If your doctor or optometrist suspects you have a cataract they will refer you to an eye surgeon for a full assessment. After the initial consultation, an extensive range of tests are performed using the latest diagnostic equipment. These tests include:
– A full vision assessment
– Measurement of the pressure in your eye (IOP)
– Assessment of your retina
– Measurement of your eye length and corneal curvature to help determine the correct intraocular lens for you
As part of this assessment your eyes are dilated so that your surgeon can examine your eyes and look at your cataracts. Some additional tests may also be performed depending on the results of your examination.
Your surgeon then discusses the proposed surgery and answer all of your questions regarding the benefits and risks of surgery so you can make an informed decision.
How Is Cataract Surgery Performed?
Cataract surgery is the procedure of removing the cloudy lens of the eye, and replacing it with an artificial clear lens called an intraocular lens (IOL). Today, revolutionary microsurgery means that cataract surgery is performed through a tiny incision in the eye no more than 3 mm long. It is remarkably successful, and recovery time has been dramatically shortened compared to only a few years ago.
At the initial consultation, numerous tests are done in order to determine the suitability of the eyes for surgery, and to determine the optical prescription that will be required for the lens implant. Additionally, the patient and their family can be taken to view the day-surgery facility in order to familiarize them with the procedures and the environment.
After surgery, patients can resume normal activities, such as driving, walking, and sports, very quickly, usually within a few days.
Can Cataracts Come Back?
In the months or years after cataract surgery a small percentage of people will develop a condition known as ‘secondary cataract’, which can reduce the vision. However, this is not a true cataract, but actually a thickening of the back of the lens capsule. Fortunately, this secondary cataract (more correctly called posterior capsular opacity or thickening) can be easily treated. A quick and painless laser treatment (YAG laser capsulotomy) makes a small opening in the back of the lens capsule, which restores vision within hours. When people remark that they know of someone who “had a cataract removed by laser”, they are probably referring to this process.
The Day of Surgery
Prior to surgery, you are encouraged to continue your normal routine. There is no need to miss meals and you can usually continue to take your regular medications. On the day of surgery, you should wear some comfortable loose clothing as you will not have to change into a hospital gown. You are looked after by a team of staff who specialize in caring for patients undergoing a day-surgery procedure.
Cataract Surgery Procedure
Eye drops are put into the eye to dilate the pupil. A mild sedative can be given, if desired. A painless anesthetic is then administered – either using eye drops or a local anesthetic injection. On rare occasions a general anesthetic may be required. You will feel drowsy, but may still be aware of voices during the surgery.
The most common surgical procedure used around the world is called phacoemulsification or phaco is short. It is the most advanced technique in use today. The main benefit is it allows the cataract to be removed through a tiny, secure opening no more than 3mm long. An ultrasonic probe, which vibrates at 40,000 times a second, is inserted through the opening. The ultrasonic action of the probe gently breaks the cataract up into tiny pieces, which are then suctioned out of the eye. The intraocular lens (IOL) is then inserted into position in the eye where it stays permanently.
Today, injectable lenses are often used, which can be inserted through a very small incision in the cornea — this type of procedure dramatically shortens the recovery period. When your eye surgery is finished your eye will be protected by a shield which should be left in place until your post-operative visit with your surgeon the next morning.
After Cataract Surgery
After surgery you are asked to rest for a while and given something light to eat and drink. Most people are able to leave the clinic within an hour of their surgery. As you will have received an anesthetic, it is essential that you arrange for an adult to pick you up and stay with you for 24 hours following your procedure.
The Day After Cataract Surgery
You will need to come back for a post-operative visit the morning after your surgery. At this visit the eye shield is removed and your vision and eye pressures checked. Your surgeon also checks the position of the lens in your eye and the surgical wound.
Cataract Surgery Aftercare and Do’s and Dont’s after Cataract Surgery
As with all surgery, post-operative care is essential. It is very important that you take your eye drops as prescribed. Your surgeon may suggest wearing a protective eye shield for a few nights after the surgery to protect your eye. Many people find sunglasses are helpful. It is quite safe to read or watch television after surgery.
Bathing or showering, and hair washing, are all quite safe. All you need to do is avoid any pressure on the eye. Physical activity may be resumed immediately, but strenuous exertion should be restricted for about one month — moderate stooping is not harmful but straining should be avoided.
You are asked to come back and see your surgeon for a check up about two to three weeks after your surgery. You may find your vision may be a little blurry initially, this is quite normal, as the healing eye needs time to adjust so it can focus properly along with the other eye, especially if there is cataract in the other eye.
With the new lens in your eye, you may notice that colors appear very bright. Removal of the cataract allows more natural light to enter the eye. Within a few months after surgery, you will become used to the improved color vision.
If you get any unusual pain or are worried about anything, call or visit your surgeon immediately.
You will probably need to get the prescription in your glasses altered three to four weeks after the operation to correct any residual refractive error after the surgery.
Photo by DFAT photo library