Cataract surgery corrects vision loss caused by cataracts in the eye. This common procedure is performed by medically licensed eye surgeons or ophthalmologists.

At a minimum, ophthalmologists must have a medical license issued by the state in which they practice. In addition, they may hold credentials from organizations such as the American Board of Ophthalmology, though such credentials are not required.

When considering a doctor for cataract surgery, be sure to find someone who is experienced with implanting the type of lens you need. Some doctors have less experience with newer specialty lenses.

In addition to finding a surgeon who is familiar with the type of lens you need, it is also important to find one who has experience with the type of cataract surgery you want. Advancements in cataract surgery include both traditional and laser-assisted surgery options, and one might work better for you than another.

Start by speaking with your regular eye doctor for a recommendation. Then, ask friends and family members who have had eye surgery in the past if they liked their surgeon. You can also take advantage of online search tools, such as the American Academy of Ophthalmology’s Find an Ophthalmologist service.

In order to find the right specialist for you, be patient with your search and ask lots of questions. The surgeon you choose should be experienced in delivering the operation you need. They should provide comprehensive information about what to expect before, during, and after surgery.

What Is Cataract Surgery & Who Performs It?

Cataract surgery is performed on people who are experiencing vision loss due to the lens in their eye becoming cloudy.

If you have a cataract, it can be described as seeing things through a foggy or dusty car windshield, explains the American Academy of Ophthalmology (AAO). Objects appear blurry or hazy, and colors are not as clear as they should be.

When cataracts become so severe that they prevent you from accomplishing activities you want to do, your eye doctor will likely recommend surgery.

Cataract surgery is the only current treatment option for cataracts. The surgery consists of removing the cloudy lens and replacing it with a clear, artificial lens. This procedure can be performed by your ophthalmologist or a cataract surgeon.

Your current eye doctor may be an ophthalmologist and trained to perform the surgery. If not, they will likely refer you to an eye surgeon who is trained in the type of cataract surgery you need.

What Credentials to Look For

Ophthalmologists are the only type of medical professionals who are medically and surgically trained to treat eye disorders and the surrounding tissues. Ophthalmologists have spent many years, including four years of college, four years of medical school, and four to six years of specialized training, to gain experience in the diagnosis and treatment of eye diseases and eye surgery.

The American Board of Ophthalmology (ABO) explains that a medical license is the minimum qualification needed to practice medicine in the physician’s state. Medical licenses are regulated by states.

Your state’s medical licensing board can provide you with information about a doctor’s educational and licensing background. The Federation of State Medical Licensing Boards also provides on online Physician Data Center service.

Ophthalmologists do not have to be certified by the American Board of Ophthalmology in order to practice medicine, but an ABO certification is an additional sign of their competencies and skills. ABO certification is a voluntary way to confirm the high level of skills required of an ophthalmologist, and it provides an extra layer of consumer protection.

To check if your ophthalmologist is certified by the American Board of Ophthalmology, you can:

  • Visit the ABO’s Verify a Physician page online.
  • Speak with a representative of the ABO by calling (610) 664-1175.
  • Go to the verification site of the American Board of Medical Specialties.
  • Call the American Board of Medical Specialties at 1-866-ASK-ABMS (275-2267).

Cataract Surgery: Choosing the Right Lens

Cataract surgery is a relatively straightforward procedure that can be completed in as little as 15 minutes on an outpatient basis. Patients typically make a full recovery within a couple of days, with highly satisfactory results. Although the procedure is common, there are important decisions that need to be made about the surgery.

Experts from Harvard Medical School explain that there are several things to consider when choosing the lens you want implanted and the surgeon who performs the surgery. The lens choice involves which type of vision correction you desire most, the cost of the lens, and which type of surgeon can perform the surgery.

The most commonly used replacement lenses in cataract surgeries include:

  • Fixed-focus monofocal lenses. These lenses are often used for people who wish to see better at a distance, though they will still need glasses for up-close activities, such as reading. It is also possible to correct one eye for distance vision and one eye for near vision.
  • Accommodating monofocal lenses. These lenses present a newer artificial lens option that shifts between near and distance vision based on your eye movement. They are not as reliable for near vision, however. About half of people who choose this lens still require reading glasses after surgery.
  • Toric lenses. These lenses are specialized monofocal lenses for people with astigmatism. With toric lenses, you may not need distance glasses after surgery because they effectively focus your vision at a single distance and correct astigmatism.
  • Multifocal lenses. Similar to progressive lenses that are used in eyeglasses, multifocal lenses have separate areas on them for distance, middle, and near vision. As you adjust to the new lenses, your brain learns which section of the lens to use when. There is a bit of a transition period with these lenses.

Once you know which type of lens you want, search for an eye surgeon who has experience implanting that type of lens. Although cataract surgery is a common procedure, not all doctors are familiar with implanting newer specialty lenses.

Traditional vs. Laser-Assisted Surgery

In addition to selecting a surgeon familiar with the type of lens you need, you will want to find an ophthalmologist skilled in the type of surgery you want: traditional cataract surgery or laser-assisted cataract surgery.

According to AAO, traditional cataract surgery, or phacoemulsification, is one of the most common surgeries in the world. It is safe, effective, and covered by many insurance plans.

Laser-assisted cataract surgery is more expensive than traditional cataract surgery, but it allows for a higher level of precision in a shorter amount of time. In order to qualify for laser-assisted surgery, you must have an astigmatism that you want corrected during cataract surgery or you have selected a premium lens to be implanted.

Confirm that laser-assisted cataract surgery is covered by your insurance provider before you commit to this option.

Both types of surgery offer similar success rates and recovery times. If you wish to have one type of cataract surgery over the other, be sure to select a surgeon who is experienced with the specific procedure.

Experience Helps Reduce Complication Rates

The technology used in a cataract surgery is advanced. As is the case with most types of technology, abilities tend to improve with repeated use. Doctors need to learn the quirks of each individual piece of equipment used during a surgery, and they need to develop a form of muscle memory while using the machine, so they can focus on anatomy and not on technology.

Research suggests that doctors who perform a large number of cataract surgeries on a regular basis develop muscle memory. As a result, they have fewer complications that arise after surgery.

For example, in a study published in the journal Current Opinion in Ophthalmologyresearchers found that the odds of a so-called "adverse event" were 70 percent lower when surgeries were done by doctors who performed between 501 and 1,000 surgeries per year when compared to doctors who performed between 50 and 250 surgeries per year. If the surgery was conducted by a surgeon who performed more than 1,000 surgeries per year, odds were 86 percent lower.

In a second study published in the journal Investigative Ophthalmology and Visual Scienceresearchers examined the difference in performance between residents (students) and attending surgeons (experienced professionals). Residents had an error rate of 10.4 percent, while residents had an error rate of 2.7 percent.

Studies like this demonstrate that skill with surgery takes time to develop, and surgeons who are new to the practice may not have the experience required to perform a surgery in the perfect way every single time.

In another assessment of the issue, performed by the Institute for Clinical Evaluative Services, researchers found that, when compared to professionals in their tenth year of practice, surgeons in their first year were more than nine times as likely to make an error. This makes the importance of experience more than clear. The more your surgeon knows, the less likely it is that you will have an issue appear after surgery.

Practical Tips for Choosing a Surgeon

A great place to begin your search for a qualified cataract surgeon is by speaking with your regular eye doctor. If you would like additional recommendations before committing to a surgeon, AAO offers the following tips for choosing a cataract surgeon:

  • Ask family and friends who have had cataract surgery if they were satisfied with the experience and would recommend their surgeon.
  • Search for eye surgeons in your area via the AAO’s Find an Ophthalmologist online tool.
  • When you do meet with an ophthalmologist, remember that you don’t have to commit to them if you don’t feel comfortable with their service or office staff.
  • Ask questions about the benefits and risks of the procedure, what to expect during surgery, and what recovery looks like.
  • Be skeptical of an ophthalmologist who guarantees perfect vision after surgery. Eyeglasses or follow-up surgery is sometimes still needed after cataract surgery.
  • Ask about the surgeon’s success rates and what follow-up care looks like.

After having a discussion with your potential cataract surgeon that covers the above points, you will have a fairly good understanding of what to expect from the surgery and if the surgeon is a good fit for you. Before you choose a surgeon, speak with multiple doctors until you find one that you are confident and comfortable with.

How to Find the Specialist You Need

In order to find the cataract specialist you need, it is important to be patient and ask questions. If you start with a solid understanding of your eye condition and your goals following surgery, it will guide you in the right direction. Be sure to ask questions specific to your situation, and only commit to a doctor who provides answers you find satisfactory.

Whether you approach your search via recommendations from friends and family or via online search tools, be sure to verify the credentials of any doctor you are considering working with. Certified doctors spend many years developing their skills, and it’s important to choose a surgeon with experience behind them.

You will be able to find a doctor who has the talent and experience necessary to safely perform the cataract surgery you need. With the right surgeon, you can get on the road to clear vision once again.

References

Cataract Surgery. (September 2019). American Academy of Ophthalmology.

Choosing a Cataract Surgeon. (October 2019). American Academy of Ophthalmology.

Considering Cataract Surgery? What You Should Know. (July 2018). Harvard Health Publishing.

Information for Patients & the Public. American Board of Ophthalmology.

Changing Techniques in Cataract Surgery: How Have Patients Benefitted? (February 2018). Community Eye Health Journal.

Traditional Cataract Surgery vs. Laser-Assisted Cataract Surgery. (August 2019). American Academy of Ophthalmology.

Femtosecond Laser-Assisted Cataract Surgery: A Current Review. (Oct–Dec 2011). Middle East African Journal of Ophthalmology.

The Benefits and Drawbacks of Femtosecond Laser-Assisted Cataract Surgery. (June 2020). European Journal of Ophthalmology.

Serious Adverse Events After Cataract Surgery. (September 2013). Current Opinion in Ophthalmology.

Does Case Order Affect Cataract Surgery Complication Rates and Case Time?(June 2013). Investigative Ophthalmology and Visual Science.

New Surgeons More Likely to Have High Complication Rates for Cataract Surgery. (January 2017). Institute for Clinical Evaluative Services.

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