Cataract Surgery

Cataract surgery is a relatively simple, safe outpatient procedure designed to replace the lens of your eye with an artificial lens. Normally, your eye’s lens is clear, but a cataract causes it to become cloudy, affecting your vision. Cataract surgery, performed by an ophthalmologist, corrects your vision so you can see normally again.

How to Prepare for Cataract Surgery

You will be instructed not to eat or drink anything 12 hours before you undergo cataract surgery.  You will also be advised to temporarily skip taking any medication that could increase your risk of bleeding during the procedure. Be sure to let your doctor know if you are taking any medications for prostate problems. These drugs can interfere with your cataract surgery.

In addition, antibiotic eyedrops are often prescribed for use one or two days before the surgery.

Although cataract surgery is an outpatient procedure and you can go home on the same day as your surgery, you will not be able to drive, so you must arrange for a ride home. Also, plan on someone helping you at home as your doctor may limit certain activities, such as bending and lifting, for approximately one week following surgery.

What to Expect

About a week before surgery, your doctor may perform a painless ultrasound test to measure the shape and size of your eye. The purpose of this test is to determine the right type of intraocular lens (IOL) to implant. An IOL improves your vision by focusing light on the back of the eye. You will not see or feel the lens once it is implanted, and as a permanent part of your eye, it does not require care.

Before your cataract surgery, you and your eye doctor can discuss the type of IOL that might work best for you. There are various types of IOLs made of plastic, acrylic, or silicone, including:

• Fixed-focus monofocal, which has a single focus strength for distance vision.
• Accommodating-focus monofocal, which, despite only having a single focusing strength, can respond to eye muscle movements and shift focus to near or distant objects.
• Multifocal, which are similar to glasses with bifocal or progressive lenses, thus allowing for near, medium, and far vision.
• Astigmatism correction (toric), which can help correct your vision if you have a significant astigmatism. Some even block ultraviolet light. Many of these IOLs are flexible, allowing a smaller incision that requires no stitches.

During the Procedure

Before your cataract surgery, your doctor will place eyedrops in the affected eye to dilate the pupil. You will also receive  a local numbing agent to numb the area and may be given a sedative to relax you while you remain awake, though groggy, during the procedure.

During the surgery, the clouded lens is removed and replaced with a clear artificial lens using one of two surgical methods.

The phacoemulsification method involves making a tiny incision in the cornea and inserting a needle-thin probe into the lens substance where the cataract has formed. The surgeon then uses an ultrasound probe to break up the cataract and suction out the fragments. Your lens capsule remains intact as the place where the artificial lens will rest. Stitches may be required to close the tiny incision in the cornea.

The extracapsular extraction method is a less frequently used procedure performed if you have certain eye complications. It requires a larger incision through which the surgeon uses tools to remove the front capsule of the lens and the cloudy lens comprising the cataract. The back of your lens is left intact as the place where the artificial lens will rest. Since there will be a larger incision, stitches will be required.

After the Procedure

Following cataract surgery, your vision will begin to improve within a few days, though it may be blurry at first as your eye heals and adjusts to its new lens.

You will likely be asked to wear an eye patch the day of surgery and for a few days thereafter, as a protective shield when you sleep during the recovery period. Your doctor may also prescribe eyedrops to prevent infection, control eye pressure, and reduce inflammation.

You will need to see your eye doctor a few days after your surgery, and then again after a month to monitoring your healing. Itching and mild discomfort for a few days after surgery is normal. However, you must avoid rubbing your eye. Most of the discomfort should disappear in a couple of days. Often, patients are completely healed within eight weeks. Contact your doctor immediately if you experience:

• Vision loss
• Persistent pain
• Increased eye redness
• Eyelid swelling