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Cataract Sugery- What you need to know

What is a cataract? A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans have either a cataract or have had cataract surgery. A cataract can occur in either or both eyes. The lens must be clear for the retina (the back of the eye)  to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred or hazy.

How is a cataract treated? The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually weeks apart.

Is cataract surgery effective? Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward. There is  the possibility of a secondary or after cataract which is different from the first cataract and is easily lasered and is an in office procedure. 

What are the risks of cataract surgery? As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision. 

What happens before surgery? At the surgical consultation, your doctor will do some tests. These tests may include measuring the curve of the cornea (the front surface of the eye) and the size and shape of your eye. This information helps your doctor choose the right type of intraocular lens (IOL or implant). You may be asked not to eat or drink anything 12 hours before your surgery. 

The surgeon will discuss different options for your implant lens. Here’s a quick break down of the options:

  • Basic Cataract Implant – this lens is typically covered by medical insurances. This lens gives very good vision, often even without glasses, for either far or near. Glasses will still be needed for at least part time use.
  • Toric Cataract Implant – this lens corrects for astigmatism and should be considered if you have a higher level of astigmatism. It helps to make your vision without glasses even better. If you do not have much astigmatism, this lens is unnecessary. There will be additional costs for this type of lens implant.
  • Multifocal Cataract Implant – this is the only implant option that allows for both far and near vision and can give the most freedom from glasses. However, this lens may not be ideal for everyone and may cause additional nighttime glare after surgery. There will be additional costs for this type of lens implant.

 

What happens during surgery? At the outpatient surgical center or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed. The operation usually lasts less than 15 and is almost painless. The cataract is removed by making a small opening on the front of the eye, dissolving the cloudy lens, and inserting an artificial lens implant in its place. After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any side effects, such as bleeding. You will need someone to drive you home. 

What happens after surgery? Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, treatment can be modified to help. After one or two days, moderate discomfort should disappear. For a few weeks after surgery, you may be asked to use eyedrops to help healing and decrease the risk of infection. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye. When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores. In most cases, healing will be complete within eight weeks. 

Your doctor will schedule exams to check on your progress. The day after surgery, the surgeon will ensure that the eye is healing properly. Subsequent follow up visits at one week and one month are done in our office or by the surgeon if more convenient.