technology and lens implant options that might best suit your needs.

What Are The Symptoms Of Cataracts?

Cataracts occur when the lens of the eye becomes cloudy. When cataracts cloud vision, it may feel like you are looking through a fogged-up window.

It can become difficult to read or drive a car, especially at night. Other cataract symptoms can include double vision, eye pain, sudden headaches, flashes of light, seeing halos, or having a strong sensitivity to light.

Objects may look blurry or hazy. The most common cause of cataracts is aging.

Vision changes start occurring around the age of 40. By the age of 60, it is common for people to have cloudy lenses due to proteins in the lens of the eye breaking down.

Cataracts can grow larger over time, and if they remain untreated, they will block more and more light that enters the eye, causing vision loss and possibly blindness. However, cataract surgery is a common and safe procedure that is quite effective in restoring vision.

The experienced eye physicians at Raleigh Ophthalmology can remove your cataracts and replace them with fully functional artificial lenses, known as intraocular lenses. It is vital to schedule an eye exam with a qualified eye doctor who can diagnose your cataracts and talk to you about your treatment options.

Diagram of vision with and without cataracts

What Is Cataract Surgery?

Cataract surgery is a procedure that removes the clouded natural lens and replaces it with an intraocular lens or IOL. Before you can have cataract surgery, you will need to undergo a cataract screening with one of the experienced ophthalmologists at Raleigh Ophthalmology.

Part of the screening will determine how nearsighted, farsighted, or how much astigmatism you have before cataract surgery. This will help determine what kind of intraocular lens you’ll get to replace your natural lens.

Your eye doctor will also take measurements of your eyes to determine the length and curvature of the eye and identify any risk factors before surgery. While cataract surgery is generally safe, your eye doctor will want to ensure that conditions such as diabetes, high blood pressure, or heart disease are under control before you have the procedure.

Be sure to tell your ophthalmologist about any medications you are taking, particularly anti-clotting drugs or aspirin.

Cataract surgery typically lasts around 20 to 30 minutes and is done under a topical or local anesthetic. You will need someone to drive you home after the procedure.

Be prepared to come in the next day for a follow-up visit so your eye doctor can check on how your eye has started healing. After surgery, your doctor will ask you to wear an eye patch while your eye heals.

You’ll also receive prescription eye drops to use during healing to prevent infection and reduce inflammation. For patients who need cataract surgery on both eyes, the procedure won’t be done on both eyes simultaneously. Instead, your eye doctor will operate on one eye first, which is usually the eye you are having the most difficulty seeing out of. Once the first eye has healed (after about two or three months), you’ll then have cataract surgery on the second eye.

Depending on the IOL chosen, you may still need to wear glasses after you have cataract surgery, but you’ll be able to see clearly!


Is Cataract Surgery Necessary?

Cataracts do not go away on their own. Though you may manage them at first using stronger light and glasses, these are only temporary fixes.

Eventually, your vision will become impaired and interfere with your everyday activities. Cataracts are the leading cause of blindness and visual impairment in the world. Fortunately, cataract surgery is a safe and effective method of restoring vision.

Intraocular Lens Clayton, NC

Your eye doctor will help you decide what intraocular lens is right for you. They will take your lifestyle and visual needs into account when helping you make this choice.

For example, an ophthalmologist may ask if you spend much time working at your computer or looking at digital devices. If so, your lifestyle may be more reliant on near vision, and you may want to consider getting a monofocal IOL for near vision and use glasses for tasks that require distance vision.

IOLs are safe and will restore your vision after cataract surgery. While certain IOLs reduce the need for glasses or contact lenses, results vary from person to person. Some lenses correct for near vision, some for far vision, and others for both.

Once an intraocular lens (IOL) is implanted in your eye to replace your cloudy lens, it becomes a permanent part of your eye, and you do not feel it.

What Are The Different Types Of Intraocular Lenses That Are Available?

A monofocal lens is the most common kind of intraocular lens. It will correct vision at one distance, either for near vision or far vision.

Often, people who use monofocal IOLs get them for distance vision and use reading glasses for up-close tasks. Medicare and other vision insurance plans cover Monofocal IOLs.

Multifocal lenses can correct both far and near vision, and some can even correct intermediate vision. Multifocal lenses are considered premium lenses and are not usually covered by most insurance plans.

However, our surgery schedulers can talk to you about your payment options and work with you to get the lens that best suits your needs.

Patients with astigmatism may do best with a toric lens that eliminates their cataract and reduces their astigmatism since toric lenses have extra correction built-in for astigmatism. Ask your eye doctor whether they recommend limbic relaxing incisions (LRIs) to help reduce astigmatism.

LRIs are strategically-placed corneal incisions that reduce or eliminate astigmatism by “relaxing” the corneal curvature and leaving it a rounder shape. This can help patients see more clearly after cataract surgery and may reduce or eliminate the need for glasses when looking at things at a distance. This procedure can be done at the time of your cataract surgery or during a separate procedure.

What Is The Difference Between Laser-Assisted Cataract Surgery And Traditional Cataract Surgery?

The experienced physicians at Raleigh Ophthalmology offer laser-assisted cataract surgery using the LenSx laser. This is a computer-controlled eye surgery system that uses a Femtosecond laser.

Laser-assisted cataract surgery is a personalized, bladeless procedure that uses a laser to create incisions in the cornea, and then the laser breaks up the cataract. This contrasts with traditional cataract surgery, which uses a blade to make corneal incisions to remove the cataract.

The LenSx system uses a 3D surgical display system that measures the shape of the surface and the thickness of the cornea. This allows the surgeon to make the most precise incisions possible since LenSx offers real-time images to guide the surgeon.

Because the LenSx procedure allows for laser precision, it may contribute to better surgical outcomes for patients. The femtosecond laser may also be able to manage astigmatism during cataract surgery better.

Patients may find that they have improved vision and less need to wear glasses after having laser-assisted cataract surgery with the LenSx system.

Patients often report a smoother recovery after undergoing laser-assisted cataract surgery, as compared to traditional cataract surgery. Whether you have laser-assisted cataract surgery or traditional cataract surgery, the recovery time is about three months.

What Are The Advantages Of Laser-Assisted Cataract Surgery Vs. Traditional Cataract Surgery?

When having cataract surgery at Raleigh Ophthalmology, you may wonder if there are advantages between laser-assisted cataract surgery and traditional cataract surgery. For patients that opt to have laser-assisted cataract surgery, benefits include:

Precision

The LenSx system automates some of the most crucial steps of the procedure. This leaves your surgeon free to focus on other parts of the surgery.

Control

With LenSx, surgeons have real-time images in front of them, which guides them and ensures that the IOL is perfectly placed every time.

Less Ultrasound Energy Used While Removing Cataracts

Because there’s less ultrasound energy used while removing the cataract, this can protect delicate structures of the eye, like the cornea.

Better Astigmatism Management

Compared to traditional cataract surgery, laser-assisted cataract surgery using the LenSx system leads to better astigmatism management for patients, meaning more optimal visual results and less dependence on glasses after cataract surgery.

Are you wondering if you may need to have cataract surgery? Schedule your cataract screening at Raleigh Ophthalmology in Raleigh, NC, today!

Cataract FAQ

What is a cataract?
A cataract is a cloudiness of the eye’s natural lens, which lies between the front and back areas of the eye, directly behind the pupil. Cataracts can develop from normal aging, from an eye injury, or if you have taken medications known as steroids. If the cataract changes vision so much that it interferes with you daily life, the cataract may need to be removed. Surgery is the only way to remove a cataract. If you decide not to have cataract surgery, your vision loss from the cataract will continue to worsen.
How is a cataract removed?
A small incision is made in the front surface of the eye with a scalpel or a laser. A circular hole is then cut in the front of the thin membrane (anterior capsule) that encloses the eye’s natural lens. Typically, the lens is then broken into smaller pieces with a laser or an ultrasonic device so it can be more easily removed from the eye. Once the entire lens is removed, it is replaced with a clear implant called an intraocular lens (IOL) to restore visual clarity. In most cases, the eye heals quickly after surgery without stitches. Today, several steps in cataract surgery can be performed with a computer-controlled laser instead of hand-held instruments.
Is cataract surgery an in-patient procedure?
No, cataract surgery is an out-patient procedure. The actual procedure takes 15 to 20 minutes. Please be prepared to be at your surgical facility for 3-4 hours in total on the day of surgery (depending on surgical facility). Hospital/ASC staff will ensure full recovery from anesthesia prior to your departure.
Am I asleep for the surgery?
For cataract surgery, your ophthalmologist or the anesthesiologist/nurse anesthetist will numb the operative eye with either topical anesthetic drops or an injection of local anesthesia.  The patient will also undergo light intravenous (IV) sedation, similar to a “twilight state” where the patient is relaxed and “sleepy” but will be able to follow simple directions by the doctor and is responsive.  Under certain circumstances, the surgeon may recommend using general sedation and would discuss this option with you during the evaluation
Do I need to bring a driver?
Yes. The surgery centers mandate the patient brings a driver; the patient should not drive for 24 hours after surgery. Your driver should plan to stay with you at the surgery center from arrival to departure.
Will my eye hurt?
Most people have no pain and very little light sensitivity. Patients have noted some mild discomfort, often describing it as “scratchy feeling.” Raleigh Ophthalmology physicians do not prescribe pain medication after surgery since most patients don’t experience any major discomfort. The discomfort is normally gone the morning following surgery.
How soon will I see better?
Color contrast and clarity are noticeably better the morning after surgery. If you don’t have much residual astigmatism, the vision is usually significantly improved by the next day. Factors that might make your recovery slower include glaucoma, high farsightedness, corneal conditions, etc., and will be discussed with you before your surgery scheduling is finalized.
What are the limitations after surgery?
  • Do not drive on the day of your cataract surgery or for 24 hours following surgery.
  • No heavy lifting, bending, stooping or straining for one week.
  • Wear a protective eye shield on the operated eye while sleeping for 1 week after surgery.
  • Restrict physical exercise (running, golf, tennis, extreme workouts) for 1 week following surgery; no swimming or hot tub use for 2 weeks.
Does my insurance cover cataract surgery?
Generally, yes. Your Raleigh Ophthalmology surgery coordinator will inform you of your benefit coverage on the day of your evaluation, so you will know of any out-of-pocket expenses. Medicare covers the hospital portion and 80% of the allowable fee for the surgeon; other plans will be verified, and we will provide you with an out-of-pocket fee estimate. The new technology lens implants have extra costs NOT covered by insurance; these will be thoroughly discussed, if they are appropriate options for you.
What is bladeless laser-assisted cataract surgery?
Many steps of cataract surgery were traditionally performed using handheld instruments. Now, your surgeon can use a laser and 3D imaging to create exceptionally accurate incisions, as well as create the circular opening for accessing and removing the cataract. Once the opening is created, the laser then softens and breaks up the hard cataract into tiny pieces, allowing for gentler, easier cataract removal with significantly less ultrasound energy than is used in traditional cataract surgery. Additionally, laser-assisted surgery can offer another option for astigmatism correction, as recommended by your doctor.
Am I a candidate for laser-assisted cataract surgery?
Some cataract patients are candidates for laser-assisted cataract surgery. Your doctor will examine your eyes and discuss your options in more detail during your cataract evaluation appointment.
Will I still need to wear glasses after cataract surgery?
With cataract surgery, you can choose from several types of replacement intraocular lenses. Options such as monovision, toric, or multifocal intraocular lenses are available for reducing or eliminating your dependence on eyeglasses. Your surgeon will also discuss these options during your examination.
What about changing my eyeglasses?
We often advise patients to have their optician remove the prescription lens from their current glasses on the operated eye. Your optometrist or your surgeon will give you a new glasses prescription, if needed, about three – four weeks after surgery. If you are having surgery on the second eye (usually two – four weeks later), we advise that you wait until after the second surgery to update your glasses prescription, as needed.
Will cataract surgery improve my night vision?
Yes – almost always, depending on the health of your eyes.  Cataract surgery will improve your night vision for driving, walking and any other activities in low light. One of the first symptoms of cataracts is a loss of contrast sensitivity, which is most apparent in dim lighting. As the cataract worsens, additional visual symptoms that affect night vision — most notably, glare, starbursts and halos around lights — become more problematic. Removing your cataract and replacing it with a crystal-clear intraocular lens (IOL) will typically result in a dramatic improvement in the clarity and quality of your vision; this is especially true for activities like driving at night.
If minor refractive errors remain after cataract surgery, you may be able to sharpen your night vision even more by wearing prescription eyeglasses. If you wear eyeglasses for driving at night, be sure to have anti-reflective coating applied to the lenses for the clearest, most comfortable vision possible.
Can cataract surgery correct astigmatism?
Astigmatism is caused by an irregularly shaped cornea; instead of being round like a basketball, the cornea is shaped like a football. This change in shape can make your vision blurry. One way to correct astigmatism is to replace the natural lens with a premium intraocular lens (IOL) called a Toric. A Toric IOL works much like contact lenses for astigmatism and can reduce your need for glasses after surgery. TORIC IOL’s can correct for moderate to high amounts of astigmatism.

To help correct mild to moderate astigmatism, the surgeon may discuss corneal lateral relaxing incisions (LRI’s) to help correct your astigmatism. An LRI is a small cut or incision the ophthalmologist makes into your cornea to make its shape rounder. More than one incision may be required.

Can I have cataract surgery if I have glaucoma?
Yes, it is possible to have cataract surgery if you have glaucoma. In some cases, cataract surgery can lower eye pressure, reduce the number of medications needed to manage your glaucoma, or possibly eliminate the need for glaucoma medication altogether.
Also, it may be possible for your cataract surgeon to perform a minimally invasive type of glaucoma surgery at the same time your cataract procedure is performed to address both conditions at once.
Extra caution is needed to monitor the intraocular eye pressure (IOP) of individuals with glaucoma who undergo cataract surgery. IOP may be elevated in the hours after cataract surgery for any patient. For this reason, it is essential for glaucoma patients to closely follow post-operative instructions provided by their cataract surgeon, regarding use of glaucoma medications before and after the cataract surgery and to attend all scheduled post-op appointments. Additional follow-up visits may be needed for glaucoma patients after cataract surgery to more closely monitor eye pressure and adjust medications as needed.