Keys to Quality Cataract Surgery

We encourage you to use this list when discussing cataract surgery with your optometrist or ophthalmologist.

Cataract Surgery Checklist

1. A Skilled Surgical Team

Choose a surgeon you trust, especially when it comes to experience. An experienced surgeon typically performs more than ten cataract surgeries per week. In addition, their entire team should be made of highly trained ophthalmic professionals. Have they authored books and research papers? Do they lecture on cataract surgery? Do they receive referrals from other surgeons? Have they done surgery on other eye surgeons? Researching your surgeon on the web should easily answer these questions.

2. Comprehensive Education Program

Your surgeon should fully explain what cataracts are, how they affect your vision, and what all of your options are. Get educated on these options so you can make the best one for your life.

3. Commitment to Delivering the World’s Best Technology

This can be hard for a patient to evaluate, but it is critical. The most important thing is that the surgeon is comfortable with all state of the art technology that goes into cataract surgery. This includes the femtosecond laser, wavefront analysis, intraoperative aberrometry, and topography, and a variety of lens types that go in the eye. These technologies will help to determine which lens is best for your eye.

4. Tear Film Analysis

A healthy tear film contributes to crisp vision. An unhealthy tear film contributes to blurry vision. If this important layer is unhealthy, it can be treated to maximize vision after cataract surgery.

5. Advanced Retinal Analysis with OCT

For the best vision results after cataract surgery, the retina needs to be healthy. OCT provides a highly magnified view of important retina structures to maximize the health assessment of the retina.

6. Advanced Corneal Analysis

The cornea provides about 70% of the focusing power of the eye because of its curvature. This curvature needs to be smooth for sharp vision; if it’s irregular, it can lead to irregular vision. Your surgeon should use technology like the Nidek OPDIII Topography, Pentacam or other topographers to measure corneal curvature and thickness, and then qualify their relationship.

7. Corneal Endothelial Analysis

The corneal endothelium is the layer on the backside of the cornea; microscopically, it looks like a honeycomb. This layer is constantly pumping water out of your cornea to keep it clear for crisp vision. If corneal thickness is increased, analyzing this layer determines if thickness is the cause of blurring alone or in combination with a cataract. Your surgeon should have the ability to perform this test.

8. Pupil Size Measurements for Implant Customization

Pupil size can vary from patient to patient, and certain implants are better for pupils of certain sizes. By measuring in dim and bright light, your surgeon can recommend the best implant for your pupils and occupational lighting situation. It is important to also know your glasses refraction in bright and dim light, so we understand if your night vision issues are related to cataracts or you need a different pair of nighttime glasses.

9. Angle Imaging Capability

Fluid in the eye drains in the angle created where the cornea and the iris meet. If necessary, this angle can be imaged to see if you are at risk for a serious condition called angle closure glaucoma, which can be caused by a thick cataract.

10. Lens Analysis

The HD Analyzer and the iTrace are are sophisticated technologies that perform density measurements of your natural lens where cataracts form. This is especially helpful when cataracts appear mild but vision is frustrating. Increased lens density or light scatter can help assess how much the cataract is affecting your vision.

11. Wavefront Analysis

Wavefront technology helps measure the optical properties of an eye to determine whether or not a cataract is the source of blurry vision. If this technology finds optical irregularities, there’s an increased chance that a cataract is the cause of irregular vision.

12. Topical Anesthesia

Advanced cataract surgeons typically only use numbing eye drops to avoid complications associated with numbing by needle. It also provides the fastest recovery. However, anesthesia professionals should be on hand to provide relaxation medication (usually orally) and often there is no need to start an IV.

13. Advanced Lens Power Confirmation Methods

In the past, surgeons couldn’t measure if an implant put in during surgery had the proper power until the next day. ORA with Verifye is a revolutionary new technology that allows the surgeon to measure the optical power of the eye during surgery to maximize accuracy of the procedure.

14. Advanced Cataract Removal Techniques

A cataract is removed through a small opening and is replaced by a clear, synthetic lens. Your surgeon should offer both a traditional approach that is fully covered by insurance and a refractive cataract surgery approach giving you and your surgeon more options and less dependence on glasses after the procedure.

15. Advanced Lens Calculation Methods

Optical biometry (like the LenStar or IOLMaster) accurately measures the length of the eye, the curvature of the cornea and the distance between the cornea and the lens to help calculate the best implant power for your eye. For cataracts that are very dense, immersion A-scan capabilities serve as a very accurate double check of important implant measurements. Your surgeon should have access to both technologies.

16. Small Incision, No Stitch Surgery

Most advanced cataract surgery is performed through an incision smaller than 3.0mm, and stitches are rarely necessary. These small, self-healing incisions maximize safety, minimize healing time and create less astigmatism.

17. Intraocular Lens Implant Options

This may be the most important one. Some surgeons use only one or two lens implant options. However, new premium lenses can be customized to lessen your dependence on glasses, correct high levels of astigmatism or even eliminate glasses altogether. Choose a surgeon who can help you weigh all lens options, including traditional implants, aspheric implants, toric implants, multifocal implants and accommodating implants.

18. Laser Vision Correction Capabilities + A Refractive Mindset

After cataract surgery, sometimes the eye needs laser vision correction adjustments. Your cataract surgeon should have a refractive mindset, taking into account the entire visual picture instead of just removing the cataract and putting a lens in place. In addition, your surgery center should offer laser vision correction technology including femtosecond flap creation, and advanced laser technology to reshape the cornea using either the VISX Customlaser technology or the WaveLight excimer laser technology. Some centers have both laser platforms, and this is ideal.

19. A Convenient Timeline

Patients can become anxious waiting for an upcoming surgery. Choose a surgeon with a system that allows you to have surgery within a month so you can get on with life.

20. Tracked Outcomes

Surgeons who carefully track their outcomes can confidently inform patients of the results, continually refine techniques and critically evaluate new technologies. Tools such as proprietary tracking software allow surgeon to carefully track outcomes and provides ideal alignment of lens at the time of surgery.