Why do you have to wait so long for cataract surgery?

After surgery, the surgeon places a shield and a patch on the eye. They should stay in place for less than 24 hours. Once the patch and shield are removed, most people can resume many of their usual activities. From a medical point of view, there aren't many reasons to postpone surgery, except for an eye infection or very high blood pressure.

For people who are otherwise healthy, there's no advantage in delaying it. For the vast majority, cataract surgery isn't urgent and can be safely delayed until the person wants surgery. Delaying surgery doesn't harm the eye. However, vision worsens over time until the cataract is removed.

When I advise patients about the time of cataract surgery, I generally assure them that they will know when the time is right: they will begin to notice the deterioration of their vision and, when this affects their quality of life, that is the time to continue with the surgery. If there are cataracts in both eyes that require surgery, the surgeries are usually performed several weeks apart. Cataract surgery on both eyes at the same time is not recommended because there is a possibility of complications affecting both eyes; the most worrying is infection. On the contrary, two European cross-sectional studies that compared the characteristics of patients undergoing cataract surgery in several centers with different waiting times found no relationship between waiting time and quality of life, as measured by the VF-14 questionnaire.

Cataract surgery is a fairly simple procedure and, as a general rule, the sooner it is addressed, the greater your chances of success. The priority criteria tool for cataract surgery is a prioritization tool developed by the Western Canada Waiting List Project and consists of the sum of 7 weighted priority criteria. Overall, the results are still very good, but ideally, these cataracts should be treated before they are so advanced that they increase the risk of problems during surgery. It is important to understand that it is the patient who should, and should, make the decision to have cataract surgery.

However, recent research shows that the average age for cataract surgery may actually be decreasing. Two randomized controlled trials presented the highest-quality data included in this review and found that patients who waited less than 6 weeks to undergo cataract surgery experienced better visual and quality of life outcomes and fewer adverse events (falls) than patients who waited 6 months or more. We conducted a systematic review to understand the relationship between waiting time for cataract surgery and patient outcomes and the variables that modify this relationship. A common reason people consider cataract surgery is to improve their vision and be able to drive safely.

The short answer to this question would be yes, there comes a time when cataract surgery would be more difficult to perform than it would have been before. In addition to correcting the cataract, the artificial lens placed during cataract surgery can often correct distance or near vision, if needed. But is this true? Can cataract surgery really be postponed until the next month, semester, or year? And how long can you postpone this without creating more problems? The number of cataract surgeries performed in Ontario doubled between 1993 and 20031 and is expected to continue to increase, as up to 21% of the population will be over 65 years of age in 2026.

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