You may have heard the term “secondary cataract” or “after-cataract” and begin experiencing cataract symptoms similar to before surgery. Once your natural lens is replaced with an IOL, the new intraocular lens will not develop a cataract like your natural lens. Although it’s not technically a “cataract”, a secondary or after-cataract occurs when the capsule holding the IOL becomes cloudy. This is called posterior capsule opacification (PCO) and can develop months or even years after your cataract surgery.

There is no reason for alarm. PCO is very common and can affect up to 50 percent of post-cataract patients⁹ and can be treated with a simple, painless, in-office procedure using a YAG laser to restore your vision.

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Cataract surgery is very safe. According to the American Society of Cataract and Refractive Surgery (ASCRS), cataract surgery has an overall success rate of more than 98 percent making it one of the most successful surgeries performed today.⁸

Following the care instructions of your surgeon is the best way to ensure a successful surgery with excellent outcomes. Some normal conditions you may experience 1-2 days after cataract surgery include:

• Mild discomfort, soreness or scratchiness
• Mild light sensitivity
• Varying degrees of redness
• Mild blurring of your vision
• Droopy eyelid
• Mild discharge
• Flickering of light or a shadow in the peripheral vision

Complications with cataract surgery are rare but if you experience the following, call our office immediately:

• Bleeding
• Infection
• Inflammation (pain, redness, swelling)
• Loss of vision
• Double Vision
• Change in eye pressure

If you notice your vision returning to how it was before your cataract surgery months or even years later, you may have posterior capsule opacification (PCO). PCO can cause cataract symptoms and is sometimes referred to as a “secondary cataract” or “after-cataract.” PCO occurs when the lens capsule becomes cloudy. Vision can be restored with a simple, painless, in-office YAG laser treatment. (see above, “Can you get cataracts again?”

You will likely experience some of the following conditions the first couple days to one week after surgery

• Mild discomfort, soreness or scratchiness
• Varying degrees of redness
• Mild light sensitivity (light may seem very bright to both eyes)
• Mild blurring of your vision
• Drooping of the eyelid
• Mild discharge (if excessive, call your dr)
• Flickering of light or a shadow in your peripheral vision

Rare but more serious conditions include:

• Sudden or nauseating pain in or around the eye that lasts for several hours and is not relieved by Tylenol or pain that continues to get worse
• A sudden, significant decrease or clouding of vision or loss of sight
• Part of your vision is missing or a curtain or shade comes over your vision with or without pain
• Onset of new flashes of light or floaters

If you experience these symptoms, call our office immediately:

Dr. Parker: 573.335.3577

Dr. Stuckenschneider: 573.686.5579

Dr. Lumsden and Dr. Kinder: 573.334.5265

Cataract surgery with a standard, monofocal IOL is covered by insurance and Medicare and is applicable to your deductible. If you elect to upgrade to a premium IOL (toric, multifocal, extended depth of focus, and accommodating), the additional cost for the lens and surgical fee will be out of pocket.

Please note, the out-of-pocket fees listed below are approximate and may vary depending on the surgery center:

• Toric IOL: $1000 per eye
• Multifocal IOL: $2000 per eye
• Extended Depth of Focus (EDOF) IOL: $2000 per eye
• Accommodating IOL: $1600 per eye

A lifestyle IOL uses advanced technology to help you be less dependent on glasses after surgery. Only standard IOLs are covered by Medicare and commercial insurance. A lifestyle IOL is considered an elective upgrade and will include out-of-pocket costs. If you qualify for a lifestyle IOL, the most up-to-date pricing is included on your elective upgrade consent form which will be reviewed with you by your surgeon’s technician at your pre-operative exam.

Not everyone is a candidate for a premium IOL. Not everyone who is a candidate for a premium IOL, elects to incur the extra out-of-pocket costs associated with the more advanced technology lens. Depending on your prescription and the IOL you choose, you can lessen your dependence on glasses. Your surgeon will help you determine which IOL options best fit your prescription, lifestyle, and budget.

You should call the office immediately if you experience any of the following:

• Sudden or nauseating pain in or around the eye that lasts for several hours and is not relieved by Tylenol or pain that continues to get worse
• A sudden, significant decrease or clouding of vision or loss of sight
• Part of your vision is missing or a curtain or shade comes over your vision with or without pain
• Onset of new flashes of light or floaters
• Bleeding around the eye

If you have any questions or concerns, contact our office:

Dr. Parker: 573.335.3577

Dr. Stuckenschneider: 573.686.5579

Dr. Lumsden and Dr. Kinder: 573.334.5265

Cataracts can cause a loss of contrast in dim lighting, glare, and difficulty seeing at night. Surgery should alleviate these issues if they are due to the cataract. However, nighttime glare and halos around lights are possible with a multifocal IOL.

Although there are great benefits to cataract surgery, it is still a surgical procedure and with all surgical procedures there are risks. In addition, insurance sometimes requires the cataract be at a specified stage to where the cataract symptoms are hindering your activities before it can be removed. The best time to have cataract surgery is when the cataract is interfering with your vision to the point it is affecting your daily activities and lifestyle.

Some facilities perform what is called clear lens extraction. This procedure is essentially cataract surgery without the cataract. When someone is not a candidate for LASIK, they may opt to have their healthy, natural lens replaced by an IOL to make them less dependent on glasses and contacts. The doctors at Eye Care Specialists do not perform clear lens extraction. They do not feel a patient should undergo surgery to remove a perfectly healthy lens.

It is possible to have a cataract and not have any noticeable vision problems. Some common cataract symptoms include:

• Dim vision or faded colors
• Difficulty seeing at night
• Increased glare or halos around lights
• Double vision in one eye
• Light sensitivity
• Not being able to get the right glasses prescription

There are no drops, injections, or medications that treat cataracts. Sometimes updating your contacts or glasses prescription can help your vision but the only true solution to correct a cataract is to replace the clouded lens with an intraocular lens implant. If you do not remove the cataract, your cataract symptoms will worsen as the lens continues to become more cloudy and vision continues to decrease. Eventually changes in prescription will no longer help clear your vision.

Regular eye exams with your optometrist will follow the progression of your cataract. Be sure to communicate any cataract symptoms with your eye doctor, any changes in your vision, and effects these changes have on your daily activities and lifestyle. When changes in your contacts and glasses prescription no longer help, your optometrist will refer you to an ophthalmologist, an eye M.D., for surgery.

The surgeon will conduct a pre-operative exam and detailed measurements, perform the surgery, then you can follow-up with your regular eye doctor for your post-operative care. Eye Care Specialists works closely many optometrists in the tri-state area.

Insurance may also play a factor in when you can have cataract surgery. Medicare and some insurance companies require cataract surgery to be “medically necessary” which they deem as your best corrected vision is 20/40 or worse. This means if you can still get glasses and contacts that allow you to see 20/20, you will have to wait to have the cataract removed.

You can have cataract surgery after LASIK. Be sure to share with your surgeon any information you have from your LASIK procedure.

Dr. Parker provides a “manifest label” for your medical records after LASIK. This label shows what your prescription and measurements were prior to LASIK which can be helpful to your surgeon when choosing your IOL.

Occasionally the IOL implanted during your cataract surgery may not clear your vision as well as anticipated. In this instance, it is possible to perform LASIK to make minor adjustments to your vision after cataract surgery.

If you have an astigmatism, you could possibly qualify for a toric lifestyle lens to corrects your astigmatism. This IOL would allow you to be less dependent on your distance glasses after surgery but you may still need reading glasses. Toric IOLs are considered an elective upgrade and incur out-of-pocket fees as these lenses are not covered by insurance and Medicare.

If you are having cataract symptoms and would like to be evaluated for cataracts, you do not need a referral from your regular eye doctor. Eye Care Specialists has a large referral network of optometrists we work closely with so you will have the option to follow-up with an optometrist or see your surgeon for your post-operative care following surgery.

Simply call the doctor or location you prefer to schedule a consultation:

• Shawn Parker, MD, FACS
• Cape Girardeau, Mo. and Marion, Ill. • 800-455-3937
• Brad Stuckenschneider, MD, FACS
• Poplar Bluff, Mo. • 573-686-5579
• Todd Lumsden, DO, FAOCO
• Cape Girardeau, Mo., Perryville, Mo., Carbondale, Ill., and Marion, Ill. • 800-333-1568
• John Kinder, MD, FACS
• Cape Girardeau, Mo. and Dexter, Mo. • 800-333-1568

It is possible to have cataract surgery if you have glaucoma. Your doctor will advise you on your options and provide instructions for your glaucoma medications before and after surgery.