Cataract Surgery in 2023: Questions and Options
By: Roger M. Kaldawy, M.D.
Milford Franklin Eye Center
Cataract surgery is by far the most common surgery performed in the United States. With advanced technology and if you choose an experienced and highly skilled surgeon, modern cataract surgery should be a rather quick outpatient and a minimal risk procedure. If you are considering cataract surgery, your expectations should not only be to improve your vision, reduce glare at night, see more vivid colors and improve your day to day activities, but you should also be given an opportunity to reduce your dependence on glasses or contacts and in many cases eliminate this need. Your expectations should also be to have your surgery by a world-class surgeon close to where you live and not be told to travel hours for testing and surgery. Many choices exist on where to have the surgery and by whom. Here are the specific questions to ask when it’s time to have the surgery:
1. Why are you referring me to this surgeon? Your optometrist may ask you to travel miles and hours away from home to have your surgery with a particular surgeon of their choice. When you have experienced surgeons within minutes from where you live and when those top-notch ethical surgeons with excellent nationwide reputation will perform your surgery in a state-of-the-art surgery center closer to home. Ask your provider why they want you to travel hours and miles away. Unfortunately, if you dig enough, you will find the only reason for this remote referral is financial and business-related interest your provider has with the far-away surgeon. In many of these referrals the referring optometrist and surgeons may also be in violation of the STARK law and anti-kickback statues. Beware referral bias. In our center, we eliminated the middleman. 100% of the surgeries are performed in a state-of-the-art facility in Milford. Very close to home. Your interest comes first.
2. What is my cost? Did you know that when your optometrist refers you to a surgeon who will perform your surgery at a hospital your insurance deductible and co-insurance will be higher at a hospital? If this is happening to you, we are available for a second opinion! All our surgeries are performed at an ambulatory surgery center in Milford with potential cost savings to you.
3. What type of anesthesia am I going to get? With modern cataract surgery, most surgeries should be completed under topical anesthesia. This means that the surgery eye becomes numb with drops. No need for injections or shots around or behind your eye. No shots will reduce the risk of bleeding and serious complications from the shots. Ask about the techniques of the surgeon you are being ask to travel to see. In our center, 100% of the surgeries are performed under topical simple anesthesia.
4. What are the risks? One of the most dreaded risks of cataract surgery is accidental damage to the posterior capsule, which is the back wall of the bag holding your lens. Ask about the complication rate of the surgeon you are being asked to travel to. In our center this rate is close to zero percent.
5. What is the rate of infections in your center? Another potentially devastating risk of cataract surgery is an infection inside the eye called “endophthalmitis”. Ask the complication rate of the surgeon you are being asked to travel to. In our center this rate is close to zero percent.
6. What type of technology is available at your surgery facility? Different centers have different equipment and resources. For instance, Massachusetts has only few centers offering laser-assisted bladeless cataract surgery. This should be an option if you want to reduce dependence on glasses and treat low grades of astigmatism at the same time as your cataract surgery. Our center was among the first in the State and New England to offer this technology. Did you know that many hospitals and other centers do not offer laser-assisted bladeless cataract surgery? We do!
7. What type of implant am I going to get? Different lens implants can be used during cataract surgery with different materials, quality and ability to reduce your need for glasses. Ask your referring provider about his/her surgeon choice of implants. Our center was the first in the greater Boston area to offer the new diffractive and extended-focus implants. With those implants you can see clearly at distance, close and intermediate like your phone and computer screen with little or no dependance on glasses.
8. Will my need to wear glasses be reduced? Cataract surgery is a wonderful opportunity to limit or eliminate your need for glasses. As the surgeon removes the cataract, there is an opportunity to replace the cloudy lens with a special high-tech implant able to achieve this goal. Ask your referring provider about his/her surgeon of choice ability to achieve those goals. Our center has many happy and glasses free patients.
9. Will I have stitches? It is ideal to eliminate the need for stitches such as the surgery is a no-stitch surgery. Placing a stitch can be complicated by stitch induced astigmatism, a foreign body sensation and a broken and irritating stitch. Ask your referring provider if his/her surgeon of choice is still using stitches. 100% of our cataract procedures are stich-free.
10. What will be my vision on day 1 after the surgery? One of the measurements defining quality of outcomes after cataract surgery is the quality of vision on day 1 after the surgery. Surgeons should strive to make the vision correct to as close to best as possible on day 1. Ask your referring provider about his/her surgeon of choice ability to achieve this outcome. Our center has many patients with happy 20/20 vision on day 1 after cataract surgery.
Cataract surgery is all about better precision, more safety and excellent outcomes. At Milford Franklin Eye Center, Dr. Kaldawy is proud to have been the first surgeon in the area and among the first in Massachusetts to offer bladeless laser assisted cataract surgery and the first surgeon in the greater Boston area to implant the PanOptix and Vivity lens implants. We have trained local and out-of-state surgeons on how to perform cataract surgery. We offer bladeless laser cataract surgery. We implant high quality premium lenses, with correction for distance, near and everything in between. Many cases of astigmatism are no longer a problem. Our percentage of posterior capsule complications and infections is one of the lowest in the Nation. No longer need to travel hours for your cataract surgery! We operate in a state-of-the-art surgery center in Milford offering bladeless laser cataract surgery. Our surgery center passed certification and accreditation by the most rigorous State and National accreditation agencies. 100% of the surgeries are performed under topical anesthesia, so only drops, no need for shots and no need for stitches. Brand new gorgeous office in Franklin and 2 other locations in Milford and Millis. Over 30 thousand procedures performed and 7 providers with your interest in mind offering the best cost-efficient surgical care in an ambulatory surgery center closer to home.
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