Diagnostics
Cataract surgery
What is cataract surgery?
Cataract surgery is the most common and safe surgical procedure. It involves replacing the cloudy natural lens (cataract) with a new artificial lens. The surgery is quick and painless, resolving vision issues caused by the cloudy lens. Additionally, the new intraocular lens can correct nearsightedness and farsightedness.
Just like a camera, the eye possesses a lens responsible for focusing light. This lens primarily consists of water and proteins. The proteins can degrade with age, resulting in the lens becoming cloudy and yellowed, ultimately leading to the development of cataracts. Besides aging, certain medical conditions, medications, injuries, or previous eye surgeries can also cause cataracts.
When a cataract forms, it blocks light from passing through the lens properly, resulting in symptoms like blurry vision, halos around lights, or double vision.
Cataract surgery removes the cloudy lens and replaces it with a clear, artificial lens called an intraocular lens (IOL).
Who performs cataract surgery?
Cataract surgery is performed by ophthalmologists (eye specialists), who are doctors specializing in the diagnosis and treatment of eye diseases and disorders, including cataracts. Ophthalmologists undergo extensive training and have the expertise to perform various eye surgeries, including cataract surgery.
Who needs cataract surgery?
Cataract surgery is advised for individuals whose daily activities are significantly disrupted by vision problems caused by cataracts, leading to difficulty in reading, driving, recognizing faces, or carrying out tasks due to poor vision.
An ophthalmologist assesses the progression of cataracts and the impact on the patient’s vision through a comprehensive eye examination and makes the decision about cataract surgery.
How is cataract surgery performed?
Before surgery
Before scheduled surgery, the patient will have a comprehensive eye examination by an ophthalmologist. During this exam ophthalmologist will:
- Assess overall eye health.
- Identify any indications that might affect the patient’s eligibility for surgery.
- Evaluate potential risk factors that could impact the surgical process.
- Determine the appropriate focusing power for the intraocular lens (IOL).
- If necessary, they may advise prescription eye drops to prevent infection and reduce swelling during and after surgery.
- A written consent form is signed by the patient or their family member after they have been provided with information about the surgery
During surgery
Before cataract surgery, patients are advised not to consume any solid food for at least 6 hours.
Cataract removal surgery (phacoemulsification) can be performed in an outpatient surgery center or a hospital. Here is what the patient can expect during the procedure:
- The eye will be numbed with eye drops. The patient may also receive medicine to help relax.
- The patient will be awake during surgery, able to see light and movement, but will not be able to see what the doctor is doing to the eye.
- The surgeon will use a special microscope to create tiny incisions near the edge of the cornea, reaching the lens in the eye. They will break up and remove the cloudy lens with the cataract using small instruments.
- A new artificial lens will be placed in the eye to replace the removed cataract lens.
- Usually, stitches are not needed as the incisions are “self-sealing” and will close on their own over time.
- After the procedure, a protective shield will be placed over the eye as the patient rests in the recovery area for about 15-30 minutes before going home.
Cataract surgery typically lasts 10 to 15 minutes. Including preparation and recovery time, it may take several hours.
After surgery
After the surgery, the patient may notice that colors appear brighter due to removing the clouded lens. However, vision might be blurry during the first couple of days, and the eye could be slightly sensitive to light. It is common to experience dryness, occasional itching, burning, and redness, but most of these effects will subside within a few days.
The ophthalmologist will prescribe eye drops or medications to prevent or manage inflammation, infection, or high eye pressure. At bedtime, using an eye shield is recommended to protect the operated eye.
The patient will have three or four follow-up appointments with an ophthalmologist to monitor recovery progress.
After cataract surgery, many patients can return to work on light duty within two to three days. However, complete recovery typically takes 1 to 2 months. During this time, the eye will adjust to the replacement lens, and vision will gradually reach its highest potential. Remember to follow the ophthalmologist’s post-operative instructions for a smooth recovery process.
What precautions the patient should take during the recovery period?
To protect the eye during the recovery period the patient should:
- Avoid getting soap or water directly in the eye.
- Refrain from rubbing or pressing on the eye.
- Wear eyeglasses or a protective shield when going out.
- Make sure to wear a protective eye shield while sleeping.
What are the risks of this procedure?
Cataract surgery is generally safe and routine.
Possible risks of cataract surgery include:
- Eye bleeding or swelling.
- Ongoing eye pain.
- Blurred vision or vision loss.
- Visual disturbances, like glare, halos, and shadows.
- Displacement of the new lens (IOL).
- Clouding of the membrane holding the lens (posterior capsular opacification).
- Retinal detachment
- Infection
Before the surgery, the level of risk should be discussed with an ophthalmologist.
References
- Cataract surgery. Available from: https://my.clevelandclinic.org/health/treatments/21472-cataract-surgery
- American Academy of Ophthalmology. Cataract surgery: Risks, Recovery, Cost. Available from: https://www.aao.org/eye-health/diseases/what-is-cataract-surgery
- Cataract surgery. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cataract-surgery
