"I was afraid of a surgery to my eyes and many people likely would understand my concern. This past month, I finally decided it was time for me to trust a good experienced ophthalmologist and get a cataract surgery to my right eye, which was performed by Dr. Stuart R. Winthrop at the Santa Barbara Surgery Center on De la Vina Street.

On the day of the surgery, which took 16 minutes, as I came out of the surgery center I deliberately kept my right eye closed (in my opinion to ensure that the new lens would stay in place) and the next morning, when I woke up, both eyes spontaneously opened up. Wow! I could see so well and so far. Unbelievable.

From my back window, on the second floor of my residence in the La Cumbre Road area, I could not only see the faraway mountains, and the houses spread out here and there on the hills, but I could also see the windows of those houses and in some cases the details of the trees.

Three weeks later, I scheduled another cataract surgery to my left eye. Same doctor, same surgery center, same excellent service — the staff was well trained and exceptionally present to the needs of their patients.

Thanks to each one of you."

Marielle Ritter
Santa Barbara

Santa Barbara News Press, Voices
January 20, 2012

"Marielle Ritter's letter in the Voices section expressing her appreciation for Dr. Stuart Winthop and his staff in treating her cataract removal and lens implant surgery mirrors my experience, which was performed in November.

My ophthalmologist told me he couldn't improve my vision any more with corrective glasses due to cataract clouding, and that my night vision problem of seeing halos could only be eliminated by cataract removal. I followed his advice and Dr. Winthrop and his amazing staff performed the surgeries four days apart with outstanding results. One eye was done at the Santa Barbara Surgery Center and the other at Cottage Hospital MacDougal Eye Center.

Since I am a dentist, Dr. Winthrop said he didn't want me to wait three weeks for both eyes to be treated. Like Marielle, I can see colors I've never imagined with clarity and distance beyond belief. I only wish I could perform quality dentistry in 10 minutes like they did for my vision."

John R. Klein, DDS

Santa Barbara News Press, Voices
January 30, 2012

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Dr. Winthrop's Step-by-Step Guide
to Your Cataract Surgery

The importance of yearly exams       

Typically, the existence of a cataract is first noted in the course of a well-patient yearly eye exam, a routine appointment that evaluates your vision and ocular health, including glaucoma and retinal testing. This is why it is so important for adults over the age of 40 to be sure to schedule an annual exam. Living in Santa Barbara exposes us to a great deal of sunlight, which is a factor in cataract formation.

It is among the safest surgeries performed worldwide. In recent years more than three million procedures are performed annually in the U.S. with over a 98% success rate. In our hands we have been able to keep the complication rate to less than one half of one percent. Typically, the surgery is done in two separate procedures (one eye at time) on an outpatient basis under local anesthesia. The patient's normal activity is usually resumed in about 24 hours.

The timing of cataract removal

If a cataract is found, the determination of whether cataract surgery should be performed sooner or later involves a combination of factors. Your lifestyle and your specific visual needs may dictate that the cataract be removed promptly. For example, such things as the need to drive at night, one’s hobbies or athletic pursuits (such as seeing a golf ball at 200 yards), and the ability to do the reading one likes are all factors. Other considerations are the general health of your eye as well as your overall health. My experience is that many patients fail to consider their overall health as a factor. If you have any other serious health issues, it is better to consider cataract surgery sooner rather than later.

Perhaps the most important consideration in determining when to schedule your surgery is the hardness of your cataract. As the cataract matures it yellows (a process called nuclear sclerosis) and hardens. This induces a shift that favors near vision over distance vision, causes a general decrease in vision and produces glare and halos around lights. The yellowing also distorts your color perception. This growth and change in the cataract is so gradual that on a day-to-day basis you are unaware it is happening. I know of many stories where patients put in new carpeting or painted their house only to find after cataract surgery that they did not select the color they intended. 

From a technical point of view, as the cataract hardens, surgery becomes more hazardous and prone to complications; so it is better not to wait until the cataract becomes too mature. Cataract surgery involves phakoemulsification, which is the use of ultrasound to break up and liquefy the cataract so that it can be extracted. The harder the cataract, the more energy is required for its removal. This is where the greater risk of a complication occurs. The notion of waiting until the cataract is “mature” is outdated, and your determination to proceed with the surgery should be based primarily on your visual needs. 

Pre-surgical appointments

Once the decision is made to go ahead with your cataract surgery, I will discuss with you the potential of and/or need for premium intra-ocular lenses (IOLs). I will perform a test called an OCT, something akin to an ultrasound, to ensure that your retina is healthy.

A follow-up appointment approximately a week prior to your surgery will take between 30-45 minutes. Jeff Harbison, my certified ophthalmic technician, will perform an ultrasound with the Zeiss IOL Master to determine the power of the lens that will be implanted following removal of your cataract. This will take 5 minutes or less.

The rest of this appointment will be used to go over the Cataract Patient Informed Consent Form, including the risks and benefits of the surgery, and your prescriptions. Three prescriptions for medicines needed for the surgery will be given to you. Two of the prescriptions are for drops that are started 3 days prior to your surgery. These are started together (spaced 5 minutes apart) and are used 4 times per day.  The eye drops will include an antibiotic to prevent infection and a non-steroidal anti-inflammatory medicine. The third prescription, a steroid anti-inflammatory, will be started on the day of surgery following the procedure.

Finally, at this appointment you will be advised of your arrival time at the Santa Barbara Surgical Center on the Tuesday of your surgery. Since cataract removal involves such a small incision, there is no need to stop any medicines, even blood thinners, prior to your surgery. I want you to take all your normal medications on the morning of surgery (although NO food and only the water needed to swallow your pills). Aspirin, Coumadin, Warfarin, and Plavix are all OK.    

The procedure           

On surgery day, you should take all your normal pills with a sip of water but NOTHING ELSE. No coffee. No breakfast. After arriving at the Surgical Center, you will register before being taken to the pre-op waiting area. You will be given a gown to wear in place of your shirt or blouse. Your pants and socks are left on. A nurse will ask a few questions about your general health, instill drops to dilate your pupil, and place an anesthetic jelly in your eye. I will mark the correct eye for the surgery, and the anesthesiologist will interview you.

You are then wheeled into the operating room where your eye area will be washed with betadine solution. At this point I start telling you what to expect, from the bright light of the operating room microscope to what you will feel. There are no shots or needles around the eye and the surgery is painless. An anesthesiologist will administer mild intravenous (IV) sedation to relax you, but you will remain awake. As the surgery takes only 10-12 minutes, I prefer you to be more awake than asleep. This is SAFER for you. During that time, you will feel water dripping and the sensation of being touched, but you will not feel pain.  I will be talking to you throughout the surgery, so you will know what to expect and there are no surprises.

Immediately after cataract surgery

At the end of surgery I will NOT put a patch over your eye.  You will be able to see but vision will be quite blurry and you may notice a pink or red cast to objects.  This is a residual from the brightness of the microscope and can last up to 24 hours before going away. You may also feel a mild foreign body sensation for the first 24 hours as well.

After surgery you can eat normally at home but I want you to remain quiet for the day.  I would prefer that you do no lifting or bending and that you keep your eye above the level of your heart.

Day after surgery follow-up appointment

I will see you the morning after surgery in my office for a short appointment.  I will check your vision and intraocular pressure, and examine your eye.  I will hand you a post-op instruction sheet that details your drop regimen.  After this appointment you can resume full activities, including golf or other athletics, and you may lift or bend over.  The only restriction is that I do not want you swimming with your head/eye under water for two weeks.

Your next appointment will be in 3 weeks at which time I will give you a prescription for new glasses if that is appropriate. And that is all there is to cataract surgery!

Potential for follow-up treatment

In the majority of cases, at some point a small membrane will need to be removed in the office using a simple 20-second laser procedure known as a YAG capsulotomy. This small membrane will form in the eye months or even years later as cells deposit themselves between the IOL and the back wall of the lens capsule, a condition known as posterior capsular opacity (PCO). back to top

Santa Barbara's Eye Doctor