June 18, 2025 • 25 mins
Lasik surgery Dry eye Optical Eye Surgery
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The topics and opinions express in the following show are
solely those of the hosts and their guests, and not
those of W FOURCY Radio. It's employees are affiliates. We
make no recommendations or endorsements for radio show programs, services,
or products mentioned on air or on our web. No liability,
explicit or implied shall be extended to W FOURCY Radio
or its employees are affiliates. Any questions or comments should
be directed to those show hosts. Thank you for choosing
(00:21):
W FOURCY Radio.
Speaker 2 (00:26):
Welcome to the Ask the Experts Show on W FOURCY
Radio and Talk for TV, where we bring you educational
information from top local experts in the fields of legal, health,
financial and home improvement. Now sit back and listen to
experts in family law, association law, hearing laws, business brokers,
(00:47):
home care, along with many other topics. Now Here are
your hosts, Stevo and Sophia.
Speaker 3 (00:55):
Good morning, Tennessee. Welcome to another sc experts show. I'm
your host, Steve. Though We've got two great shows for
you today. Our first show is I was kidding with him,
not really hidding, but he has become a real celebrity
on our show. I didn't want to tell him this,
(01:17):
but we've got so many letters during and after his show.
People loved this show. We knew it was going to
be a hit because people were asking us that why
don't we have an eye surgery show, and we finally
had an opening. But one of the letters said, is
doctor Jones married, And that is the first time anyone
(01:43):
has ever asked that. Let me welcome our expert from
Wang Vision Institute, one of the top eye surgery institute
in the state of Tennessee. Good morning, doctor Jones.
Speaker 4 (01:55):
Good morning Steve, thanks for having me again.
Speaker 3 (01:58):
I got to tell you, people love the way you
break things down. You make it. You know, you got
a lot of times you go to a doctor and
they try to tell you what's going on with your help,
and you're going, I don't understand. Halfterwards, he's saying, and
people really respect to you for how you break things down,
(02:21):
and we appreciate that so much.
Speaker 4 (02:23):
Doctor Jones absolutely that that's my job. You know, doctor
is there's a Latin or Greek ideology of it means
to teach. It's a teacher. So as a doctor, one
of my primary jobs is to teach my patients, and
so I have to explain to them complex things about
their eyes in ways they can un that's part of
(02:43):
my job.
Speaker 3 (02:44):
Well, you know what, we're getting so many new listen
Lady just said, I just found your show. How long
it has it been running. I'm really excited to hear
about because you were going to be talking about cataracts
today and it's such an important topic because we have
a much older audience. Doctor Jones, Sure, first, I'll tell
(03:05):
us about Wang Vision Institute. Yes.
Speaker 4 (03:08):
So, Wang Vision Institute is a practice here in Nashville, Tennessee,
downtown Nashville, which focuses on We do a lot of
different things in our practice, but our main focus is
on vision correction surgery. So we do laser cataract surgery.
That's the most common surgery we do, but we also
do vision correction surgery for younger patients such as refractive
(03:32):
lens exchange, LASIK, smile surgery, ICL surgery. All of the
various vision correction procedures we perform at Wang Vision and
we're one of the leading centers for those particular surgeries.
We see general eye exams and do comprehensive ophomology as well,
but our main focus is vision correction surgery.
Speaker 3 (03:51):
Well, we're going to be talking about cataract surgery today,
and it seems because we start promoting the show out
a couple of days before, sure a lot of people
they're One of the questions is, how do you know
when it's time to go in and see a doctor
thinking maybe you have it's time for cataracts.
Speaker 4 (04:14):
Yeah, that's a great question, that's a question I get
every day. And cataracts are a reality of normal aging.
As you get older, the natural lens of the eye
starts to yellow, harden, get cloudy, and this is a
universal aging process. When you examine the eyes of someone
in their eighties or nineties, they always have cataract. So
(04:34):
it's normal to develop cataract at a certain age. When
we recommend surgery or doing something about the cataract is
when it starts to affect your vision to the point
where it's affecting your daily functioning. So some of the
earliest symptoms of that cataract is getting to the point
where it may be worthwhile to consider surgery would be
trouble with night vision, trouble driving at night, seeing a
(04:57):
lot of glare and halos around lights at night, making
it difficult to drive. Some patients have difficulty with reading
early on in cataract development. If you're having any of
those problems, it's a good idea to have a consultation
with an ophthalmologist just to see where your cataracts are at.
Is surgery recommended at this stage? Can't wait? It's good
(05:18):
if you're if you're starting to have those symptoms, I
would I would seek out medical advice to see if
surgery it would be worthwhile. Because cataract surgery, let's face,
is the most common elective surgery that's performed in the world.
Has performed millions of times a year around the world,
and three million times a year in this country alone.
So it is a very common surgery, very safe surgery
(05:40):
as well, with a very good track record of success.
Speaker 3 (05:43):
I got to tell you the first thing I noticed
is one night I looked up at a star doctor Jones,
and like it multiplied. It looked like there was five
different points. And I noticed that at night. I really
noticed a lot at night. Sure with night vision, yes,
(06:05):
but you know, we're getting a lot of people saying
what because I probably waited three or four months to
go in and have mine done what happens if you
wait and don't take care of the situation.
Speaker 4 (06:19):
Yeah, sure, so, So when cataracts are very early in development,
it's okay to wait if you need If you aren't
ready for surgery, there's no harm in waiting. We sometimes
recommend patients if their cataracts look pretty early and mild
and they're not super bothered by their vision, it's okay
to wait another six months to a year. Come back.
(06:41):
We'll do another examine see if the cataract has progressed
to the point where surgery might be a good idea
at that point. But you don't want to wait too
too long. You don't want to let your vision get really,
really bad and really significant impairment due to cataract. Because
as cataract mature, as it develops and for Russian and severity,
(07:01):
it becomes harder, literally more hard, almost like a rock,
and it's very sometimes difficult to get it out of
the eye. We have to use a lot of ultrasonic
energy with our equipment to break up and emulsify the cataract.
That can sometimes cause a lot of swelling in the
pornia right after surgery, and it can prolong the healing process.
(07:23):
So I don't recommend waiting too long. But if the
cataract is still pretty early and your symptoms are really
very mild, it is okay to wait sometime for surgery.
But I just wouldn't wait too long.
Speaker 3 (07:32):
What about once you've had cataracts done, can they come back? No.
Speaker 4 (07:40):
So once the crystalline lens, which is what cataract is,
it's basically just cloudying of that lens right behind your pupil.
Once we emulsify it, it's gone. So we place a
lens implant in that membrane that's left over from the
old cataract, and that lens implant helps correct your vision
after surgery, so you can actually see the cataract never
grew rows back. Now, in a certain percent of patients,
(08:02):
maybe thirty to forty percent, they'll develop some cloudiness of
that membrane that capsule right behind the lens implant, and
that can kind of blur the vision with time as
that develops. That's very easy to take care of though,
with a laser procedure called the YAG laser, which we
do in our clinic. It's very quick and easy. It
takes just a couple of minutes, so that's the only
aspect of the cataract returning quote unquote, it's not really
(08:25):
the cataract coming back, it's just during the healing process
from the surgery, that capsule can get a little bit cloudy.
Speaker 3 (08:31):
I don't know if you at you yourself actually get
into this, but a lot of people wanted to know
why the I guess when you come back in to
for the second visit with cataract surgery, and why does
insurance not cover that? Yeah, a lot of people it
(08:54):
was an extra It was an extra fee that insurance
didn't cover. Sure.
Speaker 4 (09:00):
Sure, So you know, there's different insurances, Medicare, private insurance.
They all cover different surgical procedures and elective surgeries in
different ways. In general, cataract surgery, when we're talking about
removing a catact, placing a lens implant, that's a medically
necessary surgery for your quality of life and activitivities of
(09:22):
daily liking. We do build your medical insurance or at
least part of the surgery. We try to, you know,
take advantage of as much of the benefits that you
pay for through your insurance that we can for the surgery. Unfortunately,
insurances do not cover laser with cataract surgery. They just
(09:42):
pay for all metallic blade instruments for cataract surgery. They
don't pay for laser cataract surgery at all. And then
if you elect to get a premium lens of some
types such as an astigmatism correcting lens, call atoric lens,
or one of these multifocal for every young lenses that
give distance end up close vision without needing reading glasses,
(10:03):
those have an extra charge out of pocket as well.
Insurance will only cover what's called a basic monofocal lens,
which is just a single distance lens implant, usually for
distance vision, and you still have to wear glasses for
everything else afterwards. So that's that's part of usually why
there's extra out of pocket costs for cataract surgery in
(10:27):
a lot of cases. But in my opinion, it's worth it.
This is a one time surgery. It's not like you're
going to need the surgery every year for the rest
of your life, and it's the opportunity to really correct
your vision and improve your vision quality. And our vision
is important, it's our you know, in my opinion, it's
our most important way that we experience the world. And
so I think it's worth the cost generally.
Speaker 3 (10:48):
What about I, is there a laser cataract surgery. Yeah, yes,
so laser there's the difference.
Speaker 4 (11:00):
Yeah, so that's a great question. So in the United States,
not many cataract surgeries are actually done with laser, and
again that's generally because of the out of pocket cost
for patients associated with it. Only aboutbout five to ten
percent of cataract surgeries in the United States are being
done with laser. At Weighing Vision Institute, for example, we
(11:21):
were the very first practice in the state a Tendency
to start using laser with cataract surgery when it first
came out about ten to twelve years ago. Now and
now in our practice, we do one hundred percent of
our cataract surgeries with laser. Patients come to us specifically
or laser cataract surgery because they know of our reputation
as one of the leading laser centers in the area.
(11:43):
Laser has a lot of advantages for cataract surgery. Bottom
line is it increases the safety and the precision of
the surgery. The laser instead of having to make the
incisions with metallic blade instruments, the laser can make the
incisions for us, the laser can accrrect some stigmatism as well.
At the time of surgery, the laser opens up the
(12:04):
membrane in a perfectly circular, perfectly sized, perfectly round opening,
and that's very, very important because we use a lot
of premium lenses in our practice to get vision patient's
vision as good as possible. We want those lenses to
be very well centered and not tilted at all, and
that perfectly round, perfectly sized opening helps with that tremendously.
The laser can break the cataract up into a few
(12:26):
pieces as well, so we have to use less energy
to emulsify these really hard cataracts, for example, and the
vision recovery is a little bit faster on average because
of that. So the laser does have some tangible benefits
with the cataract surgery. Unfortunately, insurance usually is not going
to pay for it at all. It's an out of
pocket charge for patients.
Speaker 3 (12:46):
What let's talk about the surgery itself. Is it painful
or I didn't have any pain with mine? Yeah, and
I didn't have any side effects all. But are there
or side effects also? Yes?
Speaker 4 (13:03):
That's a great question. So is the surgery painful. The
answer is no, it's not painful at all. Numbin drops
are placed on the eye and that controls about ninety
nine percent of any discomfort that might occur during the surgery.
We do all of our cataract surgeries at our surgery center,
where we do have an anesthesia provider a CRNA or
antithesiologist to give some sedation as well, so you're awake
(13:25):
for the surgery, but you're nice and comfortable. It helps
relax you a lot of times. It makes patients kind
of not remember a lot about the surgery to begin with,
which is nice. But during the surgery itself, there's no pain.
There's usually just maybe a water sensation over the eye
and maybe very slight pressure at times. That's about the
extent of what one can expect during the cataract surgery
(13:47):
in terms of things you experience, and really you're just
looking at a bright light the whole time and just
trying to stay as still as you can. That's really
all all there is to it from the patient's perspective.
Side effects from the surgery are usually pretty mild. There's
a little bit of blurriness the first couple of days
that usually clears up, usually within a week, sometimes two weeks,
depending on how bad the catteract is. Some patients will
(14:10):
see a little bit of glare or halos or a
little twinkle around lights, or little leaviness or reflections when
the light hits the eye a certain way. That's totally normal.
Some patients may see the edge of the lens in
plant with a little shadow out on the side, and
their vision kind of like a black crescent almost. That
tends to get better with time. Those are kind of
some of the biggest side effects per se of the surgery.
Speaker 3 (14:33):
I gotta tell you, it was such an easy surgery.
They told me I need to have someone to drive
me home, but I got to tell you I could
have driven myself. It was such an easy And I
got to tell you Wang Institute is, and I'm in
Florida and there you know, and they're in Tennessee. Because
(14:54):
I guarantee you if I were in Tennessee, anywhere in Tennessee,
I would have gone to Wang to have my laysick
and my cataracts done. You guys are so far ahead.
I got to tell you. You probably won't admit this,
but Wang is so far ahead of most ophthalmologists.
Speaker 4 (15:17):
Well, I thank you for saying that. We try to
stay A mantra of our practice is staying on the
cutting edge of technology. So, like I said, we were
the first in the state of Tennessee to start using
laser with cataract surgery, and one of the first centers
in the whole country. Actually, we were one of the
first to adopt laser, the first practice to do smile
small incision lasick in the state of Tennessee, and we're
(15:39):
one of the leading centers in the country for that
particular surgery, one of the first centers in the state
of Tennessee, the first actually to use the trifocal lensing
plant at the time of lens replacement. So we have
a history of being one of the first to adopt
new technology as it comes out, and we become experts
in this technology as time progresses and patients come to
(16:01):
us specifically because of that reputation and knowledge that we
have as physicians.
Speaker 3 (16:06):
And I got to tell you, we are so lucky
to have you all on with us. We do a
live show and the show's become so important we replay
it throughout the month. One of the things some of
these things I know from going through cataracts. But you know,
what we're doing is we're educating the audience out here.
(16:29):
How long does the surgery take?
Speaker 4 (16:32):
Yeah, that's a good question. So the surgery is pretty quick.
The laser portion of the procedure takes like a minute
or two, very quick and easy. The surgery itself, removal
of the cataract and placement of the lens implant on
average ten minutes or so for most cats. So this
is a very very quick surgery. I tell most patients,
you'll be at our surgery center no more than like
(16:55):
an hour or two usually, yes, And get you ready,
get the dilating drops in, do the surgery, which is
really quick. Bringing back to recovery, make sure everything's good,
and you go home right after surgery. It's quite quick.
Speaker 3 (17:09):
And are there any type of restrictions during the recovery period.
Speaker 4 (17:16):
Yeah, there are some restrictions. Day of surgery, I recommend
to go home and try to take it easy. That's
the most critical time, when the incisions are still fresh,
the lensing plant is still kind of getting adjusted to
the capsule or bag that we placed it in. Day
of surgery, try to take it easy, try to do
very minimal of anything day up surgery. Day after surgery,
(17:39):
you can go back to doing most normal activities. I
would the caveat would be for the usually I reckonend
for the first two weeks, trying to avoid a lot
of aggressive exercise, bending over, heavy lifting, any really significant
exercise where you're gonna be sweating a lot and sweat
could get in the eyes. Try to avoid that for
two weeks. No water in the eyes for two weeks.
(18:02):
Showering is totally fine, but avoid pools, hot tubs, saunos,
things like that with contaminated water sources. And then we
just ask you to try to avoid rubbing the eyes
or putting any pressure on the eye for the first
week after surgery. Those are the basic restrictions. But in
terms of driving, most patients are going to be okay.
(18:22):
You can drive the next day if you feel comfortable.
You can work on the computer. If you feel comfortable
and you're able to see well enough, you can be
on your phone. All of that's fine. Day after surgery.
Speaker 3 (18:33):
Here's Molly in Nashville. I am so glad there is
a show like this. I had cataracts and it's nice
that you're educating people about this. My question is well, still, well,
people still need glass and what are my options to
(18:54):
reduce my dependency on glasses.
Speaker 4 (18:57):
Yeah, that's a great question. At WANG, we do our
best to make our patients as independent of glasses as
we possibly can, so a lot of times that does
involve using special lens implants at the time of the
cataract surgery. Top majority of the time it's to correct
people's stigmatism so they can see very very clearly for distance,
(19:18):
and they still need reading glasses after the surgery with
that particular lens implant. Some patients come to us and
don't want to They want to minimize their dependence on
glasses as much as possible, And for those patients, a
lot of times we as long as they are a
good candidate based on our testing we do in clinic,
will recommend the trifocal multifocal for every young lens which
gives a distance and up close vision. So yes, there
(19:39):
are definitely lens implant options to help reduce your dependence
on needing glasses after the surgery. In years past, you know,
twenty years ago, the goal of cataract surgery was really
just to get the cataracts out and just put some
kind of lens in there so the visions at least
mildly corrected. And the expectation was you need to wear
(20:00):
glasses full time for everything afterwards, progressive glasses for distance
and up clothes in order to see clearly. Cataract surgery
technology has involved evolved tremendously since then with laser and
these premium lenses, and we can definitely a lot of
times get patients very minimally dependent on glasses.
Speaker 3 (20:20):
I got to tell the listeners if you are looking
for a clinic and ophthalmologists that is state of the art,
sometimes way ahead of other clinics around the state. Wang
Institute is your best bet. We've actually had a couple
(20:42):
of people call us that have had surgeries different types
of surgeries by Wang Institute just recommended you so highly,
Doctor Jones. Is are there any misconceptions about the laser
cataract surgery?
Speaker 4 (21:00):
Yeah, well, I mean, I think probably one of the
biggest misconceptions about cataract surgery in general, which we kind
of alluded to earlier, is that you have to wait
to have cataract surgery until the cataract progresses to a
certain point, and a lot of people just kind of
suffer through their vision kind of slowly deteriorating with time.
And that's one of the biggest misconceptions that I hear
(21:22):
from people that I meet, you know, outside of my
practice in my daily life. They wonder, you know, if
they need to wait to have cataract surgery until it
gets really, really bad. And my answer to that is,
as I mentioned earlier, is no, it's a good idea
to have a consultation at least with an eye surgeon
or an ophthalmologist to figure out if it would be
(21:43):
recommended to do cataract surgery. And we do cataract surgery
all the time for patients who are maybe just the
cataracts kind of in the earlier stages, but they're really
bothered by their vision. They're struggling a lot, and they
want to improve it. Cataract surgery. The technologies evolved, and
so we're able to do cataract surgery much earlier in
the progression of cataracts and still get excellent outcomes for patients.
(22:07):
And so that's one of the biggest misconceptions that I
kind of encounter on a daily basis.
Speaker 3 (22:11):
Yeah, do you ever get where the vision of what
the patient changes after laser cataract surgery. I mean, if
that happened, what are their options then.
Speaker 4 (22:23):
Yeah, that's a great question. So yes, I mean vision
can change after cataract surgery. The lens implants are designed
to their biocompatible and they're designed to be able to
last the rest of your life. They're designed to be
able to last decades and decades in the future with
no problem. So the correction afforded by the lens implant
that we place at the time of surgery is permanent. Now,
(22:45):
vision can change with time due to some of the
cloudiness of the capsule, like I mentioned earlier, where we
do the ag laser to clear up the vision. That's
very common. That's probably the most common scenario where vision
might get a little bit worse with time after cataract surgery,
and it's pretty easy to address with the YAG laser.
That's one thing. Sometimes vision does change a stigmatism as
(23:07):
patients get older into their seventies, eighties, nineties, a stigmatism
on the cornea, that front part of the eye can
start to change and its magnitude with time, and when
that occurs, you know, sometimes we're rec you know, it
gets to the point where sometimes we do recommend patents
start wearing glasses. Again, that's not super common. Sometimes it
does get to that point. It's not super common that
(23:29):
a stigmatism changes dramatically with time, but that would be
one of the most common scenarios as patients get into
like their eighties and nineties and beyond. Is that a
stigmatism changing.
Speaker 3 (23:39):
Doctor Jones, Your show goes by so fast. Tell people
how they can reach Wang Vision Institute.
Speaker 4 (23:47):
Yes, absolutely so. We have a website www. Dot wang
Vision Institute dot com that has tremendous valuable information about
all the surgeries we provide and links to attend our
webinar that we do every week where we discuss all
these procedures in a little bit further detail, and there's
links to book consultations in our office if you're interested.
(24:08):
We have a phone number at six one five three
two one eight eight eight one as well where you
can speak to one of our staff if you have
any additional questions. We're interested in scheduling a consultation.
Speaker 3 (24:19):
Doctor Jones. You're such a superstar, Doctor Jones. You'll be
back with us hopefully next month. Your show's on next month.
You usually split time, but we'll see you next. Thank
you so much for all the great information.
Speaker 4 (24:33):
Absolutely, thank you Steve, thanks for having me.
Speaker 3 (24:35):
Thanks doctor Jones. That's doctor Jones with Wang Institute. We're
going to go to a break right now and we
come back. We've got more Asked the Experts.
Speaker 2 (24:47):
Thanks for tuning in today to the Ask the Expert
Show on the W four CY radio and Talk for TV.
Tune in next week and every week to hear more
from our experts on personal injury, insurance, air condition repairs,
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The topics and opinions express in the following show are
solely those of the hosts and their guests, and not
those of W FOURCY Radio. It's employees are affiliates. We
make no recommendations or endorsements for radio show programs, services,
or products mentioned on air or on our web. No liability,
explicit or implied shall be extended to W FOURCY Radio
or its employees are affiliates. Any questions or comments should
be directed to those show hosts. Thank you for choosing
(00:21):
W FOURCY Radio.
Speaker 2 (00:26):
Welcome to the Ask the Experts Show on W FOURCY
Radio and Talk for TV, where we bring you educational
information from top local experts in the fields of legal, health,
financial and home improvement. Now sit back and listen to
experts in family law, association law, hearing laws, business brokers,
(00:47):
home care, along with many other topics. Now Here are
your hosts, Stevo and Sophia.
Speaker 3 (00:55):
Good morning, Tennessee. Welcome to another sc experts show. I'm
your host, Steve. Though We've got two great shows for
you today. Our first show is I was kidding with him,
not really hidding, but he has become a real celebrity
on our show. I didn't want to tell him this,
(01:17):
but we've got so many letters during and after his show.
People loved this show. We knew it was going to
be a hit because people were asking us that why
don't we have an eye surgery show, and we finally
had an opening. But one of the letters said, is
doctor Jones married, And that is the first time anyone
(01:43):
has ever asked that. Let me welcome our expert from
Wang Vision Institute, one of the top eye surgery institute
in the state of Tennessee. Good morning, doctor Jones.
Speaker 4 (01:55):
Good morning Steve, thanks for having me again.
Speaker 3 (01:58):
I got to tell you, people love the way you
break things down. You make it. You know, you got
a lot of times you go to a doctor and
they try to tell you what's going on with your help,
and you're going, I don't understand. Halfterwards, he's saying, and
people really respect to you for how you break things down,
(02:21):
and we appreciate that so much.
Speaker 4 (02:23):
Doctor Jones absolutely that that's my job. You know, doctor
is there's a Latin or Greek ideology of it means
to teach. It's a teacher. So as a doctor, one
of my primary jobs is to teach my patients, and
so I have to explain to them complex things about
their eyes in ways they can un that's part of
(02:43):
my job.
Speaker 3 (02:44):
Well, you know what, we're getting so many new listen
Lady just said, I just found your show. How long
it has it been running. I'm really excited to hear
about because you were going to be talking about cataracts
today and it's such an important topic because we have
a much older audience. Doctor Jones, Sure, first, I'll tell
(03:05):
us about Wang Vision Institute. Yes.
Speaker 4 (03:08):
So, Wang Vision Institute is a practice here in Nashville, Tennessee,
downtown Nashville, which focuses on We do a lot of
different things in our practice, but our main focus is
on vision correction surgery. So we do laser cataract surgery.
That's the most common surgery we do, but we also
do vision correction surgery for younger patients such as refractive
(03:32):
lens exchange, LASIK, smile surgery, ICL surgery. All of the
various vision correction procedures we perform at Wang Vision and
we're one of the leading centers for those particular surgeries.
We see general eye exams and do comprehensive ophomology as well,
but our main focus is vision correction surgery.
Speaker 3 (03:51):
Well, we're going to be talking about cataract surgery today,
and it seems because we start promoting the show out
a couple of days before, sure a lot of people
they're One of the questions is, how do you know
when it's time to go in and see a doctor
thinking maybe you have it's time for cataracts.
Speaker 4 (04:14):
Yeah, that's a great question, that's a question I get
every day. And cataracts are a reality of normal aging.
As you get older, the natural lens of the eye
starts to yellow, harden, get cloudy, and this is a
universal aging process. When you examine the eyes of someone
in their eighties or nineties, they always have cataract. So
(04:34):
it's normal to develop cataract at a certain age. When
we recommend surgery or doing something about the cataract is
when it starts to affect your vision to the point
where it's affecting your daily functioning. So some of the
earliest symptoms of that cataract is getting to the point
where it may be worthwhile to consider surgery would be
trouble with night vision, trouble driving at night, seeing a
(04:57):
lot of glare and halos around lights at night, making
it difficult to drive. Some patients have difficulty with reading
early on in cataract development. If you're having any of
those problems, it's a good idea to have a consultation
with an ophthalmologist just to see where your cataracts are at.
Is surgery recommended at this stage? Can't wait? It's good
(05:18):
if you're if you're starting to have those symptoms, I
would I would seek out medical advice to see if
surgery it would be worthwhile. Because cataract surgery, let's face,
is the most common elective surgery that's performed in the world.
Has performed millions of times a year around the world,
and three million times a year in this country alone.
So it is a very common surgery, very safe surgery
(05:40):
as well, with a very good track record of success.
Speaker 3 (05:43):
I got to tell you the first thing I noticed
is one night I looked up at a star doctor Jones,
and like it multiplied. It looked like there was five
different points. And I noticed that at night. I really
noticed a lot at night. Sure with night vision, yes,
(06:05):
but you know, we're getting a lot of people saying
what because I probably waited three or four months to
go in and have mine done what happens if you
wait and don't take care of the situation.
Speaker 4 (06:19):
Yeah, sure, so, So when cataracts are very early in development,
it's okay to wait if you need If you aren't
ready for surgery, there's no harm in waiting. We sometimes
recommend patients if their cataracts look pretty early and mild
and they're not super bothered by their vision, it's okay
to wait another six months to a year. Come back.
(06:41):
We'll do another examine see if the cataract has progressed
to the point where surgery might be a good idea
at that point. But you don't want to wait too
too long. You don't want to let your vision get really,
really bad and really significant impairment due to cataract. Because
as cataract mature, as it develops and for Russian and severity,
(07:01):
it becomes harder, literally more hard, almost like a rock,
and it's very sometimes difficult to get it out of
the eye. We have to use a lot of ultrasonic
energy with our equipment to break up and emulsify the cataract.
That can sometimes cause a lot of swelling in the
pornia right after surgery, and it can prolong the healing process.
(07:23):
So I don't recommend waiting too long. But if the
cataract is still pretty early and your symptoms are really
very mild, it is okay to wait sometime for surgery.
But I just wouldn't wait too long.
Speaker 3 (07:32):
What about once you've had cataracts done, can they come back? No.
Speaker 4 (07:40):
So once the crystalline lens, which is what cataract is,
it's basically just cloudying of that lens right behind your pupil.
Once we emulsify it, it's gone. So we place a
lens implant in that membrane that's left over from the
old cataract, and that lens implant helps correct your vision
after surgery, so you can actually see the cataract never
grew rows back. Now, in a certain percent of patients,
(08:02):
maybe thirty to forty percent, they'll develop some cloudiness of
that membrane that capsule right behind the lens implant, and
that can kind of blur the vision with time as
that develops. That's very easy to take care of though,
with a laser procedure called the YAG laser, which we
do in our clinic. It's very quick and easy. It
takes just a couple of minutes, so that's the only
aspect of the cataract returning quote unquote, it's not really
(08:25):
the cataract coming back, it's just during the healing process
from the surgery, that capsule can get a little bit cloudy.
Speaker 3 (08:31):
I don't know if you at you yourself actually get
into this, but a lot of people wanted to know
why the I guess when you come back in to
for the second visit with cataract surgery, and why does
insurance not cover that? Yeah, a lot of people it
(08:54):
was an extra It was an extra fee that insurance
didn't cover. Sure.
Speaker 4 (09:00):
Sure, So you know, there's different insurances, Medicare, private insurance.
They all cover different surgical procedures and elective surgeries in
different ways. In general, cataract surgery, when we're talking about
removing a catact, placing a lens implant, that's a medically
necessary surgery for your quality of life and activitivities of
(09:22):
daily liking. We do build your medical insurance or at
least part of the surgery. We try to, you know,
take advantage of as much of the benefits that you
pay for through your insurance that we can for the surgery. Unfortunately,
insurances do not cover laser with cataract surgery. They just
(09:42):
pay for all metallic blade instruments for cataract surgery. They
don't pay for laser cataract surgery at all. And then
if you elect to get a premium lens of some
types such as an astigmatism correcting lens, call atoric lens,
or one of these multifocal for every young lenses that
give distance end up close vision without needing reading glasses,
(10:03):
those have an extra charge out of pocket as well.
Insurance will only cover what's called a basic monofocal lens,
which is just a single distance lens implant, usually for
distance vision, and you still have to wear glasses for
everything else afterwards. So that's that's part of usually why
there's extra out of pocket costs for cataract surgery in
(10:27):
a lot of cases. But in my opinion, it's worth it.
This is a one time surgery. It's not like you're
going to need the surgery every year for the rest
of your life, and it's the opportunity to really correct
your vision and improve your vision quality. And our vision
is important, it's our you know, in my opinion, it's
our most important way that we experience the world. And
so I think it's worth the cost generally.
Speaker 3 (10:48):
What about I, is there a laser cataract surgery. Yeah, yes,
so laser there's the difference.
Speaker 4 (11:00):
Yeah, so that's a great question. So in the United States,
not many cataract surgeries are actually done with laser, and
again that's generally because of the out of pocket cost
for patients associated with it. Only aboutbout five to ten
percent of cataract surgeries in the United States are being
done with laser. At Weighing Vision Institute, for example, we
(11:21):
were the very first practice in the state a Tendency
to start using laser with cataract surgery when it first
came out about ten to twelve years ago. Now and
now in our practice, we do one hundred percent of
our cataract surgeries with laser. Patients come to us specifically
or laser cataract surgery because they know of our reputation
as one of the leading laser centers in the area.
(11:43):
Laser has a lot of advantages for cataract surgery. Bottom
line is it increases the safety and the precision of
the surgery. The laser instead of having to make the
incisions with metallic blade instruments, the laser can make the
incisions for us, the laser can accrrect some stigmatism as well.
At the time of surgery, the laser opens up the
(12:04):
membrane in a perfectly circular, perfectly sized, perfectly round opening,
and that's very, very important because we use a lot
of premium lenses in our practice to get vision patient's
vision as good as possible. We want those lenses to
be very well centered and not tilted at all, and
that perfectly round, perfectly sized opening helps with that tremendously.
The laser can break the cataract up into a few
(12:26):
pieces as well, so we have to use less energy
to emulsify these really hard cataracts, for example, and the
vision recovery is a little bit faster on average because
of that. So the laser does have some tangible benefits
with the cataract surgery. Unfortunately, insurance usually is not going
to pay for it at all. It's an out of
pocket charge for patients.
Speaker 3 (12:46):
What let's talk about the surgery itself. Is it painful
or I didn't have any pain with mine? Yeah, and
I didn't have any side effects all. But are there
or side effects also? Yes?
Speaker 4 (13:03):
That's a great question. So is the surgery painful. The
answer is no, it's not painful at all. Numbin drops
are placed on the eye and that controls about ninety
nine percent of any discomfort that might occur during the surgery.
We do all of our cataract surgeries at our surgery center,
where we do have an anesthesia provider a CRNA or
antithesiologist to give some sedation as well, so you're awake
(13:25):
for the surgery, but you're nice and comfortable. It helps
relax you a lot of times. It makes patients kind
of not remember a lot about the surgery to begin with,
which is nice. But during the surgery itself, there's no pain.
There's usually just maybe a water sensation over the eye
and maybe very slight pressure at times. That's about the
extent of what one can expect during the cataract surgery
(13:47):
in terms of things you experience, and really you're just
looking at a bright light the whole time and just
trying to stay as still as you can. That's really
all all there is to it from the patient's perspective.
Side effects from the surgery are usually pretty mild. There's
a little bit of blurriness the first couple of days
that usually clears up, usually within a week, sometimes two weeks,
depending on how bad the catteract is. Some patients will
(14:10):
see a little bit of glare or halos or a
little twinkle around lights, or little leaviness or reflections when
the light hits the eye a certain way. That's totally normal.
Some patients may see the edge of the lens in
plant with a little shadow out on the side, and
their vision kind of like a black crescent almost. That
tends to get better with time. Those are kind of
some of the biggest side effects per se of the surgery.
Speaker 3 (14:33):
I gotta tell you, it was such an easy surgery.
They told me I need to have someone to drive
me home, but I got to tell you I could
have driven myself. It was such an easy And I
got to tell you Wang Institute is, and I'm in
Florida and there you know, and they're in Tennessee. Because
(14:54):
I guarantee you if I were in Tennessee, anywhere in Tennessee,
I would have gone to Wang to have my laysick
and my cataracts done. You guys are so far ahead.
I got to tell you. You probably won't admit this,
but Wang is so far ahead of most ophthalmologists.
Speaker 4 (15:17):
Well, I thank you for saying that. We try to
stay A mantra of our practice is staying on the
cutting edge of technology. So, like I said, we were
the first in the state of Tennessee to start using
laser with cataract surgery, and one of the first centers
in the whole country. Actually, we were one of the
first to adopt laser, the first practice to do smile
small incision lasick in the state of Tennessee, and we're
(15:39):
one of the leading centers in the country for that
particular surgery, one of the first centers in the state
of Tennessee, the first actually to use the trifocal lensing
plant at the time of lens replacement. So we have
a history of being one of the first to adopt
new technology as it comes out, and we become experts
in this technology as time progresses and patients come to
(16:01):
us specifically because of that reputation and knowledge that we
have as physicians.
Speaker 3 (16:06):
And I got to tell you, we are so lucky
to have you all on with us. We do a
live show and the show's become so important we replay
it throughout the month. One of the things some of
these things I know from going through cataracts. But you know,
what we're doing is we're educating the audience out here.
(16:29):
How long does the surgery take?
Speaker 4 (16:32):
Yeah, that's a good question. So the surgery is pretty quick.
The laser portion of the procedure takes like a minute
or two, very quick and easy. The surgery itself, removal
of the cataract and placement of the lens implant on
average ten minutes or so for most cats. So this
is a very very quick surgery. I tell most patients,
you'll be at our surgery center no more than like
(16:55):
an hour or two usually, yes, And get you ready,
get the dilating drops in, do the surgery, which is
really quick. Bringing back to recovery, make sure everything's good,
and you go home right after surgery. It's quite quick.
Speaker 3 (17:09):
And are there any type of restrictions during the recovery period.
Speaker 4 (17:16):
Yeah, there are some restrictions. Day of surgery, I recommend
to go home and try to take it easy. That's
the most critical time, when the incisions are still fresh,
the lensing plant is still kind of getting adjusted to
the capsule or bag that we placed it in. Day
of surgery, try to take it easy, try to do
very minimal of anything day up surgery. Day after surgery,
(17:39):
you can go back to doing most normal activities. I
would the caveat would be for the usually I reckonend
for the first two weeks, trying to avoid a lot
of aggressive exercise, bending over, heavy lifting, any really significant
exercise where you're gonna be sweating a lot and sweat
could get in the eyes. Try to avoid that for
two weeks. No water in the eyes for two weeks.
(18:02):
Showering is totally fine, but avoid pools, hot tubs, saunos,
things like that with contaminated water sources. And then we
just ask you to try to avoid rubbing the eyes
or putting any pressure on the eye for the first
week after surgery. Those are the basic restrictions. But in
terms of driving, most patients are going to be okay.
(18:22):
You can drive the next day if you feel comfortable.
You can work on the computer. If you feel comfortable
and you're able to see well enough, you can be
on your phone. All of that's fine. Day after surgery.
Speaker 3 (18:33):
Here's Molly in Nashville. I am so glad there is
a show like this. I had cataracts and it's nice
that you're educating people about this. My question is well, still, well,
people still need glass and what are my options to
(18:54):
reduce my dependency on glasses.
Speaker 4 (18:57):
Yeah, that's a great question. At WANG, we do our
best to make our patients as independent of glasses as
we possibly can, so a lot of times that does
involve using special lens implants at the time of the
cataract surgery. Top majority of the time it's to correct
people's stigmatism so they can see very very clearly for distance,
(19:18):
and they still need reading glasses after the surgery with
that particular lens implant. Some patients come to us and
don't want to They want to minimize their dependence on
glasses as much as possible, And for those patients, a
lot of times we as long as they are a
good candidate based on our testing we do in clinic,
will recommend the trifocal multifocal for every young lens which
gives a distance and up close vision. So yes, there
(19:39):
are definitely lens implant options to help reduce your dependence
on needing glasses after the surgery. In years past, you know,
twenty years ago, the goal of cataract surgery was really
just to get the cataracts out and just put some
kind of lens in there so the visions at least
mildly corrected. And the expectation was you need to wear
(20:00):
glasses full time for everything afterwards, progressive glasses for distance
and up clothes in order to see clearly. Cataract surgery
technology has involved evolved tremendously since then with laser and
these premium lenses, and we can definitely a lot of
times get patients very minimally dependent on glasses.
Speaker 3 (20:20):
I got to tell the listeners if you are looking
for a clinic and ophthalmologists that is state of the art,
sometimes way ahead of other clinics around the state. Wang
Institute is your best bet. We've actually had a couple
(20:42):
of people call us that have had surgeries different types
of surgeries by Wang Institute just recommended you so highly,
Doctor Jones. Is are there any misconceptions about the laser
cataract surgery?
Speaker 4 (21:00):
Yeah, well, I mean, I think probably one of the
biggest misconceptions about cataract surgery in general, which we kind
of alluded to earlier, is that you have to wait
to have cataract surgery until the cataract progresses to a
certain point, and a lot of people just kind of
suffer through their vision kind of slowly deteriorating with time.
And that's one of the biggest misconceptions that I hear
(21:22):
from people that I meet, you know, outside of my
practice in my daily life. They wonder, you know, if
they need to wait to have cataract surgery until it
gets really, really bad. And my answer to that is,
as I mentioned earlier, is no, it's a good idea
to have a consultation at least with an eye surgeon
or an ophthalmologist to figure out if it would be
(21:43):
recommended to do cataract surgery. And we do cataract surgery
all the time for patients who are maybe just the
cataracts kind of in the earlier stages, but they're really
bothered by their vision. They're struggling a lot, and they
want to improve it. Cataract surgery. The technologies evolved, and
so we're able to do cataract surgery much earlier in
the progression of cataracts and still get excellent outcomes for patients.
(22:07):
And so that's one of the biggest misconceptions that I
kind of encounter on a daily basis.
Speaker 3 (22:11):
Yeah, do you ever get where the vision of what
the patient changes after laser cataract surgery. I mean, if
that happened, what are their options then.
Speaker 4 (22:23):
Yeah, that's a great question. So yes, I mean vision
can change after cataract surgery. The lens implants are designed
to their biocompatible and they're designed to be able to
last the rest of your life. They're designed to be
able to last decades and decades in the future with
no problem. So the correction afforded by the lens implant
that we place at the time of surgery is permanent. Now,
(22:45):
vision can change with time due to some of the
cloudiness of the capsule, like I mentioned earlier, where we
do the ag laser to clear up the vision. That's
very common. That's probably the most common scenario where vision
might get a little bit worse with time after cataract surgery,
and it's pretty easy to address with the YAG laser.
That's one thing. Sometimes vision does change a stigmatism as
(23:07):
patients get older into their seventies, eighties, nineties, a stigmatism
on the cornea, that front part of the eye can
start to change and its magnitude with time, and when
that occurs, you know, sometimes we're rec you know, it
gets to the point where sometimes we do recommend patents
start wearing glasses. Again, that's not super common. Sometimes it
does get to that point. It's not super common that
(23:29):
a stigmatism changes dramatically with time, but that would be
one of the most common scenarios as patients get into
like their eighties and nineties and beyond. Is that a
stigmatism changing.
Speaker 3 (23:39):
Doctor Jones, Your show goes by so fast. Tell people
how they can reach Wang Vision Institute.
Speaker 4 (23:47):
Yes, absolutely so. We have a website www. Dot wang
Vision Institute dot com that has tremendous valuable information about
all the surgeries we provide and links to attend our
webinar that we do every week where we discuss all
these procedures in a little bit further detail, and there's
links to book consultations in our office if you're interested.
(24:08):
We have a phone number at six one five three
two one eight eight eight one as well where you
can speak to one of our staff if you have
any additional questions. We're interested in scheduling a consultation.
Speaker 3 (24:19):
Doctor Jones. You're such a superstar, Doctor Jones. You'll be
back with us hopefully next month. Your show's on next month.
You usually split time, but we'll see you next. Thank
you so much for all the great information.
Speaker 4 (24:33):
Absolutely, thank you Steve, thanks for having me.
Speaker 3 (24:35):
Thanks doctor Jones. That's doctor Jones with Wang Institute. We're
going to go to a break right now and we
come back. We've got more Asked the Experts.
Speaker 2 (24:47):
Thanks for tuning in today to the Ask the Expert
Show on the W four CY radio and Talk for TV.
Tune in next week and every week to hear more
from our experts on personal injury, insurance, air condition repairs,
estate planning, medicare, and many other topics in the areas
of legal, health, financial and home improvement. See you next week.
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