Cataract Surgery Introduction

Cataract surgery is one of the most common operations performed on an outpatient basis and one of the safest and most effective. Surgery involves removing the cloudy lens and replacing it with a substitute lens. If cataracts are present in both eyes, they cannot be removed at the same time. Your physician will need to perform surgery on each eye separately. This procedure is usually performed in less than 30 minutes and usually requires only minimal sedation and numbing eye drops, no stitches to close the wound, and no eye patch after surgery. There are no medications, dietary supplements, exercises, or optical devices that have been shown to prevent or cure symptomatic cataracts. Changes in diet and watchful waiting is the most common advice for non-symptomatic cataracts. There are two major types of ECCE: manual expression, in which the lens is removed through an incision made in the cornea or the sclera of the eye; and phacoemulsification, in which the lens is broken into fragments inside the capsule by ultrasound energy and removed by aspiration. The particular method and type of replacement lens will be determined by your physician.

Cataract Surgery Patient Preparation

A brief physical exam will be performed. Inform your physician of any medications you are routinely taking. You will need to have special testing known as keratometry to determine the strength of the IOL needed. Other specific instructions will be provided usually limiting eating or drinking. It is very important to follow these instructions. Arrangements should be made for transportation after the surgery is complete.

What to expect during and after Cataract Surgery

Most cataract surgery takes less than an hour and is done with minimal anesthesia and numbing drops. After the area around the eye has been cleansed with antiseptic, sterile drops are used to cover most of the patient's face. The patient is given either a local anesthetic to numb the tissues around the eye or a topical anesthetic to numb the eye itself. An eyelid holder is used to hold the eye open during the procedure. If the patient is very nervous, the doctor may administer a sedative intravenously. After the anesthetic has taken effect, a very small incision is made, the lens is removed and the IOL is inserted and placed in the correct position. During this time you may notice the sensation of pressure from the various instruments used during the procedure.

After leaving the operating room, you will be brought to a recovery room where your doctor will prescribe several eye drops that you will need to take for a few weeks postoperatively and provide specific care instructions. While you may notice some discomfort, most patients do not experience significant pain following surgery; if you do you experience decreasing vision or significant pain, you should contact your ophthalmologist immediately. In some cases, within months to years after surgery, the thin lens capsule may become cloudy, and you may have the sensation that the cataract is returning because your vision is becoming blurry again. This process is termed posterior capsule opacification, or a "secondary cataract." To restore vision, a laser is used in the office to painlessly create a hole in the cloudy bag. This procedure takes only a few minutes in the office, and vision usually improves rapidly. The lens prescription should be checked after surgery, as it is likely to need adjustment.