Pre-Op Surgery Care
Consultation and Examination
During your preoperative examination, Dr. Cavanaugh will conduct a thorough evaluation of your medical history and visual symptoms prior to conducting a complete examination of your eyes. If he recommends cataract surgery, he will then help you decide which IOL implant type and power is right for you and your lifestyle. Intraocular lenses are made out of inert material (acrylic or silicone) and should last indefinitely as they have been safely implanted for over six decades! Dr. Cavanaugh and the staff will then discuss the risks, benefits, complications, and alternatives of surgery. They will all of your questions and do their best to alleviate all of your concerns.
IOLs come in different powers, sizes and configurations. In order to choose the best IOL for your eyes, several measurements are performed. The proper prescription power for your IOL is based on accurate measurements of the curvature of your cornea and the length of the eye from front to back called the axial length. The axial length of the eye has traditionally been determined with an A-Scan (the same type of equipment used in fetal ultrasound-only on a much smaller scale). While we still utilize this technology in certain cases, Cavanaugh Eye Center has invested the most modern device available to further enhance our accuracy. The IOL Master uses laser interferometry to more accurately measure axial length compared to ultrasound. This instrument is precise with micron accuracy because minute differences in the measurement have a substantial impact on the IOL calculation and your surgical outcome. A 0.3 millimeter error in A-scan measurement can equal one diopter of glasses refraction. To put that measurement in context, 0.3-mm is less than the thickness of the letter “I” on this page. Despite the wonderful advances with cataract surgery, we must remember that the main goal of cataract surgery is to clear the cloudy vision. Every effort will be made to reduce or eliminate your need for glasses, however, some patients will still need to use vision correction.
The “iTrace “ is a revolutionary measurement device that uses Ray Tracing technology, Wavefront Aberrometry and Corneal Topography to measure quality of vision and visual function. It is the first of its kind in eye care diagnostics and allows us to separate out the distortions in your vision that are coming from your cornea versus those coming from your lens or elsewhere in the eye. By fully evaluating the unique distortions in your optical system, the iTrace provides a unique analysis that Dr. Cavanaugh uses when planning your surgical procedures. This information is especially helpful in custom selecting the appropriate IOL and vision correction treatment.
Counseling and scheduling for your surgery will occur immediately after your evaluation and recommendation for cataract surgery with Dr. Cavanaugh. Our highly skilled surgical counselors will explain all pertinent aspects of the procedure and answer any questions you may have regarding your upcoming cataract surgery. After scheduling your surgery, our Business Office will contact your insurance company to verify your eligibility and benefits. Based on your benefits we will mail out an estimate of your out-of-pocket costs for your surgery that will be due 5 days prior to services.
Surgery Day Preparation
The morning of surgery, use your eye drops and take all medications (as you would any other day) with small sips of water. If scheduled to arrive BEFORE noon do not eat or drink after midnight. If scheduled to arrive AFTER noon you may have a light meal and 8oz of clear liquid 6 hours prior to arrival time.
**Diabetic diet instructions: AM surgeries DO NOT take insulin and PM surgeries take HALF DOSE of insulin and eat 6 hours prior to arrival time.
Do not wear make-up or jewelry the day of surgery with the exception that rings can be worn. The operating room can be cold so dress comfortably but warm. You may wear your dentures and hearing aids.
Prior to your procedure, designate someone to drive you home and to the post-op visit the following day. You and your driver can anticipate a two-hour stay from your arrival time at the surgery center. You are responsible for getting your prescription eye drops prior to surgery. This has been sent electronically to your pharmacy or you have been given a paper copy.
Bring your post-op kit with eye drops on the day of surgery and to your post-op visit. Bring a list of your systemic medications to the surgery center – the drug name, strength, and how often the medication is taken.
Your Cataract Procedure
Cataract surgery is performed in an outpatient ambulatory surgery center dedicated to ophthalmic surgery with state of the art equipment and well-trained nurses. In most cases, your surgery can be done with topical anesthetic using a numbing gel. For certain patients and more difficult cases, a local block can be done that provides a deeper level of anesthesia. Both are safe and eliminate the risk associated with general anesthesia.
During cataract surgery, Dr. Cavanaugh will make a very small incision either manually or with a laser
at the junction of the white and colored parts of the eye. This incision is so small it seals without sutures in 99% of cases. In addition, you do not need to stop blood thinners for cataract surgery because the small incision is done through the clear cornea where there are no blood vessels. A sophisticated ultrasound vacuum, phacoemulsification, is used to remove the clouded cataract from within its outer clear membrane sac, called the capsule.
An Intraocular Lens Implant (IOL) is inserted into the empty capsule thereby providing a clear focusing pathway for light. This implant is individually calculated to be as accurate as possible to your eye’s prescription by measuring the length of the eye and the corneal curvature. Nearsightedness and farsightedness can be corrected at the same time the cataract is removed which can significantly reduce or sometimes eliminate the need for distance glasses.
Cataract Post-op Care
Cataract Surgery Medication
We will prescribe three types of drops for you to take and you will be provided a drop schedule – click here for a PDF
to see details. You will take an antibiotic drop to prevent infection, a steroid drop to control inflammation and a non-steroidal anti-inflammatory drop. As with most medicines, the newest and most effective drugs are the most expensive. We try to balance cost to our patients with the selection of the best medications.
What to Expect the First Month
- Initial blur like you are looking through a steamy shower door
- Fluctuation vision with progressive clearing over the next few weeks
- Mild “fluttering” in the vision due to early movement of the IOL
- Minor discomfort: dryness, mild ache or scratchiness
- Possible droopy upper eyelid
- Glare, halos or starbursts around lights at night
- You may need over-the-counter reading glasses to sharpen near vision
- Your old glasses may not be right – if necessary, new glasses will be prescribed by your Optometrist or by us at your one month visit
- Wear the plastic shield over the eye during sleep for the first 24 hours
- No rubbing the eye and avoid getting hit or bumped in the eye
- No heavy lifting more than 50 lbs for the first two weeks
- No swimming, scuba diving or hot tubs for two weeks
- Wear protective sunglasses outside
- Driving may be resumed after your one day post operative visit and when you feel confident, safe and the vision meets the State requirements
- You may fly two days after surgery
- You may take a shower the day AFTER surgery but keep your eyes closed. Do not allow water to spray directly onto your face. Avoid soap or shampoo in your eyes for one week.
- Eye cosmetics should not be used for one week
- Patients with the Crystalens or Trulign Crystalens Toric should avoid excessive reading and use +1.00 reading glasses for the first two weeks
- All other normal daily activities may be resumed
Have more questions? See our FAQ section for answers.