Cataract surgery

Overview

Cataract surgery is a medical procedure aimed at improving vision by removing a cataract, a clouding of the eye’s natural lens. This condition primarily results from the natural aging process, as the proteins in the lens gradually deteriorate over time. However, other factors such as medical conditions, medications, injuries, or previous eye surgeries can also contribute to cataract formation. The symptoms of cataracts typically include blurry vision, seeing halos around bright lights, and experiencing double vision, all of which hinder the passage of light through the lens.

During cataract surgery, an ophthalmologist removes the cloudy lens and replaces it with a clear artificial lens known as an intraocular lens (IOL). Most patients receive an IOL during the procedure, which allows light to pass through and be properly focused by the eye. Different types of IOLs are available to correct common vision problems like nearsightedness and farsightedness. Additionally, specialized IOLs can address issues like astigmatism and presbyopia, although these may not be covered by insurance. Cataract surgery is currently the most effective and established method for treating cataracts in adults, typically leading to improved vision with minimal complications.

Cataract surgery is known for its efficiency and minimal disruption to patients’ lives. It is typically performed as an outpatient procedure, and recovery is relatively swift. In many cases, only one eye requires surgery, but if both eyes have cataracts, the ophthalmologist may schedule the surgeries a week or two apart to ensure optimal results. Overall, cataract surgery is a safe and reliable option to restore clear vision and enhance the quality of life for individuals affected by cataracts.

Types of cataract surgery

Cataract surgery can be performed in two common ways:

• Small-incision cataract surgery (Phacoemulsification): In this method, a tiny incision is made near the outer corner of the eye. A small probe emits ultrasound waves to dissolve the hard core of the cloudy lens, followed by the removal of the remaining cataract material using another probe with suction through the same small opening.
• Extracapsular surgery: This approach involves making a larger opening at the top of the eye to remove the central hard part of the lens. The remaining cataract material is then suctioned out through this larger opening. Subsequently, an intraocular lens (IOL), a clear artificial lens, is inserted through the same incision. The IOL becomes a permanent part of the eye, improving vision as it allows light to pass through to the retina. Importantly, the individual does not perceive or sense the presence of the new lens.

Reasons for undergoing the procedure.

Cataract surgery may be recommended if cataracts in one or both eyes cause vision problems that disrupt daily activities or if it’s necessary to assess and manage other eye conditions like age-related macular degeneration or diabetes-related retinopathy. It’s important to note that cataract surgery only addresses vision loss due to cataracts and does not treat other underlying eye conditions. Cataracts typically worsen over time, and while initially, a new glasses or contacts prescription may help, surgery becomes necessary when cataracts significantly impede your ability to perform essential tasks or activities. The timing of surgery should be discussed with your eye surgeon, and it’s not considered a medical emergency, allowing for flexibility in scheduling.

Risks

Surgery for a cataract is a common, safe treatment. Under the skill of an experienced surgeon, complications during and after cataract surgery are rare. If you have certain eye illnesses or other medical conditions, you may be more susceptible to consequences.

Among the potential hazards of cataract surgery are:

• Blindness
• Eyesight blurring
• Bleeding or swollen eye
• Pain in the eye which constantly occurs
• Disturbances in vision, like glare, shadows, and halos.
• IOL displacement, or the shifting of your newly installed lens.
• An infection that affects less than 1 in 1,000 persons.
• Posterior capsular opacification, or clouding of the membrane encasing your lens.
• Retinal detachment, which affects 2 out of every 1,000 persons.

Most of these issues can be properly treated by your ophthalmologist. Find out about your own risk level from your ophthalmologist prior to surgery. Additionally, find out how they plan to handle any potential issues.

Before the procedure

You will have a comprehensive eye exam with your ophthalmologist prior to the day of your surgery. During this examination, your eye doctor will:

• Examine your eye’s condition.
• Watch out for any indications that surgery is not necessary.
• Identify the risk factors that can make your surgery more difficult.
• Take an eye measurement to determine your IOL’s proper focusing power.
• Inform you if prescription eye drops are required.

During the procedure

Surgery for a cataract is performed as an outpatient procedure, allowing you to return home shortly after the operation. When your surgeon performs cataract surgery, they will:

• Numb the surface of your eye using topical anesthetic. To ensure that you remain pain-free throughout the procedure, your eye will be treated with eye drops. Additionally, you may be prescribed medication to aid in relaxation. During the procedure, you will be awake, but you won’t see anything coming towards you; all you will see are a jumble of lights.
• Create a small hole in your cornea using either a laser or a blade, as determined by your surgeon. Stitches are usually not required to close the wound.
• Split open and remove the cataract. The most commonly used method for this is phacoemulsification. Your surgeon will use ultrasonic waves to break your lens into several tiny fragments and then remove those fragments.
• Insert your new lens through the same incision. Most intraocular lenses (IOLs) are designed to fold for easy insertion. Afterward, the IOL will open up within the area where your clouded lens was located.
• Protect your eyesight. Your surgeon will apply an eye patch or shield with tape to protect your eye.

Typically, cataract surgery takes ten to fifteen minutes. However, when you account for preparation and recovery, your appointment may take several hours. It’s important to confirm the timing of the surgery with your ophthalmologist so you can inform your driver.”

After the procedure

After your surgery is completed, your surgeon will observe you for a period of 15 to 30 minutes and arrange your initial follow-up appointment before allowing you to leave. It is common for your vision to appear blurry immediately after the procedure, with gradual improvement expected in the ensuing days and weeks. You may also experience temporary side effects such as a gritty sensation in your eyes, redness, or bloodshot eyes, as well as increased tear production.

Outcome

Usually, it takes about four weeks for a full recovery following cataract surgery. Nevertheless, many individuals notice an improvement in their vision just a few days after the procedure. Any discomfort or pain experienced during this period is generally minimal.

Your surgeon will provide specific instructions for your post-surgery care. It’s important to ask for details about:

• Driving restrictions.
• Swimming guidelines.
• Application of eye makeup.
• Exercise recommendations.
• Bending limitations.
• Avoiding heavy lifting.
• Returning to work and regular activities.

Consider having a friend or family member with you to hear these instructions or ask your surgeon to provide them in writing.

General post-surgery tips:

• Follow prescribed eye drop regimen.
• Keep water, shampoo, and soap away from your eye.
• Avoid rubbing or applying pressure to the eye.
• Wear sunglasses outdoors.
• Use an eye shield as directed, especially while sleeping.