What is cataract surgery?
In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens (called an intraocular lens, or IOL) to restore clear vision.
The procedure typically is performed on an outpatient basis and does not require an overnight stay in a hospital or other care facility.
Most contemporary cataract procedures involve the use of a high-frequency ultrasound device that disruptions the cloudy lens into small pieces, which are then gently removed from the eye with suction.
This procedure, called phacoemulsification or “phaco,” can be performed with lesser incisions than preceding surgical techniques for cataract removal, promoting faster healing and reducing the risk of complications from cataract surgery, such as a retinal detachment.
Cataract laser surgery
Recently, the FDA approved a series of femtosecond lasers, similar to the lasers used to create the corneal flap in all-laser LASIK, for use in cataract surgery performed in the United States.
These lasers have been approved for the following steps in cataract surgery, reducing the need for surgical blades and other hand tools:
- Create incisions in the cornea to allow the surgeon to access the lens.
- Removal of the anterior lens capsule
- Fragmentation of the cataract
- Creation of peripheral corneal incisions to reduce astigmatism (when necessary)
Why it’s done
Cataract surgery is done to treat cataracts. Cataracts can cause blurred vision and increase the glare of lights. If a cataract makes it difficult for you to do your normal activities, your doctor may suggest cataract surgery.
When a cataract interferes with the treatment of another eye problem, cataract surgery may be recommended. For example, doctors may recommend cataract surgery if a cataract makes it difficult for your eye doctor to examine the back of your eye to monitor or treat other eye problems, such as age-related macular degeneration or diabetic retinopathy.
In most cases, waiting to have cataract surgery will not harm your eye, so you have time to consider your options. If your vision is still pretty good, you may not need cataract surgery for many years.
When seeing cataract surgery, keep these questions in mind:
- Can you see to do your job safely and drive?
- Do you have trouble reading or watching television?
- Is it difficult to cook, shop, garden, climb stairs, or take medicine?
- Do vision problems disturb your level of independence?
- Do bright lights make it harder to see?
Complications of cataract surgery
For most people, cataract surgery goes smoothly. You end up with a better vision and recover smoothly in the long run. But like any surgery, there are risks, especially if you have other eye problems or a serious medical condition.
So it helps to know what could go wrong. You can keep a close eye on any symptoms and call your doctor if something seems wrong.
Germs that enter the eye during surgery can lead to infection. You may feel sensitive to light or have pain, redness, and vision problems. If this happens to you, call your doctor immediately.
Infections after cataract surgery are rare, but if you have one, antibiotics will be injected into your eye. In some cases, your doctor also removes the vitreous, the clear gel in the centre of the eye, to stop the spread of the infection.
Some swelling and redness after surgery are normal. If you have more than usual, you will receive eye drops or other medicine to treat it.
The retina sits way back in the eye, detects light, and sends messages to the brain. After surgery, you are slightly more likely to detach from the back of the eye, this problem called retinal detachment.
It is an emergency that can cause vision loss. See your eye doctor right away if:
- I feel like a curtain has fallen over part of your eye
- Have new floating points in your vision.
- Lens fragments
- See flashes of light
When your doctor removes your cloudy lens during cataract surgery, some pieces may fall into your eye and be left behind. The little ones are not a problem, but the bigger ones can be.
The vision when one has a cataract is similar to looking through a dirty windshield of a car or smearing grease over the lens of a camera or your glasses. Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty with glare (often with the bright sun or automobile headlights while driving at night), dull colour vision, increased nearsightedness accompanied by frequent changes in eyeglass prescription, and occasionally, double vision in one eye. A change in glasses may initially help once vision begins to change from a cataract. However, as the cataract continues to become denser, vision also becomes cloudier, and stronger glasses or contact lenses will no longer improve sight. Some people with cataracts may experience symptoms of vision problems with only a mild cataract in one eye, while others may not notice any visual abnormalities until both eyes develop significant cataracts.
Cataracts generally develop gradually and are generally not painful or associated with eye redness or other symptoms, unless they are extremely advanced. Rapid and/or painful changes in vision raise suspicion for other eye diseases and should be evaluated by an eye doctor.
How do health professionals diagnose cataracts?
Cataracts are detected by finding clouding or clouding of the lens during a medical eye exam by an eye doctor or sometimes a primary care physician. The abnormal lens can be viewed using a variety of specialized viewing instruments. Through various tests, an ophthalmologist (MD, a doctor who specializes in diseases of the eye) or an optometrist (a doctor in optometry, a health professional trained in primary eye care, not the same as a doctor) can find out how much a cataract can affect vision. Common eye tests include tests of visual acuity, glare sensitivity, color vision, contrast sensitivity, and a thorough examination of all other parts of the eye, making sure that vision loss is not due to other common eye problems, such as diabetes, glaucoma or macular. degeneration.
Most cataracts associated with aging develop slowly, and many patients may not notice visual loss until it is well advanced. It is not imperative to have surgery to eliminate a cataract until it begins to affect vision. The development of cataracts is unpredictable. Some cataracts remain less dense and never progress to the point where they cause cloudy vision and require treatment, while others progress more rapidly. Therefore, the decision and timing to proceed with cataract surgery is individualized for each patient. Your doctor will be able to tell you how much of your vision loss is due to cataracts and how much vision recovery can be expected with surgery. If your vision loss is solely due to the presence of a cataract, vision must be fully restored with successful cataract surgery.
What to expect from cataract surgery?
Before the surgery:
Your surgeon will measure your eye to determine the proper focusing power for your IOL. Also, you will be asked about any medicines you take. You might be asked not to take some of these medicines before surgery.
You may be prescribed eye-drop medicines to start before surgery. These medicines help prevent infection and reduce swelling during and after surgery.
The day of surgery:
Your ophthalmologist may ask you not to eat any hard food for at minimum 6 hours before your surgery.
How do you prepare
Food and medicine
You may be told not to eat or drink anything for 12 hours before cataract surgery. Your doctor may also recommend that you temporarily stop taking any medications that may increase your risk of bleeding during the procedure. Tell your doctor if you take any medications for prostate problems, as some of these medications can interfere with cataract surgery.
Antibiotic eye drops may be prescribed to use a one or two days before surgery.
Normally you can go home on the same day as your surgery, but you won’t be able to drive, so arrange for a ride home. Also arrange for help around home, if necessary, because your doctor may limit activities, such as bending and lifting, for about a week after your surgery.