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Cataract and RLE Surgery FAQs

Cataract and Refractive Lens Exchange Surgery FAQs

Below is a list of questions commonly asked by people considering Cataract or Refractive Lens Exchange (RLE) surgery. Click on the question below to link directly to the answer. Use your browser's "Back" button to return to the list of questions. If you are unable to find an answer to your specific question here or elsewhere on the site, please call 800-573-1010 or email us at greatvision@furlongvision.com. We will be happy to respond directly to you.

What Do I Need to Know Before a Cataract or RLE Surgery?

What Can I Expect During the Procedure?

What Can I Expect After Cataract or RLE Surgery?


What Do I Need to Know Before a Cataract or RLE Surgery?

What is a cataract?
A cataract is usually the result of the natural aging process. As you get older, the natural lens, located behind the iris in your eye, may gradually begin to get "cloudy" and interfere with light and images getting to your retina. As the lens becomes cloudier, your vision slowly becomes more blurred. If allowed to remain, the cataract will progress to the point where there will be a complete loss of vision in your eye. Surgery is the only way to remove a cataract.

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How do I know if I am a candidate for Cataract or RLE surgery?
You may be a candidate for RLE surgery if you

  • are over the age of 50 and having difficulty focusing on objects up close.
  • do not qualify for laser vision correction, such as LASIK, because you are either too farsighted or too nearsighted.
  • are tired of wearing bifocals or progressives lenses for both reading and distance vision

You may be a candidate for Cataract surgery if you

  • are noticing decreased night vision, impaired depth perception, and increased color distortion

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How is RLE surgery different than Cataract surgery?
RLE and Cataract surgery are essentially the same procedure. In both instances, the natural lens of your eye is removed through a small incision made in the iris of your eye and replaced by a man-made lens that is designed to remain permanently. The only difference is that RLE is a totally elective procedure done to decrease the need for glasses; removing the cataract in Cataract surgery is done for medical reasons (i.e. adequate vision cannot be achieved with glasses).

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What are the risks with Cataract and RLE surgery?
As with any surgery, there are certain risks. Fortunately, however, the risks of RLE and Cataract surgery are low and patient satisfaction is high. The main risks include infection and retinal detachment.

  • Infection - The risk of infection is very low, affecting only about 1 patient in 3000 procedures. Dr. Furlong will prescribe antibiotic drops for use after surgery and monitor your eyes to ensure that there is no sign of infection.

  • Retinal Detachment is a very rare complication that occurs when the retina becomes detached from its underlying supporting tissue. Retinal detachment is a very rare complication of eye surgery (less than 1%), but is a particular risk for those who are very nearsighted. Even if detachment occurs, it can usually be effectively repaired.

  • More common eye complications - It's possible that some nearsightedness or farsightedness will remain after surgery. This can be taken care of by replacing the artificial lens with one of a different power or by laser vision correction that can fine-tune the result. Increased glare or halos around light at night can also result, although these tend to diminish over time. Twenty percent of patients will develop hazy or cloudy vision over time that requires a further, non-invasive laser procedure to fix.

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What are the side effects?
Side effects are minimal. Most patients experience some temporary blurring for a few days and can also expect increased light sensitivity for a few weeks. Depending upon the lens used, you may experience halos or rings around lights and glare at night. These side effects may make it more difficult to see while driving at night or to complete tasks in a room with low lighting.

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What are the differences between the lenses?
Traditionally, lenses used in Cataract surgery have been monofocal, allowing the user to see well at a single distance. Patients with monofocal lenses usually choose to have their natural lenses replaced with lenses that allow them to see well at distance and wear reading glasses for up close or intermediate work. Recent advancements, however, have resulted in multifocal and Advanced Lifestyle Lenses or accommodating lens implants. Multifocal lenses contain concentric rings that provide focus at different distances. Accommodating lenses bend and steepen as the eye changes focal points. These new style lenses allow the patient to focus at different distances, giving good distance vision, plus improving intermediate or near vision.

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How long have multifocal lens implants been used?
As compared to the monofocal lenses that have been used in Cataract surgery for decades, multifocal lenses are relatively new. Multifocal lenses have been implanted since the mid-1990s with good results.

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Does insurance pay for RLE or Cataract surgery?
RLE surgery is an elective procedure not covered by most insurance companies. It is more expensive than laser vision correction because it must be performed in an ambulatory surgical center. Since Cataract surgery is a medical procedure, insurance companies and Medicare will pay for the surgery and the implantation of a monofocal lens. If you choose a multifocal or Advanced Lifestyle Lens, however, you will have to pay for the additional cost of the lens upgrade.

Your employer's flexible spending or cafeteria plan may offer tax advantages for RLE or Cataract surgery upgrades. We can help you understand your options and what questions to ask your benefits administrator. In addition, Furlong Vision Correction offers several different payment options to help make RLE surgeryand lens upgrade fit your budget.

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Does it treat astigmatism?
Astigmatism is caused by an irregularly shaped cornea and is not affected by replacing the lens. If you are a cataract patient who has astigmatism that is affecting the quality of your vision, you have several treatment options, including a LASIK or PRK procedure 12-24 weeks after RLE Cataract surgery. There are a few intraocular lenses that have been introduced recently to help correct astigmatism, including the Toric Accommodating lens. Additionally, astigmatism can be treated with the Femto laser. This technology is ideally suited to treat patients who have cataracts as well as astigmatism, a non-spherical curvature of the cornea. Astigmatism can be partially managed at the time of surgery using either Laser-Assisted corneal incisions or through the implantation of the Toric intraocular lenses. As this procedure must be precise, the laser is used for the creation of a perfectly round surgical opening, which is critical for the best possible outcome.

Whether using an accommodating intraocular lens to treat astigmatism, or using an multifocal intraocular lens to allow both clear distance and near vision, only Laser-Assisted Cataract surgery can consistently create a perfectly round surgical incision to ensure ideal placement of the lens implant. This specialized surgery's results are improved vision, decreased dependence on eyeglasses, faster recovery and less discomfort.

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What Can I Expect During the Procedure?

How long does it take?
RLE and Cataract surgery takes about 20 minutes.. You'll need to plan to be at the surgery center for approximately 2-3 hours, however, to accommodate the pre-op preparation and post-op recovery period. You will need to arrange to have someone drive you home after the procedure.

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Is the procedure painful?
Patients experience virtually no discomfort during RLE or Cataract surgery. The procedure is performed under a local or topical anesthesia (eye drop to numb the eye), and you are given a sedative intravenously to relax you. Mild discomfort for the first 24 hours is typical. If you experience post-operative discomfort, you may use Tylenol or ibuprofen during the first day or two after the procedure.

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Can both eyes be treated at the same time?
No, only one eye will be treated at a time. The second eye can be treated approximately 1-2 weeks later after the first eye has stabilized.

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What Can I Expect After Cataract or RLE Surgery?

Will I still have to wear glasses?
Whether you will need to wear glasses or contacts after your procedure depends on which type of lens you choose to implant. Patients who choose to implant monofocal lenses will have to wear glasses for either distance or up close work, since monofocal lenses are designed to focus only at one distance. Patients who choose to implant multifocal lenses will have a broader range of vision. According to the clinical trial results for the AcrySof® ReSTOR® multifocal lens, four out of five patients reported never wearing glasses following Cataract surgery in both eyes, compared to only 1 out of 10 patients with monofocal lenses. In the clinical trials for the ReZoom™ Multifocal lens, 92% of those who received the lenses reported wearing glasses either "never" or only "occasionally."

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What precautions do I have to take after surgery?
You will be given a plastic shield to wear immediately after surgery and for the next five nights to protect your eyes while sleeping. For the first month, care should be taken to not touch your eyes for any reason, and patients should avoid getting sweat, dust, or smoke in their eyes. It is also better to avoid swimming for two weeks, but with care, there is usually no problem with showers.

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If my vision is still not corrected, can I have a re-treatment?
As the lens capsule closes around the new lens implant, the focusing range may change requiring a second surgical procedure to adjust or replace the lens. Additionally, laser surgery to improve the focus is also possible.

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Will RLE surgery increase my chances of getting a cataract?
A cataract is the clouding of the natural lens of your eye. Since RLE surgery removes that clear lens and replaces it with an artificial one, you will never get a cataract.

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