Cataract Surgery

What it is

The lens sits behind the pupil and focuses light onto the back of the eye. A cataract is that lens turning cloudy, which scatters light and blurs vision. Surgery removes the clouded lens and replaces it with a clear artificial one, called an intraocular lens or IOL. The common technique uses an instrument that breaks the lens up with sound waves so it can be drawn out through a very small opening; the artificial lens is then folded in through the same opening. The incisions are usually small enough to seal themselves without stitches. This code covers the routine, one-stage version of that operation.

Why it is done

• To restore vision that a cataract has clouded enough to interfere with reading, driving, or everyday activity
• To reduce glare and halos around lights, which are common as a cataract develops
• Occasionally to clear the view of the back of the eye so another eye condition can be examined or treated

What to expect

This is outpatient surgery. Adults are usually awake with the eye numbed and often with light sedation, and the operation itself generally takes under half an hour, followed by a short recovery period before going home. Each eye is done as its own procedure on its own day, so a person with cataracts in both eyes has two surgeries and two bills. Afterward there are eye drops on a schedule, a period of not rubbing the eye and keeping water out of it, and follow-up visits. Vision often improves within days, while full healing takes several weeks.

Questions worth asking

• Which lens is included in the quoted price? Standard monofocal lenses are typically covered, while multifocal or astigmatism-correcting lenses often carry an out-of-pocket charge on top.
• Is this price for one eye? If both eyes need surgery, expect the facility and surgeon fees twice.
• Is it being done at a hospital outpatient department or an ambulatory surgery center? The facility fee is often the biggest difference between the two.
• Are the pre-operative measurements of the eye, the anesthesia, and the post-operative visits included, or billed separately?
• If a laser is used for part of the operation, is that an extra charge?