Before, During & After Cataract Surgery

1
Why Cataract Surgery Is Performed

Doctor looking in microscope using a cracker instrument and phaco hand piece during cataract surgery
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In a healthy eye, the lens is transparent and focuses light on the retina. Over time, the lens can slowly lose the ability to let light into the eye as it becomes cloudy. A cataract is a simply lens that becomes opaque over time. When severe, the cataract must be removed because it prevents light from entering the eye and decreases vision. In the worst cases, the patient can be nearly blind due to cataracts.

2
Before Cataract Surgery

Prior to your procedure, your doctor will want to examine your eyes in great detail. Your eyes will be examined externally and internally. This will include the typical eye exam that is done with a light, but may also include a laser scan of the eye or an ultrasound examination of the inside of your eye. These tests will determine the health of your eye, if any other conditions are present, and the best type of lens implant for you.

Choosing a lens implant may be part of the preparation process once you have decided to have your cataracts removed. There are a variety of types of intraocular lens (IOL) implants, ranging from lenses that correct vision to those that can decrease ultraviolet light exposure. Your doctor will work with you to select the best lens for your unique condition.

You will want to arrange for transportation to and from the surgery center. Your vision will not be accurate enough to allow you to drive yourself home safely from the appointment.

3
Cataract Surgery: What Happens During The Procedure

When performed on an adult, the procedure to remove cataracts is typically done as an outpatient surgery. Rather than having anesthesia, the patient typically is given eye medication that numbs the eye completely and allows the physician to perform the procedure without causing pain.

Medication may be given to help the patient relax during the procedure. This helps decrease the risk factors associated with cataract surgery, as there are no anesthesia risks.

For children, cataracts are rare. When they do occur, general anesthesia is far more likely to be used than with adult patients, as it can be a very scary thing for a child to have eye surgery, even if there is no pain. For that reason, it is preferable that children not be awake for the procedure, unless they are old enough to understand what is happening, why it is happening and be able to cooperate with the surgeon.

Phacoemulsification Cataract Surgery

There are two main types of cataract surgery. The first is phacoemulsification. This procedure uses highly focused sound waves to break the cloudy lens (cataract) into tiny pieces. Breaking the lens into pieces allows the surgeon to use a very small incision, through which the pieces are then removed using gentle suction. This method may removed the entire lens, or the back of the lens may be left in place. Once the pieces are removed an artificial lens, called an Intraocular Lens or IOL, is put into place. Made of plastic, silicone or another material, the lens is very flexible (similar to a contact lens) and can be slipped into a tiny incision. Stitches are typically not necessary to close the incision.

Extracapsular Extraction Cataract Surgery

The second type of surgery is called an extracapsular cataract extraction. This procedure is less common and uses a larger incision than the phacoemulsification technique. In this technique, the cloudy portion of the lens is removed surgically, and suction is applied to remove the additional pieces. Once the old lens has been removed, an artificial lens is inserted. Once the lens is properly placed, the incision is closed. The size of the incision used in this procedure typically makes stitches necessary.

The primary difference between the two procedures, from the patient’s perspective, is the size of the incision and if stitches are necessary. Both remove the cloudy lens and replace the lens with an implant. Both procedures are typically completed in less than an hour, and are most often performed on one eye rather than both. If both eyes are affected, the second procedure is typically performed after the first is done healing.

4
Recovering After Cataract Surgery

Recovering after a cataract surgery is not typically painful, but you may experience discomfort or itching. It is important to remember not to rub your eyes. It is also important not to touch your face or eye area without washing your hands. This will help prevent irritation and infection during the healing process.

Depending on your surgeon’s preferences, you may receive eye drops to prevent infection or to soothe irritation. You may also be given additional instructions, such as wearing an eye patch, wearing dark sunglasses or special instructions for when you may drive safely.

You may have several follow-up appointments with your ophthalmologist. If your incision required stitches to close, your doctor will need to remove them once the incision heals. If both eyes require surgery, the second procedure will typically be done the first eye has healed completely.

Your vision will likely continue to improve for the first two weeks after the procedure. After that point, any changes in your vision should be minimal. If you required glasses prior to the surgery, you may or may not need them after the procedure. It is very likely that your prescription will change following your surgery and your old glasses will no longer be appropriate.

Source:

Cataract. Medline Plus. Accessed July 2012. http://www.nlm.nih.gov/medlineplus/cataract.html

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