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Eye Care (Expert Forum)
catarac surgery for my mother @ 77
Answered by
John C Hagan III, MD, FACS - Ophthalmology
Discover Vision Centers
Kansas City - MO
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
catarac surgery for my mother @ 77
by trinks, Jul 20, 2007 12:00AM
My mother is 77, has macular degeneration and gloacoma as well as severe cataracts. He last opthamologist (for years) told her she can't have the surgery and continued to charge her high amounts (700.00) for her glasses, but no improvement. My mother went to a new specialist and was told that he didn't understand why no surgery to remove the cataracts as they are now almosst completely embedded in her eyes. I one eye she has a growth as well. This dr has scheduled the surgery. She lives far away from me and doesn't have daily help. I have heard recovery time is slight, but want to make sure. Should I plan to be there for her surgery, is she going to need help getting around and if so, for how long. the dr plans on doing the other eye a few weeks later.
Doctor's Answer
by John C Hagan III, MD, FACS, Jul 20, 2007 12:00AM
, Jul 20, 2007 12:00AM
You need to find out if the surgeon plans on just doing the regular cataract surgery and intraocular implant (IOL) insertion or if the ophthalmic surgeon (Ophthalmologist = Eye MD) will do a 'triple procedure' 1. Cataract removal 2. insert IOL 3. glaucoma relieving operation (usually a trabeculectomy). If a triple procedure is planned there will be more visits, a slower recovery and a higher chance of complications. Triple procedures are generally appropriate if 1. the glaucoma is not well controled. 2. the patient is on 3 or 4 types of glaucoma mediciations 3. the patient is controled on 1 or 2 types of glaucoma drops but cannot manage to get in (forgets, tremors, etc.) or the cost of the drops is getting prohibitive.
Also it's important to realize that any damage to your eye by macular degeneration, glaucoma and the 'growth' (?) will still be there after the surgery. It's not realistic to expect 'normal' vision after her surgery. You should only compare her vision after surgery with what it was before surgery, not what it was 30 years ago or with some friend that has 20/20 after cataract surgery because she has no other eye problems.
Having said all of that you need to get the information you asked about post-operative care directly from the ophthalmologist that will be doing the surgery. I can't generalize. Many 77 year olds living alone are 'just holding on' and the stress of surgery, the need for putting drops in several times per day, going to the surgeon's office is just more than they can handle. These people may need assistance for surgery on both eyes for a month or two. There are often other resources you can call on such as 'home health care agencies', 'visiting nurses', 'Meals on Wheels', some churchs have volunteer groups that assist church members by daily visits.
Other 77 year olds are breezing along playing golf, swimming, jogging and in better shape than most 40 year olds. They are back to unassisted living the day after surgery.
The state of the art catract surgery is a small incision (often no stitch) procedure done by phacoemulsification.
Talk directly with the surgeon rather than relying on what you mother says the surgeon says.
Good luck and hope it turns out well. Cataract surgery is one of the most successful and life enhancing operations in the history of medicine.
And a bargain too. In the area (Midwest USA) where I practice Medicare pays us less than the cost of her last pair of glasses--currently about $678.00 for the surgeon's fee AND three months of care for a cataract removal and insertion of an intraocular implant. For comparison dentists in my city are paid $900-1200 for a crown on a tooth.
JCH MD Fellow American College of Surgeons, Fellow American Academy of Ophthalmology.
Also it's important to realize that any damage to your eye by macular degeneration, glaucoma and the 'growth' (?) will still be there after the surgery. It's not realistic to expect 'normal' vision after her surgery. You should only compare her vision after surgery with what it was before surgery, not what it was 30 years ago or with some friend that has 20/20 after cataract surgery because she has no other eye problems.
Having said all of that you need to get the information you asked about post-operative care directly from the ophthalmologist that will be doing the surgery. I can't generalize. Many 77 year olds living alone are 'just holding on' and the stress of surgery, the need for putting drops in several times per day, going to the surgeon's office is just more than they can handle. These people may need assistance for surgery on both eyes for a month or two. There are often other resources you can call on such as 'home health care agencies', 'visiting nurses', 'Meals on Wheels', some churchs have volunteer groups that assist church members by daily visits.
Other 77 year olds are breezing along playing golf, swimming, jogging and in better shape than most 40 year olds. They are back to unassisted living the day after surgery.
The state of the art catract surgery is a small incision (often no stitch) procedure done by phacoemulsification.
Talk directly with the surgeon rather than relying on what you mother says the surgeon says.
Good luck and hope it turns out well. Cataract surgery is one of the most successful and life enhancing operations in the history of medicine.
And a bargain too. In the area (Midwest USA) where I practice Medicare pays us less than the cost of her last pair of glasses--currently about $678.00 for the surgeon's fee AND three months of care for a cataract removal and insertion of an intraocular implant. For comparison dentists in my city are paid $900-1200 for a crown on a tooth.
JCH MD Fellow American College of Surgeons, Fellow American Academy of Ophthalmology.
I just wanted to make a comment to you about your mom's surgery. My mother who is 85 just had cataract surgery. She is having a very slow recovery, in that they had to really cut deep to get the cataract out. It was so hard and deep that she has 16 stitches. I don't know if your mom's cataract is really deep, but this surgery was really hard on my mother. It has now been over 3 weeks and she still can't see. She also has controlled glaucoma. I 'm just saying you may need to get somebody to help you take care of her. This surgery was NOT a piece of cake .