Cataract FAQ

We wanted to share with you the answers to questions our professionals are most often asked. It’s perfectly normal to have such questions and concerns. If ever you don’t find the answer you’re looking for here, please feel free to contact us. We’ll be happy to take your questions.

Is it dangerous to have an intraocular lens implantation?

Today, thanks to modern microsurgery techniques, the risk of serious complications of eye surgery is very small (less than 1 in a 5000 for infection for example). There is therefore little cause for concern, even though it’s quite normal to be anxious about the idea of such a procedure.

Where are the intraocular lenses inserted?

They are placed in place of the crystalline lens. The crystalline lens is the eye’s natural lens. It is what allows you to focus on objects close up.

Is cataract surgery painful?

Medicine has evolved a great deal, and nowadays cataract surgery is not painful. During the procedure, which lasts about 6 minutes, you will only feel pressure and the occasional prickling sensation. Patients can resume their everyday activities the very next day. The anesthesia is administered in the form of eye drops; no needles are required.

How long will it take for my vision to improve after cataract surgery?

Patients usually notice an improvement in their vision one day after surgery. Vision continues to improve over the course of one month after surgery, until healing is completed.

Are cataracts treatable?

YES for sure. There is only one treatment for cataracts: replace the crystalline lens. This is done by microsurgery. The surgeon first makes a tiny incision in the eye, then removes the crystalline lens and replaces it with a flexible intraocular lens. This surgical procedure generally yields excellent results.

What should I do immediately after the surgery?

  • DO NOT RUB YOUR EYE(S). Rubbing them after cataract surgery may result in SERIOUS post operative complications. Do not rub your eye(s) for at least a month.
  •  Patients need to keep their eyes closed for the first two hours after surgery (with the exception of getting around).
  • At the end of the two hours the tape should be removed and the drops started. Patient will start to use the drops two hours after surgery.
  • NOT two hours after hospital discharge. This is without exception unless you are told specifically by the doctor himself.
  • At the hospital you will be given a schedule of when the drops are to be used. Patients are not required to get up during the night to use the drops. They will be used during waking hours only.
  • Always follow the instructions given to you on the day of surgery as that will be that most current schedule.
  • Your first appointment will be done the afternoon of your surgery, ON THE SAME DAY OF THE SURGERY. You’ll receive your appointment time for the same day when you are at the hospital.
  • Once at the office, you’ll be given an appointment for approximately one week later.
  • Patients having Bilateral Cataract surgery will receive a prescription for two sets of each drop. One set for the left eye and one for the right. This is done for your own safety; in keeping one set for each eye you reduce the risk of infection due to cross contamination.
  • You will also be given cards for your records with the name and power of the lenses you’ve had implanted. Please be sure you have them when you leave the hospital, as they are produced there and we do not have copies of the cards in the office.

When may I go back to wearing makeup?

You may resume wearing makeup about one week after your surgery. However, throw out your old makeup and buy new to decrease your risk of infection.

How do you know what lens power to implant?

On the day of the assessment, you will undergo an eye measurement, to calculate the strength of your lens implant. The most accurate IOL Master is the preferred method to get the best results. If you wear contact lenses, please remove them at least one (1) week prior to your measurement. The longer you have them out, the better your measurement.

You will be given artificial tears to use, four (4) times a day in both eyes, starting one week before your measurement or right away. You will have to buy a bottle from the pharmacy, but you will use it for at least two months after your surgery, so it will not be wasted.

Please make sure you have read over this booklet before this appointment. Any questions you have will be answered this day. Please bring along a friend or family member, if you feel it might be necessary. A prescription for the surgery drops will be given at this appointment. You will also be given a calendar to follow (for the eye drops).


The ZEISS IOLMaster® 500 is the gold standard in optical biometry with more than 100 million successful IOL power calculations to date. With the new version of the ZEISS IOLMaster 500 you get a piece of cutting-edge technology that points the way to the future of optical biometry.

  • Improving refractive outcomes: Any intraocular lens calculation is only as reliable as the lens constant it is based on. More than 40,000 sets of patient data created with the ZEISS IOLMaster are the basis of more than 200 optimized lens constants in the User Group for Laser Interference Biometry (ULIB) website – absolutely unique in the industry. Together with its one-of-a-kind distance independent telecentric keratometry (watch video) and the exclusively integrated Holladay 2 formula, the gold standard in optical biometry helps you improve your refractive outcomes.
  • Advanced measurement of challenging eyes: The true test of a biometer is its performance with challenging eyes. In denser cataracts the ZEISS IOLMaster 500 achieves a measurement success ratio that is up to 20% higher than that of other optical biometry devices. Even with staphyloma, pseudophakic and silicone-filled eyes the ZEISS IOLMaster 500 measures along the visual axis, yielding the relevant axial distance. And with its Haigis-L formula on board the ZEISS IOLMaster 500 is dedicated to myopic and hyperopic post-LVC cases.
  • Proven toric outcomes: The results of a meta-analysis of 28 published clinical papers covering more than 1900 cases show that the reported clinical outcomes for the ZEISS IOLMaster with regard to residual astigmatism “[…] exceed, or are at least as good as those using manual or automated keratometry

Can I go back to work right away?

Most people who have LASIK return to work the next day. With PRK, we recommend two or three days of rest instead.

What if I blink or move during the procedure?

Although everyone shares these concerns, we take measures to ensure that moving or blinking is not a problem. Your eye will be held open with a holder supporting your lid so that you can’t blink. The holder is placed immediately before the treatment and removed immediately afterward. Lying still during the treatment is another common concern. The bed of the laser has a contoured headrest with an indent, which allows the back of your head to rest securely, but comfortably in place. During the treatment itself, Dr. Youssef will gently hold your head in position to help keep you steady. He also uses a focusing mechanism to assure that the treatment is precisely centered. Your job is simply to watch a blinking target light. While you are doing this, the laser’s computer will also be using its tracking system to monitor the position of your eye. The eye tracker adjusts the laser treatment to follow the small movements everyone’s eyes make during the procedure.

What is Dysfunctional Lens Syndrome?

DLS is the progressive loss of function of the natural lenses inside your eye.  The lens is clear and flexible when you are born.  The clarity of this vital part of your eye allows light to pass cleanly through without light scatter, glare, or blurry vision.  It’s flexibility allows it to change shape and focus so you can see both far and near objects. From the day you were born, your lens started to lose both its clarity and its flexibility.  The early losses go largely unnoticed.  The good news about DLS is that there is a cure: dysfunctional lens replacement.  This involves removing the dysfunctioning lens and replacing it with a plastic intraocular lens implant.  The new intraocular lens is clear, restoring clarity of light transmission.  Advanced technology intraocular lens implants can be toric (astigmatism correcting) or they can be a multifocal or accommodating implants to restore some focusing ability.  Many patients with mulifocus  or accommodating implants do not need glasses for near or far vision after the surgery.  While these implants are not perfect, they are spectacular.  The ability to correct many of the ravages of DLS dysfunctional lens replacement is one of the marvels of modern medicine.

Am I too old to have LASIK?

Although there’s no real “maximum age” for laser vision correction, we would first need to determine that the overall health of your eyes is good, and that your vision difficulties are not being caused by cataracts or some other eye disease. Before the decision is made to proceed with laser vision correction, your vision needs to be stable. Depending on your age, you may need reading glasses after treatment. Nearly everyone needs reading glasses by their mid-40s. This is known as presbyopia. Presbyopia is a natural change in the lens inside of the eye and is not influenced by refractive surgery. If you are wearing bifocals or readings glasses now, you will still need reading glasses after LASIK. A treatment option with refractive surgery is known as monovision. In a monovision treatment, the patient’s dominant eye is corrected for distance vision with their non-dominant eye being left slightly nearsighted. Although not a replacement for reading glasses, this preserves a degree of near vision clarity. If you have a early changes in the crystalline lens (Dysfunctional Lens Syndrome) you might benefit from a lens exchange rather LASIK.

What is Dysfunctional Lens Syndrome?

DLS is the progressive loss of function of the natural lenses inside your eye.  The lens is clear and flexible when you are born.  The clarity of this vital part of your eye allows light to pass cleanly through without light scatter, glare, or blurry vision.  It’s flexibility allows it to change shape and focus so you can see both far and near objects. From the day you were born, your lens started to lose both its clarity and its flexibility.  The early losses go largely unnoticed.  The good news about DLS is that there is a cure: dysfunctional lens replacement.  This involves removing the dysfunctioning lens and replacing it with a plastic intraocular lens implant.  The new intraocular lens is clear, restoring clarity of light transmission.  Advanced technology intraocular lens implants can be toric (astigmatism correcting) or they can be a multifocal or accommodating implants to restore some focusing ability.  Many patients with mulifocus  or accommodating implants do not need glasses for near or far vision after the surgery.  While these implants are not perfect, they are spectacular.  The ability to correct many of the ravages of DLS dysfunctional lens replacement is one of the marvels of modern medicine.

Do you offer financing?

At PVSC, we understand that laser vision correction is an investment. We offer various financing options—ranging from short-term, no interest to long-term plans through a patient financing company, Medicard. Feel free to contact our patient education staff to learn more.  You can visit their website at

Canada’s Patient Financing Company


Can you work with my regular eye doctor/Optometrist?

In order to make the process of care as comfortable as possible for you, we offer to co-manage with your current ophthalmologist or optometrist. You may choose to have your pre-operative evaluation, treatment and one day post-op visit at PVSC with the balance of your post-op care provided by your personal eye doctor. We believe that it is very important for you to continue seeing your personal eye doctor starting one year after your surgery. We will keep your doctor fully updated about the care you receive while with PVSC.

What is Cataract?


A cataract is a clouding of the lens inside the eye which leads to a decrease in vision. It is the most common cause of blindness and is conventionally treated with surgery. Visual loss occurs because opacification of the lens obstructs light from passing and being focused on to the retina at the back of the eye. It is most commonly due to biological aging but there are a wide variety of other causes. Over time, yellow-brown pigment is deposited within the lens and this, together with disruption of the normal architecture of the lens fibers, leads to reduced transmission of light, which in turn leads to visual problems.


Those with cataracts commonly experience difficulty in appreciating colors and changes in contrast, driving, reading, recognizing faces, and coping with glare from bright lights. Signs and symptoms vary depending on the type of cataract, though there is considerable overlap. People with nuclear sclerotic or brunescent cataracts often notice a reduction of vision. Those with posterior supcapsular cataracts usually complain of glare as their major symptom. The severity of cataract formation, assuming that no other eye disease is present, is judged primarily by a visual acuity test. The appropriateness of surgery depends on a patient’s particular functional and visual needs and other risk factors, all of which may vary widely.

Cataracts may be partial or complete, stationary or progressive, or hard or soft. The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular.

Can I wear my contacts before my surgery?

Because contact lenses can alter the shape of your cornea, you will need to remove your contacts prior to your pre-operative exam. If you wear soft lenses, they should be removed a minimum of one week before your exam. If you wear rigid/gas permeable lenses, remove them at least 6-8 weeks prior to your exam. By removing the lenses, the cornea will be restored to a more natural shape before measurements are taken. Following your pre-operative exam, if you are a soft lens wearer, you will be able to wear your lenses up to 24 hours before your surgery. If you wear rigid/gas permeable lenses, you may be asked to leave your lenses off until your day of surgery.

How often will I see the doctor following my surgery?

Your postoperative appointments will be scheduled:

  • One day
  • One week
  • One month
  • Three months
  • And six months (optional)

More frequent appointments may be scheduled as needed. The doctors at PVSC will be available to see you whenever they or you feel that it is necessary.

What are my options for INTRA-OCULAR LENSES (IOLs)?


Before intra-ocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or special contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. Discuss these options with your eye doctor to determine the IOL that best suits your vision needs and lifestyle.



Like your eye’s natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime.  Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.

Which lens option is right for you?


Before surgery your eyes are measured to determine your IOL prescription, and you and your eye doctor will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.If you have astigmatism, your Eye M.D. will discuss toric IOLs and related treatment options with you.In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium lOLs that may reduce your need for glasses.

Monofocal lens



This common IOL type has been used for several decades. Monofocals are set to provide best corrected vision at near, intermediate or far distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses. Presbyopia is a condition that affects everyone at some point after age 40, when the eye’s lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.


Multifocal or accommodative lenses

These newer IOL types reduce or eliminate the need for glasses or contact lenses. In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly. The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision. The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes. It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.




Considerations with multifocal or accommodative IOLs


For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses. Each person’s success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their eye doctor about toric IOLs and related treatments. Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.





The latest addition to the TECNIS® Family of IOLs offers new optical technology for providing an Extended Range of Vision.

Traditional IOL solutions for treating presbyopia include Multifocals and Trifocals, which work on the principle of simultaneous vision by splitting light into multiple distinct foci, and Accommodative IOLs, which change in shape and power when the ciliary muscle contracts.

Traditionally with these technologies, the correction of presbyopia is commonly thought of in terms of the distinct distance for which functional vision is provided.

Key Needs for Presbyopia-Correcting IOLs

  • High patient satisfaction by providing reliable outcomes
  • Low number of complaints (on refractive outcomes or halos and glare)
  • No significant additional chair time


Is intraocular lens implantation a safe and effective procedure?

Yes. The insertion of intraocular lenses is a procedure that has been performed for decades to treat cataracts. Millions of people have undergone this type of surgery with great success. Moreover, the quality and precision of intraocular lenses has vastly improved, and they are now an effective treatment for a variety of other vision problems.

Can I have both eyes done at the same time?

Most surgeons perform a LASIK procedure on both eyes at the same time. Because it takes longer for clear, comfortable vision after PRK, many surgeons will wait a week or two between eyes for PRK. At PVSC, we do at the same time.

What if time passes and I’m not seeing better?

A small number of patients see well after surgery then experience regression, a gradual worsening of vision. If this happens, consult Dr. Youssef to determine the cause and to see if retreatment (enhancement) is appropriate.

What is Femto-Laser Cataract Surgery?

CATALYS® Precision Laser System

The CATALYS® Precision Laser System is indicated for use in patients undergoing cataract surgery for removal of the crystalline lens.  Intended uses in cataract surgery include anterior capsulotomy, phacofragmentation, and the creation of single plane and multi-plane arc cuts/incisions in the cornea, each of which may be performed either individually or consecutively during the same procedure.

Femtosecond laser assisted cataract surgery offers a reproducible, noninvasive technique to replace the least predictable and most technically demanding steps of conventional cataract procedures.



Designed for Laser Cataract Surgery

Designed specifically for laser cataract surgery, the CATALYS® System offers:

  • LIQUID OPTICS Interface, gentle docking with minimal intraocular pressure rise and clear optics for excellent imaging and laser delivery
  • INTEGRAL GUIDANCE System – proprietary 3D Full Volume Optical Coherence Tomography (OCT) and automated surface mapping algorithms that guide laser delivery
  • Precise capsulotomies within 30µm
  • Complete segmentation and softening of the cataract with adjustable grid sizing
  • Multiple corneal incision centration options that are based on anatomical landmarks

The CATALYS® Precision Laser System combines a <600 femtosecond laser, gentle LIQUID OPTICS Interface, and integrated 3D Full Volume Optical Coherence Tomography (OCT) image-guidance system to create precise incisions in the lens and cornea. The CATALYS® System was developed in close collaboration with a medical advisory board of cataract experts from around the world. In 2012, the CATALYS® System was recognized as one of the top 100 technological innovations in the world.

Throughout the development of the CATALYS® System, numerous technology choices were made aimed at delivering excellent precision. Two of the most critical components are the patient docking interface and the image-guidance system. The LIQUID OPTICS Interface is designed to provide a stable, gentle dock and a clear optical path for the OCT and laser.

In addition, the CATALYS® System is equipped with INTEGRAL GUIDANCE System, an image-guidance system which maps ocular surfaces, establishes safety zones allowing the physician to select and customize the treatment, ensuring that the femtosecond laser pulses are delivered precisely to the intended location.

Understanding the user experience is another critical area focus for the CATALYS® System development team. The system’s intuitive and ergonomically designed user controls were developed with the needs of the patient, surgeon, technician and nurse in mind. A Medical Advisory Board of cataract experts and Medical Staff Advisory Board of dedicated technicians and nurses have had extensive input in system design and usability.


 The CATALYS® System procedure consists of four steps:


The CATALYS® System includes design features that optimize the precision, safety and control of all four steps of the procedure. Two of the key features that were developed to help surgeons deliver predictability and quality of outcomes are:


The novel two-piece liquid interface docks the patient to the system and is designed to provide:

  • A clear optical path for real-time video, OCT imaging, and laser treatment by:
  • Filling in corneal surface irregularities with liquid
    Creating a wide field of view, enabling all cuts to be performed in a single dock

A gentle dock for the patient by:

  • Minimizing the rise in intraocular pressure, which is particularly important for older cataract patients and those with glaucoma
  • Minimizing scleral contact of the interface with minimal redness of the eye after surgery



During the CATALYS® System procedure, the ocular surfaces are visualized by a proprietary, integrated Optical Coherence Tomography (OCT) system. The OCT is enhanced by sophisticated algorithms designed to ensure that the femtosecond laser pulses are delivered precisely to the intended location.


Steps in the INTEGRAL GUIDANCE System process:

Proprietary, 3D spectral-domain OCT imaging system visualizes the ocular surfaces
Algorithms process the image, automatically and accurately maps surfaces and create safety zones
The surgeon’s treatment plan is then customized, based on the patient’s ocular anatomy and the precise orientation of the eye
After the surgeon confirms the customized treatment plan, the femtosecond laser pulses are delivered precisely to the intended location, maintaining the safety zones

Information on this page is taken from AMO website,

Wiki Femto Cataract

Astigmatism Correction at the Time of Cataract Surgery

Especially with advanced intraocular lenses that provide good vision without glasses after cataract surgery, it is important that the surgery results in minimal astigmatism. Examples of these advanced lenses are presbyopia-correcting multifocal IOLs and accommodating IOLs.


Because astigmatism involves the cornea being more curved in one axis than the other (like a football shape), incisions can be used in the more curved axis to reduce the astigmatism so the cornea has a rounder shape (like a basketball). The procedure is called astigmatic keratotomy or AK.


Surgeons perform AK free-hand with a diamond blade, and it is quite effective in reducing astigmatism.

During refractive laser-assisted cataract surgery, the OCT image can be used to plan the AK incisions in a very precise location, length and depth, and then the laser accurately creates them. Since the laser minimizes the variables involved, the AK procedure becomes more accurate and reproducible.

A New Era in Cataract Surgery

An exciting aspect of laser cataract surgery is the concept of optimization — the continuous improvement of a technique or technology.

One example is the incision. When it is made with a human hand guiding a blade, there are limitations. But a laser can make a perfect zigzag incision that interlocks precisely and improves the chance of self-sealing, and this is an advancement over traditional manual technology.

Once a laser enters the surgical arena the opportunities to optimize are endless. We are just in the beginning of this refractive laser-assisted cataract surgery journey, and precision improvements will arrive quickly.


It is important to put this new technology into proper perspective. Traditional cataract surgery is very effective and successful. People who do not want to invest out-of-pocket money in laser cataract surgery can still feel confident about the traditional approach.

But for those who want the best possible vision, the laser approach is appealing. A more accurate incision, capsulotomy and astigmatic correction will help to achieve their goal of less dependence on glasses after cataract surgery.

Keep in mind that even though the early results of laser cataract surgery are promising, this is newer technology that deserves in-depth research and discussion with your doctor so that you can make the best possible decision for your situation



How much does cataract surgery cost?

The cost of the procedure varies according to the nature of the vision problem and its severity, the type of treatment needed and the type of intraocular lens selected. If you come for a consultation at one of our clinics, we will be able to give you an exact quote for the cost of your procedure.

What should I do the weeks after the surgery?

The week after the surgery



  • Once you have had your cataract surgery, please contact your optometrist’s office and arrange an appointment for their office to see you 6 weeks after your surgery date.
  • Eyes should also remain covered with regular sunglasses when outside to prevent anything getting into the eyes.


The month after the surgery

  • Patients must also cover the eyes with swimmers goggles to shower for the first three weeks after surgery.
  •  Swimming Goggle
  • Glasses (if still needed) should not be purchased until after the five to six weeks appointment.
  • Most people will find that they require reading glasses after surgery. We recommend dollar store reading glasses during the healing process.
  • After cataract surgery, patients will often report seeing what resembles quarter moons or black blinders in the peripheral (corner or side) vision. This is perfectly normal. The swelling of your eye is causing you to pick up extra light that creates the flickering quarter moons. These flickers of light will most likely be present when you go from a dark to light area or vice versa. These flickers should not be present when your eyes are closed. If they are present with the eyes closed, our office should be contacted as soon as possible. The dark blinders are caused by the inflammation and what you’re seeing is the wound, which gets better with time. If this is caused by the lens edge, it would last longer but finally most of the patients would adapt and stop seeing it.
  • Patients will often report the sensation of grit or sand in the eyes like the feeling of an eyelash or stitch. There are no stitches in your eyes. The sensation is dryness caused by the surgery. Using the Artificial Tears four times a day should avoid/correct this feeling.
  • A common misconception is that one should not bend forward after having cataract surgery. We now feel that simple bending is acceptable. Acts like bending to pick something up, tie your shoes, etc. are harmless.
  • You should avoid very heavy lifting or strenuous activity for a period of two weeks after cataract surgery.
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