Typically, you are not completely asleep. You will be sedated, relaxed enough to feel comfortable. We will customize the anesthesia. We essentially tailor it to each person—some people need more, some less, some none at all. If you’re more nervous, we can use more medications.
We use topical drops, no injections.
We have a wide variety of anesthetic options.
No, the lens is actually inside the eye itself, not on the surface.
If you have to use a lubricating drop before the surgery, you’ll most likely have to use it after as well.
No, we do one eye one day, the other several days or a week later, usually.
All of the lenses we use are made of an acrylic or silicone polymer, so they will last longer than all of us. Not forever, but at some point in the future, when you don’t need those lenses any longer, they’re still going to be there. Lenses don’t have to be switched or replaced.
Yes, implants come in different sizes and different powers. The implant is made specifically for you depending on the measurements of your eyes.
The whole procedure, start to finish, in Dr. Weinstock’s hands, usually takes about 6 minutes.
They’re all very similar. They’re all made very similarly and they insert similarly. There are different sizes, so some need a larger incision.
From a procedural point of view, it really does not have an effect, but having a cataract taken out won’t solve a vision problem that you’re experiencing from a corneal scar.
Bleeding, infection, swelling of the retina, retinal detachment, there are all sorts of things, a laundry list a mile long from scratchiness in the eye for a couple of days to blindness. There is risk, just as with any surgery, but the risk is extremely low. The risk of going blind is one in 10,000. It’s a very delicate procedure, but in the right hands, with the right experience, doing it repetitively, it becomes very routine.
People with high prescriptions, high glasses, history of previous retinal surgery, history of macular degeneration, glaucoma, myopic degeneration, astigmatism…there are so many different eye conditions and all those are very individual, specific situations. That’s why you want to find a doctor that’s going to take into account all of the little nuances of your particular eye and your particular conditions. Dry eye, glaucoma, all these things affect the outcome, all these things affect the surgery, all these things affect what lens is the right lens for the eye. There is no way to determine that in a group, the only way is to meet individually, get a history, figure out what’s going on, then make some intelligent decisions about what to do.
The capsule from which the cataract is removed and in which the lens is placed can often get “milky” or hazy after the surgery. Sometimes this happens within 6 weeks of the surgery, sometimes it takes 6 years. The doctor can see that film and do a quick, approximately 10-second laser procedure in the office that puts a hole in that film so the vision clears up. This is called a YAG laser.
You’ll use drops four times a day for 4 to 6 weeks to prevent any rejection, swelling, inflammation or infection.
Dr. Weinstock often does surgery on people with keratoconus. The patient will still not have perfect vision because of the irregular shape of their cornea. The cataract procedure does not help to improve the shape of the cornea.
The surgery is exactly the same, no matter the lens, whether a standard or Crystalens is implanted. The patients that have those lenses that understand the shortcomings of lenses –like those with the ReZOOM and ReSTOR who know they’ll have a little glare and halos at night and that night driving might not be the sharpest, but that they’ll be able to read without glasses during the day, for instance—those patients who understand that and choose that–they love it. The Crystalens patients, as long as they understand their Crystalens may not flex all the way up for fine, fine print and are ok with distance and middle and some light reading vision, they love it. The unhappy patients are the ones that are expecting a miracle and to never wear glasses again, and its not that perfect. They’re disappointed. So I do my best to get them out of glasses, I can’t control everything. But all of these lenses, in the right situation, if chosen properly and if the eye is healthy, and the patient is a good candidate for that lens, they will all lead to an improvement in their quality of life.
No, the Crystalens is more advanced and not covered by Medicare. The standard lens is covered by Medicare. The Crystalens is considered cosmetic by Medicare because the goal is to try to get you out of glasses, just like LASIK.
How many cataract procedures does Dr. Weinstock perform in a normal year? And how many years has he been doing cataract surgery?
Dr. Weinstock performs several thousand cataract procedures a year. He has been performing cataract surgery for about 9 years.
Is there an age factor when it comes to how well the muscles work? (required to flex for the Crystalens)
Not that we’ve found yet. It’s kind of like the mouth muscles you use for talking. There might be a little bit of an age factor, but it might be more a function of the use of the muscles.