Informed Consent For Cataract Surgery

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STUART R. WINTHROP, M.D.
INFORMED CONSENT FOR CATARACT SURGERY
WHAT IS A CATARACT AND HOW IS IT TREATED?
The lens in the eye can become cloudy and hard, a condition known as a cataract. Cataracts can develop from
normal aging, from an eye injury, or if you have taken medications known as steroids. Cataracts may cause
blurred vision, dulled vision, sensitivity to light and glare, and/or ghost images. If the cataract changes vision so
much that it interferes with your daily life, the cataract may need to be removed. Surgery is the only way to
remove a cataract. You can decide not to have the cataract removed. If you don’t have the surgery, your vision
loss from the cataract will continue to get worse.
HOW WILL REMOVING THE CATARACT AFFECT MY VISION?
The goal of cataract surgery is to correct the decreased vision that was caused by the cataract. During the
surgery, the ophthalmologist (eye surgeon) removes the cataract and puts in a new artificial lens called an
intraocular lens or IOL. Cataract surgery will not correct other causes of decreased vision, such as glaucoma,
diabetes, or age related macular degeneration. Most people still need to wear glasses or contact lens after
cataract surgery for either near and/or distance vision and astigmatism.
WHAT TYPES OF IOLS ARE AVAILABLE?
Your ophthalmologist will help you decide on the type of IOL that will replace your cloudy lens. There are IOLs
available to treat nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. IOLs usually provide
either near or distance vision: these single focus lenses are called monofocal IOLs. Some newer IOLs provide for
near, intermediate, and distance vision: these multiple focus lenses are called multifocal IOLs. IOLs that treat
astigmatism are called toric IOLs. You can also have one eye corrected for near vision and the other for distance
vision, a choice called monovision.
WHAT IS ASTIGMATISM? ARE THERE OTHER TREATMENTS FOR IT?
Patients with nearsightedness and farsightedness often also have astigmatism. An astigmatism is caused by an
irregularly shaped cornea; instead of being round like a basketball, the cornea is shaped like a football. This can
make your vision blurry. In addition to toric IOLs, astigmatism can be reduced by glasses, contact lenses and
refractive surgery (LASIK or PRK). There is also a procedure called a limbal relaxing incision (LRI), which can be
done at the same time as the cataract operation, or as a separate procedure. A limbal relaxing incision (LRI) is a
small cut or incision the ophthalmologist makes into your cornea to make its shape rounder. Any attempt at
astigmatism reduction could result in over-or-under-correction, in which case glasses, contact lenses, or another
procedure may be needed.
WHAT ARE THE MAJOR RISKS OF CATARACT SURGERY?
All operations and procedures are risky and can result in unsuccessful results, complications, injury, or even
death, from both known and unknown causes. The major risks of cataract surgery include, but are not limited to
bleeding; infection; injury to parts of the eye and near by structures from the anesthesia, the operation itself, or
pieces of the lens that cannot be removed; high eye pressure; a detached retina, and a droopy eyelid. The major
risks of a limbal relaxing incision are similar to those for cataract surgery, but also could include loss of vision,
damage to the cornea, and scarring; under-or-over-correction could occur.
Depending on your eye and the type of IOL, you may have increased night glare or halos, double vision, ghost
images, impaired depth perception, blurry vision, and trouble driving at night. The ophthalmologist might not be
able to put in the IOL you choose. In addition, the IOL may later need to be repositioned or replaced.
Depending on the type of anesthesia, other risks are possible, including cardiac and respiratory problems, and, in
rare cases, death.
There is no guarantee that cataract surgery or astigmatism reduction will improve your vision. As a result of the
surgery and/or anesthesia, it is possible that your vision could be made worse. In some cases, complications
may occur weeks, months or even years later. These and other complications may result in poor vision, total loss
of vision, or even the loss of the eye in rare situations. You may need additional treatment or surgery to treat
these complications. This additional treatment is not included in the fee for this procedure.
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