Questions To Ask Your Surgeon
How many cataract extractions have you done?
In the UK most eye surgeons have done 500 to 1000 cataracts by the time they become a consultant, and then do 300 to 500 per year. The average surgeon induced complication rate reduces from 10% to 2% over the time of training.
How do you audit your results?
Every consultant should have a constant rolling audit of their cataract results using a software package such as Medisoft. They should then be able to provide you with their latest data for outcome and complication rates.
What is your audited incidence of posterior capsule rupture?
Posterior capsule rupture is one of the simplest complications to measure. Essentially we leave the outer layer, the "capsule", of your own lens behind to act as a carrier bag into which we insert your new artificial lens. It is essential that this layer does not rupture, otherwise it is much more difficult to insert your lens in the perfect position, and consequently there is a risk of a worse visual outcome. Certain factors increase the risk of capsule rupture, but these should all be evident prior to starting the surgery. The last factor is simply surgeon error. In the UK the average posterior capsule rupture rate was 2.7% in 2003, and 1.92% in 2009. A good cataract surgeon, when operating on a straightforward cataract with no additional risks, should have an audited rate of 0.5% or less.
How will you treat my astigmatism?
If you have significant astigmatism your surgeon should have a plan for how to correct it at the time of your surgery. The options include changing the position of the main port into the cornea, separate partial thickness cuts into your cornea, post operative refractive laser surgery and the insertion of special toric intraocular lenses. All of these techniques have their place, but one of the most reliable is the toric lens.
Which Intraocular lens do you use?
Each surgeon will have a favourite IOL, but they should nontheless be able to offer you your choice of the available premium lenses.