Cataract Surgery

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KEY POINTS

• Cataract surgery is a procedure in which a provider removes a clouded lens from the eye and replaces it with an artificial lens. A cataract is a cloudy lens inside the eye behind the iris (the colored part of the eye). This cloudy area can cause trouble seeing.
• Cataract surgery is recommended when a cloudy area in the lens of the eye causes vision problems.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is a cataract surgery?

Cataract surgery is a procedure in which a provider removes a clouded lens 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 iris (the colored part of the eye). It helps focus light and images on the retina, the lining of the back of your eye, so that you can see clearly. If the lens gets cloudy, it can cause trouble seeing.

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 clear vision if the rest of your eye is normal. You may still need glasses or contact lenses to see clearly after cataract surgery. For example, you may see clearly at distance without glasses but need to wear reading glasses.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Plan for your care and a ride home after the procedure.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• 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 and a sedative to help you relax.

There are different ways to break up the lens:

• Phacoemulsification: The provider will make a small cut in your eye and use sound waves (ultrasound) to break the lens into small pieces. The small pieces of the old lens are then removed with a tiny vacuum
• Femtosecond laser: The provider uses a special laser to make a small cut in your eye and help break the lens into small pieces. Ultrasound may still be used.
• Nuclear expression: The lens is removed in one piece. This approach is used rarely, only if your cataract can't be broken up by ultrasound.

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 cut. You will have a protective shield and a patch 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 short time after cataract surgery. After 1 to 2 days, the discomfort should stop. Some clear 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 need to use eye drops 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
• If there are 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. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Problems with anesthesia
• 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 plastic lens implant. This problem is easily fixed with a quick, painless laser procedure that is usually done in your provider’s office.

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