As Cataract Awareness Month comes to a close, the physicians and staff at Cornea Associates of Texas want to make certain our current and prospective patients are armed with the knowledge and understanding to make the right decision about cataract surgery.
We’ve discussed in a previous article an experience one of our surgery counselors, Sidney, had when she came across a gentleman who’d had cataract surgery with another practice and had become regretful about the lens choice he had made. Often times, patients hear buzzwords like “premium” and “upgrade” and feel that they are being upsold a lens that don’t necessarily need. This is where communication in the counseling session is key. It is imperative that all of our staff have the knowledge and experience to guide patients through their cataract evaluations and help them make the surgical decision that is right for them.
At Cornea Associates, we have a fully-qualified staff of technicians to perform diagnostic and pre-operative testing for our well-experienced physicians to interpret. These appointments tend to take an hour or more because they are so comprehensive and our physicians understand that surgery (even one as commonplace as cataract surgery) is not to be taken lightly. We compile a host of measurements and testing to ensure that the diagnostic information the surgeon is using to make his recommendations and plans with is thorough, complete, and accurate. As the old adage says; measure twice, cut once!
After our measurements are taken and the patient has had a chance to be fully examined by the doctor and he has made a recommendation to proceed with surgery, the next step is a meeting with one of our coordinators for surgical counseling. It’s at this time that the patient is briefed on what to expect financially and guided through their options and recommendations to make a decision about surgery. These decisions include what one would typically expect (dates, locations, requirements, etc.), but also extend to what type of lens implant the patient elects based on the doctor’s recommendations and the patient’s own expectations and abilities. It is important to note that not every patient qualifies for every lens.
Most simply put, there are three types of lens implants: monofocal (traditional), toric, and multifocal. The monofocal is the most commonly elected and is covered by insurance. As the name suggests, it provides correction for one (mono) focal length, and is typically set at “distance.” Most patients who are near-sighted and/or wear reading glasses for up-close work elect this option because it allows them to see most comfortably at a distance and typically only requires correction for near (reading glasses), which they are already used to. There are other options to consider with the monofocal lens (setting your focal length for near, or setting one eye for near and one for distance to achieve what’s known as “monovision”), but the most common treatment continues to be setting both eyes for distance. On exam, your doctor will make a recommendation as to which option will suit you best.
The toric lens option is for those patients with significant astigmatism (toricity of the cornea). This option is one that the doctor must recommend if he thinks it will be more beneficial than the traditional lens and one that the patient elects because he aims to reduce his dependence on glasses after surgery. This lens is also considered “monofocal” in that it corrects for astigmatism as well as the given refractive error (nearsightedness, etc.). This option would still require the patient to wear reading glasses and may not totally eliminate the need for distance glasses.
The multi-focal lens does exactly what its name suggests; it allows for correction across multiple focal points (distance, intermediate, and near). This option would minimize the patient’s reliance on any type of glasses after surgery. Most recently, a wider number of magnification alternatives have become available to offer more specific correction based on the patient’s preferences and goals. Again, this is where the doctor will make a recommendation as to what power lens to implant based on his discussion with the patient. It’s areas like these, where the choices become varied, and the differences more difficult to understand, that patients can often be confused about the information they’re being presented with. This is why we value patient-staff communication so highly; we know what a daunting experience it can be to be considering surgery on your eyes and consider it a top priority to ensure that our patients are comfortable and well-informed at every step of the operative process.
All this information can be overwhelming, understandably, and this is why it is important to express your needs and wishes along with any concerns throughout your preoperative experience. Letting your technician know what your goals and expectations are during your work up will help her identify what indicators or counter-indications to be aware of, what specifics to bring to the doctor’s attention, and what information to be ready with. Expressing your concerns and preferences to your doctor will help him make a recommendation that will suit your lifestyle. Being honest and vocal with your coordinator will help her counsel you through your options to find one that is the best fit for your needs, your desires, and your budget!
The first step to making any surgical decision is that first evaluation. If you suspect you have cataracts, or that your existing cataracts are worsening, contacting your eye care provider should be your next move. A comprehensive dilated exam as well as pre-operative assessment testing will help you and your doctor decide if cataract surgery is right for you.