Cure_Article_6 Things to know about cataract surgery_Wilg_202_SM

6 Things to know about cataract surgery

Dr. DD. Shastry – Visusense Ophthalmologists

Once your Ophthalmologist has assessed your eyes and determined that cataracts are present, here are 6 things you should know before your procedure.

1. What is cataract surgery?

Cataract surgery is recommended because the lens in your eye has become cloudy. This may have made it difficult for you to see well enough to carry out your daily activities, including reading, driving and vision in dim light conditions. If the cataract is not removed, your vision may stay the same or it may get worse over time. If you choose to wait this may not make the operation more difficult at a later stage.

During the procedure, the cloudy lens (cataract) is removed through a small incision made on the eye and replaced with a new lens (implant) inside the eye.

Cataract surgery improves colour vision and the lens implant used will give you clear distance vision. However, you will still require reading glasses after surgery.

2. Will I still need glasses following cataract surgery?

Cataract surgery is not the same as laser vision correction and therefore will not eliminate the need for you to wear spectacles afterwards. Whilst the majority of patients have improved eyesight following cataract surgery, it cannot be guaranteed that you will not need distance spectacles following surgery. It is expected that nearly all patients will need to wear reading glasses afterwards.

In patients who have astigmatism, there are special intraocular lens implants which can be used at the time of surgery to reduce the need for distance glasses afterwards.

The choice of intraocular lens implant used will differ based on each patient’s individual vision requirements and eye measurements. These lens options will be discussed with you during your consultation.

3. What can I expect on the day of surgery?

You will be provided with an anaesthetic form to complete prior to surgery so that your anaesthetist is aware of any possible medical conditions that you may have. Once you are admitted to the day ward, eye drops will be instilled in the eye to dilate your eye pre-operatively. The operation is performed under local anaesthetic which consists of anaesthetic eye drops. This may be supplemented with either mild sedation or a local anaesthetic block. The most suitable anaesthetic for you will be determined once you have been seen and examined by your anaesthetist.

It is recommended that you take your chronic medications prior to surgery, however, diabetics may need specific advise especially if on insulin injections.

You will be awake during the operation, which can take between 30 – 45 minutes. You will not be able to see what is happening, but you will be aware of a bright light from the microscope.

During the operation you should keep your head still and lie as flat as possible. You will be accompanied to and from theatre and at the end of the operation, a shield may be placed over your eye to protect it. You will be advised when this can be removed. You will not be able to drive yourself home after the operation, so plan to have a family member, relative or friend collect you once you are discharged.

4. What information should I tell my surgeon?

It is important to alert your surgeon to the following as soon as possible: Any history of previous laser eye treatment (such as LASIK or RK); any medical history including your chronic medications or previous anaesthetic exposure; any recent lower respiratory tract infection and coughing or difficulty lying supine (flat) for prolonged periods. Smokers are advised to stop or cut down their smoking prior to surgery.

5. What to expect after the operation?

It is normal to have some bruising or swelling of the eye or eyelids, cloudiness of the cornea (front part of the eye), increased awareness of floaters, glare from the intra-ocular implant and / or high pressure inside the eye in the initial days following surgery. You will be followed up the day after your surgery and thereafter a week later. You will also be prescribed eye drops to reduce inflammation and help the eye heal. These must be used at specific intervals in the operated eye starting from the first day after your surgery.

The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Please note that if you have another condition such as diabetes, glaucoma or age-related macular degeneration, your quality of vision may still be limited after surgery.

Normal daily activities may be resumed after surgery unless otherwise stated. Please discuss with your surgeon if heavy lifting or job specific requirements will be needed sooner.

6. When will new glasses be prescribed?

In most cases, healing will take about 4 to 6 weeks after which new glasses can be prescribed. Slight discomfort following surgery is not unusual and the vision will gradually improve. However, if you experience excessive pain, loss of vision, increased redness, swelling of the eyelids or a discharge, contact your doctors room immediately as these signs are indicative of an infection.

With ever advancing technology, cataract surgery has become a routine day procedure in most centres. However, each eye is different – sometimes even within the same patient. It is important not to compare your journey with that of another patient and to allow the eye sufficient time to heal. Always discuss your queries with your doctor before making a final decision on surgery.

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