Eye Associates of Lancaster

Lancaster Office
1254 Lititz Pike
Lancaster, PA 17601-4395
Office: 397-4724
Optical Center
397-7377

LGH Health Campus
2106 Harrisburg Pike,
Suite 309
P.O. Box 3200
Lancaster, PA 17604-3200 Office: 290-6879
Optical Center
290-7456

Elizabethtown
222 South Market St.
Suite 105
Elizabethtown, PA 17022
Office: 397-4724

New Holland
654 East Main St.
New Holland, PA 17557
Office: 397-4724

INFORMED CONSENT FOR CATARACT SURGERY AND/OR IMPLANTATION OF AN INTRAOCULAR LENS

Except for unusual situations, a cataract operation is indicated only when you cannot function satisfactorily due to decreased vision caused by the cataract. If you decide to have an operation, the surgeon will replace your natural lens with an intraocular lens implant (IOL) in order to restore your vision. Usually eyeglasses will be required in addition to the IOL for best vision. The alternatives are not to have a cataract operation and continue to manage with your current vision, or the limited improvement obtainable with glasses or contacts.

BENEFITS OF CATARACT SURGERY

The goal of cataract surgery is to correct the decreased vision that was caused by the cataract. The doctor has explained to me the expected improvement in my visual function. However, I understand there is no certainty that I will achieve these benefits and no guarantee has been made to me regarding the outcome of the procedure(s). Cataract surgery will not correct other causes of decreased vision, such as glaucoma, diabetes, or age-related macular degeneration. Since only one eye will undergo surgery at a time, a period of imbalance between the two eyes may be experienced if there is also some cataract in the other eye. If this is expected to be the case, usually within 4 weeks the first eye has healed and surgery on the second eye can be performed.

Patients who desire as much functional vision as possible without the use of eyeglasses may choose to have implantation of a special advanced technology IOL. These IOLs can correct astigmatism (TORIC IOL) or correct presbyopia (MULTIFOCAL IOL). Separate information will be provided to me and attached to this consent if I am determined to be a candidate for one of these surgical options.

RISKS OF CATARACT SURGERY

Cataract surgery is usually quite comfortable. Mild discomfort for the first 24 hours is typical, but severe pain would be extremely unusual and should be reported immediately to the surgeon. Sudden changes in vision in the postoperative period are also uncommon and should be reported immediately.

RISKS OF CATARACT SURGERY INCLUDE, BUT ARE NOT LIMITED TO:

Complications of removing the natural lens may include damage to any part of the eye, hemorrhage (bleeding); severe inflammation or infection, rupture of the capsule that supports the IOL; clouding of the capsule, which is treated with a laser procedure after surgery, perforation of the eye; persistent swelling or clouding of the cornea; swelling in the center of the retina (macula); retained pieces of cataract that could not be removed at the time of surgery; distortion of the pupil or iris; infection; detachment of the retina; uncomfortable or painful eye; droopy eyelid; increased astigmatism; glaucoma; and double vision. These and other complications may occur whether or not an IOL is implanted and may result in failure to improve vision after cataract surgery, permanent poor vision, total loss of vision, or even loss of the eye in rare situations. Complications may occur at the time of surgery or in the future. Additional eye surgery may be required to treat these complications. This additional treatment is not included in the fee for this procedure.
Complications associated with any type of IOL may include increased night glare and/or halo, double or ghost images, inflammation, and dislocation of the IOL. In some instances, corrective lenses or surgical replacement, repositioning, or exchange of the IOL may be necessary for adequate visual function following cataract surgery. If complications occur at the time of surgery, the doctor may decide not to implant an IOL in your eye or to use a different type of lens implant than was originally planned. 3. Complications associated with anesthesia may include damage to the optic nerve, direct or indirect damage to the retina, hemorrhage, droopy eyelid, double vision, respiratory depression, hypotension, cardiac problems, and in rare situations, brain damage or death. You may be advised to temporarily stop certain blood thinners such as aspirin, plavix, or coumadin prior to surgery to reduce the risk of uncontrolled intraoperative bleeding. Do not stop these medications unless you are instructed by you primary care provider. Serious complications such as blood clots, stroke, heart attack, and death may occur as a result of discontinuation of these protective blood thinners prior to surgery.

LENS IMPLANT POWER CONSIDERATIONS

The selection of the proper IOL power, while based upon sophisticated equipment and computer formulas, is not always perfect, and no guarantee can be made regarding the final result. Even with the very best measurements and uncomplicated surgery, after your eye heals, its visual power may be different from what was predicted by preoperative testing. If the eye’s visual power after surgery is considerably different from what was planned, and your visual outcome does not meet the anticipated level of functioning without eyeglasses, the full time use of glasses may be required or additional surgery might be considered. The additional expenses and risks of these options need to be considered. Furthermore, this occasionally unexpected outcome may occur with patients who choose a standard monofocal IOL, toric IOL, or multifocal presbyopia correcting IOL.

PATIENT ACKNOWLEDGMENT OF FINANCIAL OBLIGATIONS

My ophthalmologist has informed me that if I have Medicare or private insurance coverage for this cataract surgery, which provides coverage for standard cataract and monofocal IOL surgery, there will be extra charges that will not be paid by insurance if I choose a toric IOL or multifocal IOL. I acknowledge that I am responsible for payment of that portion of the charge for the these specialized IOLs and additional services that exceed the charge for insertion of a conventional, monofocal and are not covered by Medicare or other insurance plans. I have been informed about these extra charges and accept responsibility also for any deductible and co-payment amounts that apply to my standard insurance coverage for this procedure.

IOL SELECTION

Monofocal IOL

I wish to have a cataract operation with a standard monofocal IOL on my _________ (state "right" or "left" eye) and expect to wear glasses for both distance and near vision (bifocals or separate distance and near glasses)
Toric IOL/Astigmatism Reduction

I wish to have a cataract operation on my ___________(state "right" or "left" eye) with a toric IOL implanted in to achieve reduction of my astigmatism. The goal of this option is better vision for distance without glasses than could be obtained with a standard monofocal IOL. I expect to need glasses for near visual tasks such as reading and computer use and possibly for distance if some residual astigmatism remains.
Multifocal IOL Option/Presbyopia Correction

PATIENT CONSENT

The basic procedures of cataract surgery, the realistic expectations of the type of IOL I have chosen, and the advantages and disadvantages, risks, and possible complications, and possible limitations have been explained to me. I authorize the administration of any sedation an/or anesthesia that may be deemed advisable or necessary for my comfort, well-being and safety. Although it is impossible for the doctor to inform me of every possible complication that may occur, all my questions have been answered to my satisfaction.

I consent to any photographing or videotaping of the procedure(s) that may be performed, provided my identity is not revealed by the pictures or by descriptive texts accompanying them. I also consent to the admittance of students or authorized equipment representatives to the procedure room for purposes of advancing medical education or obtaining important product information.

For any questions before or after surgery please call 717-397-4724.