Dr. Bradford J. Shingleton

Questions to ask the doctor

When evaluating surgeons to perform your cataract surgery

The journalist, Richard A. Knox, wrote the following questions for patients anticipating cataract surgery to ask their ophthalmologist. The questions were published in Boston and New York newspapers. Dr. Shingleton has taken this opportunity to provide you with answers relevant to his cataract practice and the specialized care he gives to all of his patients.

Answers to the questions written by Mr. Richard Knox have been answered by Bradford J. Shingleton, M.D.

How many cataract procedures do you perform yearly? (should probably be more than 150).
Dr. Shingleton performs over 2,000 cataract procedures per year.

Do you use a minimal incision (3 mm or less), phacoemulsification and foldable intraocular lens implant?
Dr. Shingleton uses a tiny incision ( <3 mm) with phacoemulsification and foldable intraocular lens implantations almost exclusively for his patients with typical cataracts.

If so, what proportion of your total cataract operations are "sutureless" (or sometimes one-suture) procedures? (should be well over 50%).
Dr. Shingleton performs over 90% of his operations without sutures. Sutures are used for special types of incisions, cataracts, intraocular lenses and and medical situations. Sutures are not a problem per se, the key issue is the size of the incision. Dr. Shingleton always uses the smallest incision possible for each patient.

If I am not a candidate for a small incision, why not?
Dr. Shingleton will explain his choice for your type of operative procedure with you. The vast majority of Dr. Shingleton's patients have small-incision, sutureless surgery, but depending on cataract type and associated findings, larger incisions may occasionally be indicated.

What is your surgical complication rate, and what is the risk of the most important complications?
Dr. Shingleton has one of the largest databases for cataract surgery results in New England because of the thousands of cataract surgeries he has performed. Our goal is for excellence and continual improvement in our surgical treatment and Dr. Shingleton is constantly analyzing his data and fine-tuning his procedure. He is willing to match his results with any surgeon in the country. Dr. Shingleton has developed a consultation practice for cataract surgery and sees patients who are referred from all over the world. Even with a large number of complicated and challenging cases, his surgical success rate is extremely high. Bleeding, infection and retinal detachment are the most important complications, but these are very rare. The success rate for significant vision improvement in all Dr. Shingleton's patients is over 95%

What portion of your cataract patients need only reading glasses after recovery? (it should be a majority, even over 90%, some specialists say).
Dr. Shingleton will design your implant to best serve your needs. Some patients are focused preferentially for the distance, and others are focused preferentially for near. Dr. Shingleton also occasionally uses multifocal lenses, which allows some patients to do very well without glasses for both reading and distance viewing. Your final refraction after the operation will be planned specifically for you, your visual needs and what will balance with your fellow eye. For Dr. Shingleton's patients who are focused for the distance, the vast majority can see very well far away without any glasses and simply need reading glasses. Dr. Shingleton also uses the Crystalens accommodating IOL and multifocal IOLs to help many patients see well, both near and far, without glasses.

How long do you suspect my recovery will take? How soon can I be fitted for a new permanent prescription for any glasses that I will need? (If the answer is "several months", ask about an alternative offering faster recovery with equal results).
It is very common for Dr. Shingleton's cataract patients to see very well the next day after surgery or even the same day of their surgery. However, even with the tiny incision required for phacoemulsification and the absence of sutures, a short healing time is required for the eye to stabilize in terms of its final shape. For people who need glasses after the operation, we generally feel that 2 to 4 weeks following the operation is the best time to get their permanent prescription.

What is the risk that the lens capsule might become clouded after several years? If this happens, do you perform a laser procedure to correct it, or refer me to someone who does?
The rate of capsule clouding is approximately 25%. This is a normal phenomenon that occurs even more commonly in younger people. If this does happen, Dr. Shingleton will perform your laser procedure in the surgical center. This only takes several minutes and there are no limitations on activities. Most patients note significant improvement the next day.
If I should have new or worse astigmatism after surgery, do you perform astigmatic keratotomy to reduce it or would you refer me to someone who is familiar with the procedure?
Dr. Shingleton has extensive experience with treating astigmatism and utilizing astigmatic keratotomies. He utilizes the technique when indicated and will consider it for any patient that is suited for the procedure. This is often done at the time of the cataract surgery.