Cataract Surgery

What is a cataract surgery?

Cataract surgery is a procedure in which a provider removes a cataract from the eye and replaces it with an artificial lens. A cataract is a cloudy area in the lens of the eye. The lens is located inside the eye behind the colored part of the eye. For some people, the lens gets cloudier over time and causes vision problems.

When is it used?

Cataract surgery is recommended when a cloudy area in the lens of the eye causes vision problems. The benefit of this procedure is that you can regain nearly normal vision if the rest of your eye is normal.

Instead of this procedure, you might be able to get a stronger prescription in your glasses. You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for the procedure?

• Plan for your care and a ride home after the procedure.
• Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take.
• Do not wear eye makeup on the day of the surgery.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a local or general anesthetic to keep you from feeling pain during the operation. A local anesthetic numbs your eye while you remain awake. The local anesthetic can be given to you with drops or ointment or with a shot of medicine behind the eye. General anesthesia relaxes your muscles and you will be asleep. Most surgery is done with local anesthesia only. Sometimes your provider will give you a sedative to help you relax.

The provider will make a small cut in your eye and remove the cloudy lens. There are 2 ways to remove the lens:

• Phacoemulsification: Sound waves (ultrasound) are used to break the lens into small pieces. The small pieces are then removed with a tiny vacuum.
• Nuclear expression: The lens is removed in one piece. This approach may be used if your cataract can't be broken up by phacoemulsification.

After the lens is removed, the provider will put an artificial lens in your eye. The provider may put one or more stitches in your eye to close the incision. You will also have a patch and protective shield over the eye.

What happens after the procedure?

You will be in the recovery area after surgery until you are ready to go home. It's normal to feel itching, sticky eyelids, and mild discomfort for a while after cataract surgery. After 1 to 2 days, the discomfort should stop. Some fluid discharge is also common.

You can read and watch TV almost right away, but your vision may be blurry at first. You can do simple tasks such as ride in a car, get dressed, cook, and visit friends. You should not drive a car the day of surgery. To protect your eye from injury, cover the eye at all times with sunglasses, glasses, or a special eye shield while your eye is healing

You may need to use eyedrops or pills to help healing, prevent infection, or to control the pressure in your eye. Since you may have several different drops to use, be sure you have a written schedule to follow to avoid confusion.

Ask your healthcare provider:

• how long it will take to recover
• what activities you should avoid
• how to take care of yourself at home and when you can return to your normal activities
• what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• an allergic reaction to medicines used during the procedure
• infection, bleeding, or blood clots
• drooping eyelid
• double vision
• glaucoma (damage to the optic nerve usually caused by high pressure inside the eye)
• retinal tear or detachment
• need for additional surgery
• decreased or loss of vision (rare)
• a cloudy film that may form on the covering of the lens, but is not a cataract. (This problem is easily fixed with a quick, painless laser procedure.)

Anesthesia has some risks. Discuss these risks with your healthcare provider.

Every procedure or treatment has risks. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.