Robert Cykiert, M.D. - New York City's Premier Cataract Surgeon
What Dr. Cykiert wants you to know before having surgery
What is my best corrected vision?
Before having cataract surgery, make sure that you have the best eyeglass (or contact lenses) prescription. I have seen many patients who complained about blurry vision and were told to have cataract surgery. In many cases, I was able to update their eyeglass or contact lens prescriptions and significantly improve their vision without needing cataract surgery. If you're not sure that you have the best glasses (or contact lenses) get a second opinion before having cataract surgery.
How is the cataract affecting my life?
Before having surgery, consider whether you're having vision problems. If you have been diagnosed with a cataract and have been told to have surgery, but don't have any vision problems, and are functioning well visually, get a second opinion before having cataract surgery.
What's the harm of having cataract surgery?
Modern cataract surgery is highly successful and the recovery of vision is rapid after surgery. Most patients can resume their normal activities within a few days after surgery. However, in about 2% of cases there can be serious complications which may result in need for additional surgeries, permanent partial loss of vision, and extremely rarely total, permanent loss of vision or even loss of the eye. If you haven't been told of the risks of cataract surgery, get a second opinion before having surgery.
Are my dry eyes causing my blurry vision?
Many patients with cataracts also have a dry eye condition. Dry eyes can often cause significant blurry vision which may cause cataracts to appear more significant than they are. Occasionally, dry eyes may prevent full recovery of vision after cataract surgery. I have seen many patients that were scheduled for cataract surgery elsewhere and had untreated or inadequately treated dry eye. In many cases I was able to treat their dry eye condition and improve their vision enough to avoid cataract surgery. I have also seen patients who have had cataract surgery elsewhere with poor results due to untreated postoperative dry eye condition. After treating their dry eye, their vision improved significantly. If you have a dry eye condition that has not been adequately treated, get a second opinion before having cataract surgery.
Are my corneas causing reduced vision that is blamed on my cataract?
Many patients who are scheduled for cataract surgery, have cornea problems as well, and the cornea problems are causing most of the decreased vision. If the cornea problem is significant, then cataract surgery alone may not significantly improve your vision after cataract surgery. Things such as corneal scarring, irregular corneal astigmatism, keratoconus, corneal dystrophies of the epithelium or endothelium can all cause vision problems after cataract surgery. I have seen many patients who have cornea problems associated with cataracts. Therefore, make sure to ask about your corneas if you're about to have cataract surgery. If you have a cornea problem, it's best to get a second opinion before having cataract surgery.
Is glaucoma causing my decreased vision?
Many patients who have significant cataracts also have glaucoma, or elevated intraocular pressure, because the incidence of glaucoma increases with age, as does the incidence of cataracts. I have seen many patients whose glaucoma has not been diagnosed or not treated adequately, and who are scheduled for cataract surgery. This can result in poor results from cataract surgery and possible worsening of glaucoma and loss of vision. If you have glaucoma or are a glaucoma suspect, and you're scheduled for cataract surgery, consider a possible second opinion about the cataract surgery if things don't seem right.
Is a retina problem causing my reduced vision?
Many patients with significant cataracts also have simultaneous retina problems such as macular degeneration, because both of these conditions are found in the same age group. I have seen many patients who are scheduled for cataract surgery whose retinal abnormality has not been diagnosed and treated. These patients would have poor results from cataract surgery, and sometimes the cataract surgery may worsen the retina problem. These patients need diagnosis (and management) of their retina problem before having cataract surgery. This can be done with sophisticated retinal testing such as OCT (Optical Coherence Tomography). If you have retina problem, or your mild-moderate cataract is not consistent with your severe reduction of vision, consider a second opinion before having cataract surgery.
Do I have an unusual cataract that increases the risk of surgery?
Some types of cataracts have a significant increased risk of complications during and after surgery. For example, eyes with pseudoexfoliation have risks above and beyond the usual cataract surgery in eyes without this condition. I have seen many patients who were not told they have pseudoexfoliation prior to cataract surgery, and unfortunately had serious complications from their cataract surgery. If you have pseudoexfoliation or other unusual eye or cataract conditions, consider a second opinion before having cataract surgery.
Are medications increasing the risks of cataract surgery complications?
Some patients are on medications such as Flomax (tamsulosin) or other alpha-blocker drugs which significantly increase the risk of cataract surgery. I have seen many patients on these medications who were not told in advance of the increased risks associated with these drugs. If you're on Flomax or similar medications (for prostate or urination problems), consider a second opinion before having cataract surgery.