Brandon Menke, MD, refractive and cataract surgeon and co-founder of Modern Vision Centers, has performed thousands of cataract surgeries. His mother has had cataract surgery. His mother-in-law has had cataract surgery. Both had both eyes done the same day. Dr. Menke reflects on these experiences and answers frequently asked questions on same-day bilateral cataract surgery at Modern Vision Centers in West Des Monies, IA in a recent WHO13 Hello, Iowa! interview.
Is same-day cataract surgery on both eyes safer than having each eye done at separate appointments?
In Dr. Menke’s clinical assessment, yes — and the research supports him. The period between a first and second cataract surgery is not a neutral waiting period. For patients who are nearsighted, it is a period of significant visual imbalance. One eye has a new lens. The other still has a cataract. “Those patients are almost nauseous having a discrepancy in their vision,” Dr. Menke explains. A published study he references found that the highest risk of falls after cataract surgery occurs during exactly that window — not during recovery from the surgery itself, but during the weeks between procedures when the two eyes are seeing at fundamentally different levels. Doing both eyes the same day eliminates that window entirely.
How long does same-day bilateral cataract surgery take, and what does recovery look like?
The procedure itself is brief. “Most patients, it takes about 30 to 40 minutes to do both eyes the same day,” Dr. Menke says. Recovery moves at a similar pace. Most patients in Des Moines are seeing well enough to drive within 24 to 48 hours after surgery. “Your post-op visit the next day, use your drops for a few weeks, and you’re done for life.” Patients who have other underlying eye conditions — retinal problems, advanced cataracts — may need additional healing time, and Dr. Menke or Modern Vision Centers co-founder Drew Dickson, MD, address those cases individually. For the typical cataract patient, the recovery timeline compresses significantly compared to staged surgery: one procedure, one recovery period, and a return to normal life measured in days rather than weeks.
Are you awake during same-day cataract surgery, and does it hurt?
Patients are awake, but the experience is designed to be manageable. “There’s no needles to numb you up, just drops,” Dr. Menke explains. “There’s no IV. We give you a medical pill to just kind of relax you. You look at a light while I talk you through it.” The procedure uses advanced lasers to break up the cataract and correct astigmatism on the same day, which makes the surgery less invasive and reduces trauma to the eye, contributing to the faster healing time. For patients anxious about the idea of being conscious during eye surgery, Dr. Menke’s framing is practical: you are aware, but relaxed, and the entire process for both eyes is finished in roughly half an hour.
Why do nearsighted cataract patients benefit most from having both eyes done the same day?
The vision imbalance between a surgically corrected eye and an uncorrected eye is tolerable for some patients. For more nearsighted patients, it is not. A patient who relies on strong prescription lenses to see at all experiences a particularly disorienting mismatch when one eye has been corrected and the other has not. The older approach to cataract surgery — correcting one eye, waiting a period of time, then correcting the second — required some of those patients to go weeks with one lens removed from their glasses entirely. Dr. Menke’s description of the resulting nausea is not hyperbole. The fall risk data referenced in the transcript reflects real clinical consequences of that imbalance. Same-day surgery removes the problem rather than managing it.
What lens options are available for cataract surgery, and how do you choose the right one?
Lens selection at Modern Vision Centers is driven by the EyeAnalysis diagnostic testing. For patients with healthy eyes who are nearsighted, multifocal lenses (lenses that correct both distance and near vision, often reducing or eliminating glasses dependence entirely) are typically the conversation. Toric lenses address significant astigmatism. The third option Dr. Menke describes is the Light Adjustable Lens which is “kind of like a blank canvas,” where the lens is implanted in both eyes and then adjusted using a light device after healing, allowing the prescription to be refined and locked in for life. The Light Adjustable Lens is particularly suited to patients who want the most customized possible outcome, because the final prescription is set after the eye has stabilized rather than before. The full overview of lens options and procedure specifics for cataract surgery at Modern Vision Centers is covered at mvcvision.com.
Who is a good candidate for same-day bilateral cataract surgery in Des Moines?
The candidacy threshold is broader than most patients expect. “Anybody who has cataracts, or frankly, would like to become glasses free, is a great candidate,” Dr. Menke says. Patients who have been told they have cataracts forming but don’t need surgery yet are often candidates for Refractive Lens Exchange — replacing the natural lens before it becomes a cataract, correcting vision and eliminating the future risk of cataract development simultaneously. The diagnostic evaluation at Modern Vision Centers determines which path fits each patient’s eyes, prescription, and lifestyle. Cataract surgery is the most commonly performed surgery in the United States [source: American Academy of Ophthalmology], and Dr. Menke’s practice in Des Moines offers the advanced laser technology and lens options that allow that procedure to accomplish significantly more than it did a generation ago.
If you have cataracts in both eyes, or have been told cataracts are forming, a consultation at Modern Vision Centers will tell you exactly what your options are. Call 515-674-2020 or visit mvcvision.com to schedule.
Brandon Menke, MD on Same-Day Bilateral Cataract Surgery on WHO13 Hello, Iowa!
Host: Today, we’re talking about a major advancement in cataract surgery. Same day, bilateral cataract surgery. I visited Modern Vision Centers in West Des Moines to learn more about that with Dr. Brandon Menke. Dr. Menke, we are talking cataracts today. What are those?
Brandon Menke, MD: Yeah, so cataracts. Cataract surgery is certainly one of the most common surgeries done in the U.S., definitely the most common surgery that I do and everybody at some point in their life is going to get cataracts. Where, if you think of your eye kind of like a camera, we’re not talking about the film of the camera, which is your retina. We’re talking about the lens of the camera, where, with time and age, everybody’s lenses just get cloudy and yellow and hazy, making you see glare and halos at night, and frankly, just the quality of your vision goes down. So, cataract surgery is the process of taking that cloudy lens out and putting a new lens in.
Host: And you do same-day bilateral cataracts. What is that?
Dr. Menke: With advancements in technology, we get the most advanced and in-depth testing on your eyes. So we know your retina, your cornea, the inside of your eyes, what lenses are going to work with your prescription, with your lifestyle. We help to pick out the correct lens type, number one, and then using advanced lasers, we’re able to correct your astigmatism on the same day as your cataract surgery. We use the laser also to break up your cataract surgery to make your cataract less invasive and less traumatic to the eye, so the healing time is a lot faster. With those advancements, we’re able to do both eyes the same day. Most patients, it takes about 30 to 40 minutes to do both eyes the same day. There’s no needles to numb you up, just drops. There’s no IV. We give you a medical pill to just kind of relax you. You look at a light while I talk you through it, and again, in about 30 or 40 minutes, you’re done for life.
Host: So you’re awake this whole time, and it’s very quick, right?
Dr. Menke: My mother and Mother-in-Law both have had this surgery done. And so yes, you’re awake, but relaxed. You look at a light while we talk you through it again, using advanced lasers and technology to give you the most precise outcome possible?
Host: Why are more people choosing this option?
Dr. Menke: I think that if most people had the option, they would want both eyes the same day for various reasons. Number one, it gets you back to your normal life quicker. You don’t have to wait and have one lens popped out of your glasses for a week or two or four, like we used to do, for people that are very nearsighted. So let’s say you’re very nearsighted. You can see up close, but you can’t see it far away. Those patients are patients where, you know, for those one or two weeks, they’re almost nauseous having a discrepancy in their vision. And so that’s alleviated with how we do it now. And also, the post-op visits are less so you don’t have to come back, back after your first eye, and then after your second eye and then after both eyes, so your visits are less. Your return to normal life is quicker. The outcomes are better. And again, patients that are nearsighted, for example, don’t have that discrepancy, which they actually came out with a good, good study that showed that the highest risk of falls after cataract surgery are during that time in between the eyes. For exactly what I stated, because the nauseated feeling.
Host: So does this make it safer?
Dr. Menke: Certainly, yeah. In my opinion. Again, my mother and Mother-in-Law both had both eyes done the same day. I had my LASIK done by my partner, both eyes done the same day. You’re using your drops. It takes a day or two for, you know, kind of the fuzziness and the cloudiness to improve, but it’s a day or two one time. And so, it’s safer, you’re able to drive, typically, the very next day, not, you know, coming back and a week later. And so yes, it’s safer, the outcomes are better. And again, kind of return to life a lot quicker.
Host: So how soon do you get back to life, seeing clearly and like you want to?
Dr. Menke: So I’d say most patients are within about 24 to 48 hours, seeing well enough to drive. There’s certainly some patients that have other eye issues where, again, we’re going to tell you to take your time and heal, whether they have advanced cataracts, retinal problems, etc. But again, for most patients with most typical problems, they’re seeing well within 24 to 48 hours, typically able to drive. Your post-op visit the next day, use your drops for a few weeks, and you’re done for life.
Host: You mentioned lenses earlier, and I was like, Oh, you get to pick a lens, almost like picking glasses?
Dr. Menke: As far as the lenses go, I would say, typically, we have a thorough discussion based on what the testing allows us and kind of guides us through a journey, as far as what your eyes are capable of seeing. So, you know, assuming you have a healthy eye and you’re nearsighted, we’re probably going to talk about lenses that are called multifocal lenses that, again, give you distance vision as well as near vision, all typically independent of glasses. There are other lenses that are called toric lenses, where people have a crazy amount of astigmatism, which is simply the shape of your cornea that allows for you to have some focus for that distance vision, alleviating your glasses for distance, but may need readers for up close. And then lastly, a newer lens that’s out there, called a Light Adjustable Lens, that our patients typically love. That’s a lens actually, that’s kind of like a blank canvas where we put these lenses in – again, both eyes the same day – and then after you’ve healed for a few weeks, we actually are able to use light device to change the prescription of that lens to truly give you the best vision your eyes are capable of getting, and then lock that in for life, so that patients have their distance vision, have their near vision, and again, all of that for life in a purely customized setting.
Host: Who is a good candidate for this?
Dr. Menke: I’d say anybody who has cataracts, or frankly, would like to become glasses free, is a great candidate for something called a Refractive Lens Exchange, or an RLE, or, again, a cataract surgery once those cataracts have kind of developed. Again, a cataract just when that lens becomes yellow and hazy. So, anybody that’s looking to become glasses free, anybody that’s been told that they have cataracts and need to get them out, they’re a great candidate to have same-day bilateral cataract surgery.