Cataract Surgical Techniques

Not all cataracts need to be removed. The decision to operate and extract a cataract is based on several factors. It is inappropriate to assign a particular level of visual acuity (as measured by your ability to read an eye chart) as the only determinate of when to perform cataract surgery. One does not need to wait until the cataract becomes "ripe" to have surgery. Ripeness is an archaic term used in the old days when the surgical risks were significantly higher and ophthalmologists waited until the cataract was very advanced before performing surgery. Patients cannot really be too old for cataract surgery. I believe it is the individual patient’s ability to function normally, coupled with their desire to see better, that determines the ultimate need for cataract surgery.

The Surgical Experience

Smooth Touch Cataract Surgery is the microsurgical technique that I use to remove cataracts. It is an extremely gentle method that can be safely used even on very elderly patients.

I like my surgical patient to receive a preoperative consultation with their personal medical physician. A solid medical work up can usually indicate any temporary contraindications to surgery. Special care is taken for diabetic patients and patients who are on anticoagulants, such as Coumadin or aspirin. (Patients should take all routine medications on the day of surgery unless otherwise instructed by their personal physician.)

The surgery is performed at my specialized ambulatory surgical center. Complimentary limousine transportation is available on the day of surgery; and I encourage a family member to accompany the patient to the surgical center. The actual amount of time spent at the surgical center is between two and a half to three hours. Patients are allowed to have a light breakfast the morning of surgery. Wear loose fitting clothing and do not wear any eye or face make-up.

The facility is ultramodern with state-of-the-art equipment and a highly experienced staff of ophthalmology surgical nurses and technicians. Upon arrival at the center, the patient will be asked a series of questions about their health. A nurse will escort the patient to the operating areas, where an anesthesiologist will interview the patient, start a small intravenous and administer any local anesthetic or sedation that may be required. We use no medications that would disrupt a patient's heart, breathing, or blood pressure. If necessary, patients receive a mild sedative. The patients are carefully monitored during the surgical procedure to make sure that their medical condition remains stable.

A common misconception is that ophthalmologists are currently removing cataracts with lasers. Although this is not true, as new technologies develop, that may change in the future. My present technique utilizes high frequency ultrasonic energy (phacoemulsification) to gently remove the cataract. A soft, foldable artificial lens implant is then inserted into the eye. My normal operating time is between ten and twenty minutes. Following the procedure, the patient will be escorted to the recovery area where they will receive refreshments, post-operative instructions, and an appointment for their first post-operative checkup at my office the following morning.

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