What to Expect Before Cataract Surgery
Before cataract surgery a patient may need to:
- Go through tests—About a week before cataract surgery, the doctor will conduct a painless ultrasound test measure the shape and size of the eye. The helps dictate the correct type of lens implant (intraocular lens, or IOL).
- Discontinue the use of particular medications—The doctor may recommend that a patient briefly stop taking any medications that could increase the chance of bleeding during the surgery.
- Use eye drops to minimize the risk of infection—The doctor may prescribe antibiotic eye drops to use a day or two before surgery.
- Fast prior to surgery—The doctor may instruct the patient to refrain from drinking or eating anything twelve hours before the operation.
- Make preparations for recovery—The patient will usually be able to return home the day of the surgery but will not be able to drive, so arrangements will need to be made. Arrangements will also need to be made for assistance around the home if needed, because activity may be limited for about a week after surgery.
What to Expect During Cataract Surgery
Cataract surgery is typically an outpatient procedure that takes an hour or less to perform. The doctor will first put eye drops in the eye to dilate the pupil and administer local anesthesia to numb the area. The patient may also be given a sedative for relaxation. If given a sedative, the patient may feel groggy during the surgery but stay awake.
During cataract surgery, the foggy lens is taken out and replaced with a clear artificial lens. Sometimes, however, a cataract may be removed without the implantation of an artificial lens.
There is more than one way to perform cataract surgery:
Ultrasound Probe Removal of Cataract—The doctor performs a procedure called phacoemulsification, which means the surgeon makes a small cut in the front of the eye (cornea) and interjects a needle thin probe into the substance of the lens where the cataract has formed. The surgeon will then fragment or break up (emulsify) the cataract with an ultrasound probe and suction out the pieces. The back of the lens (lens capsule) is left undamaged to function as the housing place for the new artificial lens.
Lens Removal by Incision in the Eye—This procedure is called extracapsular cataract extraction. This form of cataract removal is less common and necessitates a larger incision than the phacoemulsification procedure described above. This method of procedure may be chosen if the patient has particular pre-existing eye complications. Through the larger incision, the surgeon takes out the cloudy part of the lens and the front capsule of the lens, which makes up the cataract. The back capsule of the lens is left untouched to function as the housing place for the new artificial lens.
Once the cataract has been taken out through one of the two surgical methods described above (phacoemulsification or extracapsular extraction), an artificial clear lens is implanted into the empty capsule of the lens. The lens implant is called an intraocular lens (IOL) and is made of silicone, acrylic, or plastic material. The lens does not require special care and becomes a long-term and durable part of the body. The patient will not be able to feel or see the lens. There are a variety of IOLs with different features, so the patient and surgeon should discuss which type is most beneficial and appropriate. Read more about the different types of intraocular lens replacement.
What to Expect After Cataract Surgery
Within a few days after cataract surgery, vision should begin improving, although it may be blurry at first as the eye adapts and heals. The patient will return to the doctor for follow-up checks a day or two after surgery, a week after surgery, and again about a month after surgery.
For a couple days after surgery, the patient may feel itching or discomfort around the eye. It is important to keep from rubbing or pushing on the eye. The doctor may even ask the patient to wear a protective covering or eye patch the day of the operation and even a few days after the operation when sleeping. The doctor may prescribe medication or eye drops to protect against infection, decrease inflammation and control eye pressure. Most pain or irritation should disappear within a couple days following surgery, and usually patients make a full recovery within about eight weeks.
If experiencing any of the following symptoms post cataract surgery, the patient should contact their doctor immediately:
- Vision loss
- Persistent pain (despite the use of over the counter pain medication)
- Increased redness of the eye
- Light flashes or multiple new spots (floaters) in front of the eye
- Nausea, vomiting, or uncontrolled coughing
After cataract surgery, most patients need glasses, at least sometimes. The doctor will inform the patient when their eyes have recovered enough to receive a final prescription for eyeglasses.
For a patient with cataracts in both eyes, a surgeon usually schedules two separate surgeries. The surgery on the second eye is typically performed a month or two after the first surgery to remove the cataract in the other eye. This gap permits healing time for the first eye before the second surgery.
Outcome of Cataract Surgery
In the majority of patients who undergo cataract surgery, vision is successfully restored.