Answers to Frequently Asked Questions

How long has MACS been in use? [top]
MACS technologies — including the diagnostic technology to measure the eye and the replacement lens in more-accurate quarter-diopter increments of power — were approved by the Federal Drug Administration (FDA) and have been in use since 2009. MACS eye specialists report that between 60-80% of their cataract patients choose MACS.

What is the difference between conventional cataract surgery and MACS? [top]
The major difference is in the additional measurements taken, which help Dr. Pilkinton select the most appropriate replacement lens power for you and determine the exact MACS surgical procedure needed. The other difference is the replacement lens, which is available in quarter-diopter increments of power vs. half-dipoter increments available with conventional replacement lenses. With the MACS lens, Dr. Pilkinton can choose a more precise power for you, to optimize your vision.

How do I know if I’m a candidate for MACS cataract surgery? [top]
Based on the measurements and diagnostic results, Dr. Pilkinton will be able to determine if you could benefit from MACS cataract procedures. If Dr. Pilkinton determines that your retina would not be able to distinguish the difference between a conventional cataract operation and a MACS procedure, he will discuss moving forward without the MACS procedure.

How do I know if I’m a candidate for the HD Blended Vision option? [top]
Most patients do qualify for HD Blended Vision. However, Dr. Pilkinton will need to determine if you are a candidate by taking some additional eye measurements, performing a few tests, and possibly conducting a trial with temporary contact lenses that simulate blended vision. The measurements and tests vary by surgeon and practice. Most practices will look at your vision history, and your experience with contact lenses and/or eyeglasses, since many patients have already experienced blended vision with their contacts or glasses. Another qualifying factor is the refraction of each eye. Some patients have been living with a significant difference between each eye and don’t even know it. Their brains have naturally blended their vision, so they are good candidates for the MACS HD Blended Vision procedure.

Are there any risks with MACS cataract surgery? [top]
According to the National Health Association, cataract surgery is one of the most successful operations in all of medical care. However, as with any surgical procedure, there are some risks to both MACS and conventional cataract surgery, such as infection and bleeding, Prior to surgery, Dr. Pilkinton will provide you with an “informed consent” form that outlines any risks in detail.

Are there any side effects with MACS? [top]
As with any surgery, pain, infection, swelling and bleeding are possible, but very few patients have serious problems or complications following MACS or conventional cataract surgery. Prior to surgery, Dr. Pilkinton will discuss any possible side effects.

Can MACS treat astigmatism? [top]
Astigmatism causes blurred vision due either to the irregular shape of the cornea, the clear front cover of the eye, or sometimes the curvature of the lens inside the eye. Your MACS specialist will determine the best placement for your replacement lens to manage any astigmatism you may have.

Will insurance cover MACS? [top]
As with any cataract surgery, you’ll need to first cover your deductible, which is typically around $200. Then Medicare covers a significant portion of MACS, typically the lens and the procedure. The testing and measurements may not be covered, but these additional charges will be modest in comparison to the benefits of ongoing clear vision. Many doctors offer reasonable financing plans for any out-of-pocket expenses you may incur.

Will insurance cover the HD Blended Vision option? [top]
Medicare typically covers the procedure and replacement lens, but does not cover the testing and measurements needed to determine the candidacy of a patient for HD Blended Vision. Dr. Pilkinton will be able to identify exactly what is covered and what will be an out-of-pocket expense.

How long does the MACS procedure take? [top]
The MACS procedure is not any longer than conventional cataract procedures, typically about 10 minutes. The exception is if your doctor needs to correct any astigmatism, which may take another 3 to 4 minutes. However, you should plan to be at the clinic for about 2 hours because of pre-surgery planning, and post-surgery time in the clinic for testing and vision examinations to determine the effectiveness of the MACS operation.

Is the MACS procedure painful? [top]
Most patients experience no pain. MACS and conventional cataract procedures are typically performed under a local topical anesthetic to keep you comfortable during the operation. Some patients experience mild discomfort from the anesthetic.

Can both eyes be treated at the same time? [top]
No. Both MACS and conventional cataract operations are performed with one eye at a time. Because both eyes work together to produce MACS vision, Dr. Pilkinton needs to determine the exact outcome from the first eye before creating a final plan for the second eye. Typically, surgery on the second eye is done 1-2 weeks later.

Will I still have to wear eyeglasses? [top]
Your use of eyeglasses will be totally dependent upon your individual situation. With MACS, as a general rule, your vision is optimized for high-quality distance sight, and your need for eyeglasses in the intermediate and close range is reduced. To further reduce your need for eyeglasses, we recommend the MACS HD Blended Vision procedure, if your doctor determines you’re eligible for it. With the Blended Vision procedure, Dr. Pilkinton focuses one replacement lens for distance and one for close range. Both eyes then work together naturally for optimal vision at all distances.

Could I get another cataract after the surgery? [top]
No, cataracts do not come back. However, the capsular bag in which the replacement lens sits can become cloudy. This is easily taken care of with a quick laser procedure, which is typically covered by Medicare (after co-pays and any deductibles).




As we age Dry Eye Syndrome can become a problem for people who are otherwise healthy. If you have this complaint ask the staff at Pilkinton Eye Center about available treatment options.