What to Expect Before Cataract Surgery: Pain, Costs, and Lens Care

By Dr. Paul Patel

Cataract surgery is a common effective procedure that can enhance your vision and overall quality of life. It’s normal to have questions about cataract surgery pain, costs, Medicare coverage, and what recovery looks like.

From understanding whether cataract surgery is painful to knowing the cost and whether Medicare covers the procedure, this comprehensive guide will provide you with the information you need to make an informed decision about whether you can afford any potential out-of-pocket cataract surgery costs, what types of intraocular lenses might best benefit you, and what to expect after surgery. We’ll also address important topics such as after surgery IOL lens care, whether cataracts can come back, and any potential disadvantages of having cataract surgery.

At Thomas Eye Group in Atlanta, we’re committed to helping you navigate the cataract removal process with confidence and clarity.

Is Cataract Surgery painful?

One of the most common questions is whether cataract surgery is painful. Fortunately, it’s not usually considered a painful operation. Most patients experience little to no pain during the procedure, thanks to surgical eye drops and ocular anesthesia, which can be administered as a topical anesthetic or an injection before the operation. To help the individual stay calm and relaxed during the surgery, a sedative may also be given.

During the procedure, some patients may feel slight pressure on the eye, but experiencing sharp or piercing pain is extremely rare. After the surgery, mild to moderate discomfort is more common, but this can usually be managed with over-the-counter pain relievers. Individuals can expect the discomfort to subside within a few days as the eye begins to heal.

How Much Does Cataract Surgery Cost?

The cataract surgery cost can vary depending on several factors, including where you receive the surgery, the type of cataract surgery you undergo, and your health insurance coverage. On average, the cost of standard cataract surgery ranges from $1,808 to $2,866 per eye, with a total cost of around $6,000 for both eyes.

If you are eligible for Medicare, much of the cost of cataract surgery may be covered. Medicare typically covers medically necessary cataract surgery, including the removal of the cataract and the insertion of a standard intraocular lens (IOL).

However, if you do not have Medicare or private insurance, you will need to pay out-of-pocket for the procedure. If you’re concerned about the cataract surgery cost, it’s important to consult with your eye care provider and insurance company to understand the specific costs associated with your surgery and what you may have to pay from your own finances.

What Type of Lens Does Medicare Cover for Cataract Surgery?

As cataracts are a common condition, especially among older adults (65+), many patients wonder what type of lens Medicare covers for cataract surgery. Medicare covers the cost of standard cataract surgery, including the removal of the cataract and the insertion of a basic or conventional intraocular lens (IOL). This basic lens implant is designed to improve your vision by replacing the clouded natural lens with a monofocal lens, which offers a single prescription. If you choose to receive a premium cataract surgery lens or other advanced treatments, you may need to pay additional out-of-pocket costs.

Do New Lenses After Cataract Surgery Require Special Care?

After cataract surgery, most patients receive an intraocular lens (IOL) in the affected eye. These specialized lenses work by focusing light on the back of the eye, which helps provide you with clear vision. The best part is that you won’t be able to see or feel the cataract surgery lens because it becomes a permanent part of your eye and requires no further special care.

Once your eyes have healed from the surgery, your eye surgeon may recommend getting a new prescription for glasses or contact lenses to further enhance your vision. If you are experiencing further complications, be sure to talk with your doctor about the right post-surgery care to ensure the best possible outcome.

Can Cataracts Come Back?

One of the most reassuring aspects of cataract surgery is that cataracts cannot come back after the procedure. Once your natural lens is removed, it is not possible for cataracts to grow back. However, it is possible to experience blurry vision or red eyes in the days or weeks following the surgery, but these symptoms generally improve within 4 to 6 weeks as your eye heals. There is a chance of developing “secondary cataracts” or posterior capsule opacification (PCO). While secondary cataracts are not the same as primary cataracts, they can cause similar symptoms, such as blurry vision and glare. Fortunately, the treatment for secondary cataracts is simple and quick. Most times, it’s just a fast, painless laser procedure that clears the cloudiness with a short recovery time.

What are the Disadvantages of Cataract Surgery?

Cataract surgery is a safe and effective procedure, but like any medical operation, it does have some potential risks. Some of the possible complications include:

Inflammation

Inflammation or swelling can occur after cataract surgery, but it is usually treatable with medication.

Bleeding

Some patients may experience bleeding during or after cataract surgery. While this is uncommon, it could result in complications that may require additional medical attention.

Infection

Although rare, infection is a potential risk with any type of surgery. It is important to follow your doctor’s post-operative care instructions to minimize this risk.

Visual Disturbances

Some patients may experience visual disturbances such as halos or glare, particularly during the recovery period. These symptoms typically subside as the eye heals.

It is also worth noting that complications can arise from pre-existing eye conditions such as macular edema or glaucoma. It’s important to discuss these risks with your eye care provider to ensure you are fully informed before undergoing cataract surgery.

What happens at my pre-op visit, and what tests/measurements will you do?

Prior to the day of your cataract surgery, your eye surgeon in Atlanta will thoroughly examine your eyes and perform some measurements so that they can choose the right intraocular lens for your needs and plan your surgery. Some of the tests and measurements taken include:

Biometry – The biometry test measures the axial length, which is the distance from the front to the back of your eye, and the curvature of your cornea. These two measurements help calculate the focusing power of your intraocular lens (IOL). These measurements help your surgeon calculate the correct focusing power for your intraocular lens (IOL). The procedure is quick, painless, and essential for achieving the best possible vision after cataract surgery.
Corneal Topography – This test is usually included in the biometry scan and is typically performed using laser imaging. Ultrasound may also be used, but it’s less common. The corneal topography scan creates a detailed map of your cornea’s surface in order to detect any irregularities so that they may be included in your cataract surgery planning.
Astigmatism Measurements – During your pre-op visit for cataract surgery, our eye surgeon will measure your cornea to determine if you have any astigmatism. Astigmatisms occur when the cornea isn’t perfectly round and is, instead, shaped more like a football. These measurements are often taken as part of the biometry test or as a corneal topography test.

In addition to these eye measurements, your pupils will be dilated in order to check the health of the back of your eye, and our ophthalmologist will want to know about your medical history, as well as any over-the-counter and prescription medications that you might be taking. This also includes any supplements. In some cases, you may be asked to stop or adjust certain medications before surgery.

If you’re worried that cataract surgery will be painful, your pre-op visit is the best time to review anesthesia, recovery expectations, and when to call the office. Ask, so that you can feel fully informed about what to expect. Near the end of the consultation, you may be prescribed pre-surgery eye drops. These drops are to help prepare your eye for the surgery and minimize the chances of acquiring a post-surgery infection and to control inflammation.

How do I choose the best intraocular lens for my habits?

When looking for the right intraocular lens for your lifestyle, consider what you do all day. Do you spend a lot of time driving or watching TV? Do you spend a lot of time looking at your cell phone or reading, or do you spend a lot of time on a computer? Your answers to these questions will help determine what type of lens you need and the best prescription for your lifestyle.

Near Vision – Clear vision out to three feet
Intermediate Vision – Clear vision from three feet to 10 feet
Distance Vision – Clear vision beyond 10 feet

Choosing a Lens for Your Lifestyle

Monofocal IOLs – These IOLs have one prescription, and most people choose distance. This means that they can drive and watch TV, but need glasses for seeing things up close. These lenses are typically considered best for driving. However, if an intermediate distance is chosen, they can be good for computer work.
Multifocal IOLs – These IOLs provide clear vision for near, intermediate, and far distances. This can greatly reduce your reliance on glasses. However, the cataract surgery lenses are prone to halos and glare, especially while driving at night.
Toric IOLs – Toric IOLs are designed for people who have astigmatism. These lenses have multiple powers in order to accommodate the oddly shaped cornea. These are usually fine for computer work and driving.
Extended Depth-Of-Focus (EDOF) IOLs – These IOLs offer clear vision at a range of distances. These lenses are good for people who spend most of their time looking in the intermediate to distance vision ranges. Glasses may still be needed for reading or very close work. However, they typically work well for computer work.
Small Aperture IOLs – These lenses have a small hole in them in order to improve clarity and sharpness from unfocused peripheral light. It’s important to note that these lenses are typically only put into one eye. The other eye usually gets a monofocal lens for distance vision. The goal of this combination is to reduce reliance on glasses.
RxSight® Light-Adjustable Lenses (LALs) – Light-adjustable intraocular lenses (LALs) are monofocals. However, their unique design allows the prescription to be adjusted after implantation, using UV light. This allows the prescription to be customized after surgery to your preferences.

If Medicare covers a standard intraocular lens, what usually triggers out-of-pocket cataract surgery costs, and what are common ‘add-on’ line items?

According to Medicare, the vision coverage typically includes a conventional IOL, which is usually considered to be the monofocal lens. Coverage also usually includes pre- and post-op appointments and all of the services, supplies, and medical personnel needed to safely insert the lens. Patients are also usually allotted one pair of standard glasses or contact lenses for use after the surgery, not both. It’s important to note that Medicaid may not cover multifocal lenses, lenses for presbyopia, lenses for astigmatism, or lenses with advanced technology, such as light-adjusting lenses and extended-depth-of-focus lenses. To know what’s covered under your Medicaid plan and to understand any out-of-pocket cataract surgery costs that you might incur, it’s important to consult with our medical team at Thomas Eye Group.

What to Expect at Thomas Eye Group for Cataract Surgery

Thomas Eye Group is dedicated to providing you with the highest quality eye care and optical services. Our experienced doctors and staff are committed to improving your vision and your life through comprehensive and personalized care. Many of our physicians are highly specialized and have undergone additional training to offer the best cataract care available, including helping you choose the right cataract surgery lens for your needs and budget. By understanding what to expect before, during, and after the surgery, you can approach the process with confidence and peace of mind. Whether you have concerns about cataract surgery pain, cost, or Medicare coverage of the procedure, our team at Thomas Eye Group is here to guide you every step of the way. We strive to ensure that you are well-informed and comfortable with your decision to undergo cataract surgery, helping you achieve the best possible outcome.

About Paul Patel, M.D.

Paul Patel, M.D. is a board-certified comprehensive ophthalmologist and cataract specialist serving patients at Thomas Eye Group’s Newnan and Tyrone locations. With extensive experience in comprehensive eye care, he specializes in cataract surgery. He previously practiced in LaGrange, Georgia, for nine years. Dr. Patel completed his medical training and ophthalmology residency at the University of Texas Medical Branch.