The Truth About Cataracts

What causes cataracts and will everyone need cataract surgery?

Cataracts are a cloudiness of the natural lens inside the eye. I say the main cause of cataracts is “more birthdays” but there can be many other causes. While everyone will eventually have a cataract that can be removed, there are times when cataract surgery would potentially not be in the best interests of the patient.

Is a laser used in cataract surgery?

Laser assistance is an option, but it should never be required. The laser only does a few steps of the surgery. However, all the current research states, and the leaders in the field agree, the laser does nothing to improve patient outcomes in cataract surgery when compared to a qualified cataract surgeon. Given the lack of improved patient outcomes and the high cost associated with laser assisted cataract surgery, I do not offer it to my patients, as I have excellent results without it. 

What about lens upgrades? Are those required?

There are many types of lenses to help eliminate the need for contacts or glasses after cataract surgery for activities of daily living. Insurance companies consider this a “cosmetic fix,” and patients pay extra for these premium lenses. There is never a requirement to pay for a premium lens during cataract surgery. Standard cataract surgery insurance coverage includes the cost of a single-vision lens. With a single-vision lens, glasses may be needed to ensure best vision. But, with most premium lens options, activities of daily living can usually be performed without contacts or glasses, or sometimes with reading glasses.  Each type of lens has pros and cons, and I discuss these options with my patients and only recommend what lens is best for your eyes.

Does insurance pay for cataract surgery?

Yes, if certain visual criteria are met to show there is a disability. But there are two sides to any surgical procedure: the physician fee and the facility fee. Some surgeons perform surgeries in a converted clinic room in what is called “office-based surgery” where insurance will not pay a facility fee, so that loss is made up by requiring the patient to pay for needless expenses such as laser. I perform surgery in a surgery center recognized as one of the state’s top facilities, and this facility is fully credentialed for all major insurance providers.

Is cataract surgery different from a refractive or clear lens exchange? 

The surgeries are exactly the same. The only difference is who pays for it. With cataract surgery there is enough visual disturbance to have insurance pay for it. With RLE there is a desire to be free from glasses or contacts, so the patient pays out of pocket for the surgery because there is not enough visual disturbance to have insurance cover the surgery. Both surgeries utilize the same lenses, and both can give a lifetime of independence from glasses and contacts.