Cataract Surgery

Cataract surgery is a procedure done to remove the lens of your eye, in most cases and replace it with an artificial one. Cataract surgery is used to treat the clouding of the normally clear lens of your eye (cataract).

Cataract surgery is performed by an eye specialist (ophthalmologist) on an outpatient basis, which means you do not have to stay in the hospital after the procedure. Cataract surgery is very common and generally a safe procedure.

Here are the most common reasons to receive a cataract surgery.

Cataract surgery is performed to treat cataracts. Cataracts can cause blurry vision and also increase the glare from lights. If a cataract makes it difficult for you to carry out your normal activities, your doctor may recommend a cataract surgery.

If a cataract makes it difficult for you to carry out your normal activities, your doctor may recommend a cataract surgery.

When a cataract interferes with the treatment of another eye problem, cataract surgery may be recommended. For instance, doctors may recommend cataract surgery if your cataracts make it difficult for an eye doctor to examine the back of your eye to monitor and treat other eye problems such as age-related macular degeneration or diabetic retinopathy.

In the majority of cases, waiting to have cataract surgery will not harm your eye, thus you will have enough time to consider your options. If your vision is still quite good, you may not need cataract surgery for many years, if ever.

When making a consideration for cataract surgery, keep these questions in mind:

• Can you see safely to do your job and drive?
• Do you have problems reading or watching television?
• Is it difficult to cook, shop, do yardwork, climb stairs or take medications?
• Do vision levels affect your level of independence?
• Do you have difficulty seeing faces clearly?
• Does bright light make it more difficult for you to see?

Complications after cataract surgery are not common and most can be successfully treated.

Cataract surgery risks include:

• Infection
• Swelling
• Bleeding
• Inflammation
• Glaucoma
• Retinal detachment
• Secondary cataract
• Loss of vision

Your risk of complications is greater if you have another eye disease or any serious medical condition that affects any part of your body.

Occasionally, cataract surgery fails to improve vision because of the underlying eye damage from other conditions, such as glaucoma or macular degeneration.

If possible, it may be beneficial to evaluate and treat other eye problems before making a decision to tackle cataract surgery.

In order to prepare for your cataract surgery, you may be asked to do the following:

• Undergo tests: A week or so prior to your procedure, your doctor will perform a painless ultrasound test to measure the shape and size of your eye. This usually helps him or she determine the right type of lens implant (intraocular lens, or IOL).
• Stop taking certain medications: Your doctor may also advise you to temporarily stop taking any medication that could increase your risk of bleeding during the procedure.
• Use eye drops to reduce the risk of infections: You may be given a prescription of antibiotic medication one or two days before the procedure.
• Fast before the surgery: You may have instructions not to eat or drink anything 12 hours before the procedure.
• Prepare for your recovery: In normal circumstances, you can go home on the same day as your surgery. However, you will not have the capability to drive, so arrange for a ride home. It is also advisable to arrange for help at home, if necessary because your doctor may limit activities such as lifting and bending, for about a week after your surgery.

Read on to learn more about what to expect before, during, and after your cataract surgery.

During cataract surgery

Cataract surgery is normally an outpatient procedure that takes an hour or less to complete.

• Initially, your doctor will place eye drops in your eye with the aim of dilating your pupil.
• You will be given local anesthetics to numb the area, and you will also be given a sedative to help you relax. If you are given a sedative, you may stay up, but groggy, during the procedure.

• During cataract surgery, the clouded lens is taken out, and a clear artificial lens is implanted. In some cases, however, a cataract may be removed without implanting an artificial lens.

  Surgical methods used to remove cataracts include:

  • Using an ultrasound probe to break up the lens for removal: During this procedure called Phacoemulsification, your surgeon makes a tiny incision in the front of your eye (cornea) and inserts a needle-thin probe into the lens at the site of the cataract. Your surgeon will then use the probe, which transmits ultrasound waves, to break up (emulsify) the cataract and suction out the fragments.

    The very back of your lens (lens capsule) is left intact to serve as a place for the artificial lens to rest on. Stitches may or may not be too close the tiny incision in your cornea at the completion of your procedure.

  • Making an incision in the eye and removing the lens: A less frequently used procedure called extracapsular cataract extraction requires a larger incision than that used for phacoemulsification. Through this larger incision, your surgeon uses surgical tools to remove the front capsule of the lens and the cloudy portion of your lens comprising the cataract.

    The very back capsule of your lens is left in place to serve as a place for the artificial lens to rest. This procedure may be performed if you have certain eye complications. With its larger incision, stitches are required to close the incision.

• Once the cataract has been removed by either phacoemulsification or extracapsular extraction, a clear artificial lens is implanted into the empty lens capsule. This implant, known as an intraocular lens (IOL), is made of plastic, acrylic or silicone.

You won't be able to see or feel the lens. It requires no care and becomes a permanent part of your eye. A variety of IOLs with different features is available. Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close.
However, many IOLs are flexible, allowing a smaller incision that requires few or no stitches. The surgeon folds this type of lens and inserts it into the empty capsule where the natural lens used to be. Once inside the eye, the folded IOL unfolds, filling the empty capsule.
Some types of IOLs block ultraviolet light. Some types of IOLs work like bifocals to provide both near and distant vision. Others provide only distant or near vision. For some people, a lens can be chosen to provide a distant vision in one eye and near vision in the other eye.

Discuss the benefits and risks of the different types of IOLs with your eye surgeon to determine what's best for you.

After cataract surgery

After cataract surgery, expect your vision to begin improving within a few days. Your vision may be blurry at first as your eye heals and adjusts.

You'll usually see your eye doctor a day or two after your surgery, the following week, and then again after about a month to monitor healing. It's normal to feel itching and mild discomfort for a couple of days after surgery.

Avoid rubbing or pushing on your eye. Your doctor may ask you to wear an eye patch or protective shield the day of surgery. Your doctor may also recommend wearing the eye patch for a few days after your surgery and the protective shield when you sleep during the recovery period. Your doctor may prescribe eye drops or other medication to prevent infection, reduce inflammation and control eye pressure.

After a couple of days, most of the discomfort should disappear. Often, complete healing occurs within eight weeks.

Contact your doctor immediately if you experience any of the following:

• Vision loss
• Pain that persists despite the use of over-the-counter pain medications.
• Increased eye redness
• Light flashes or multiple new spots (floaters) in front of your eye
• Nausea, vomiting or excessive coughing

Most people need glasses, at least some of the time, after cataract surgery. Your doctor will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses.

If you have cataracts in both eyes, your doctor usually schedules a second surgery a month or two later to remove the cataract in your other eye. This allows time for the first eye to heal before the second eye surgery takes place.

Understanding the results of your procedure will be made possible by your doctor. Cataract surgery restores vision in the majority of individuals who undergo the procedure.

Individuals who have had cataract surgery may develop a common complication called posterior capsule opacification (PCO), it can also be called secondary cataract. This occurs when the back of the lens capsule, the part of the lens that was not taken out during surgery and now, the lens implant becomes cloudy and impairs your vision.

PCO is treated using a painless, five-minute procedure known as yttrium-aluminum garnet (YAG) laser capsulotomy. In YAG laser capsulotomy, a laser beam is utilized to make a small opening in the clouded capsule to make a clear path through which the light can pass. Following the procedure, you usually stay in the doctor's office for about an hour to make sure that your eye pressure does not rise.

Other complications are quite rare but can include increased eye pressure and retinal detachment.