The what, where and when of cataract surgery
Cataract surgery is one of the more commonly performed surgeries carried out today. Fortunately it is also one of the least invasive surgeries and one that dramatically improves vision for patients who undergo the procedure.
Cataracts impair vision by scattering the amount of light that passes through the eye lens. When light passes through the lens and is scattered, the eye cannot focus properly. This impairs vision.
Before deciding if you are a proper candidate for eye surgery your doctor will perform a comprehensive exam. Typically when performed today cataract surgery is performed using a procedure referred to as a "microincisional" procedure. This results in relatively little discomfort for patients and a speedy recovery. The additional benefits of this procedure include a reduced risk of developing astigmatism, which sometimes results from any kind of eye surgery.
Because certain conditions and medications can adversely affect the results of your cataract surgery, it is important that you let your eye care professional know your full health history as well as all medications that you are taking. This should include any supplements and herbal medicines that you use on a regular basis, as they can increase the risk for certain complications as well.
If you are taking a blood thinner, such as Coumadin, or are on aspirin therapy, you may be asked to stop taking those medications, if possible, for a few weeks beforehand. If the medications cannot safely be stopped or reduced, your eye doctor may do what's called a drops-only surgery, using numbing only eye drops for anesthesia.
What to expect
Most cataract surgeries are performed on an outpatient basis only. Patients typically will arrive and prepare for surgery an hour before the actual procedure takes place. Your health care provider will then apply multiple medications to help prevent pain, reduce irritation and reduce your risk of infection. Your pupil will also be fully dilated.
Most of the time cataract surgery is performed using a local or topical anesthetic. When a local anesthetic is used the surrounding muscles of the eye are often numbed to help improve your comfort level.
During surgery it is likely you will remain awake, though some physicians may opt to place you under mild sedation depending on your preferences and other health factors. Surgery is relatively quick and painless, lasting no more than 30 minutes in most cases. If for some reason during surgery a patient needs to cough or sneeze they must simply inform their surgeon ahead of time. Don't worry, you will have adequate opportunity to cough or sneeze!
There are two main cataract removal methods: phacoemulsification and phacofracture. Phacoemulsification is the more popular of the two, because it involves a smaller incision and therefore less pain and a shorter recovery time. During this procedure, the cataract is broken up using ultrasound waves, and the resulting fragments are suctioned out of the eye. In the phacofracture procedure, the lens is also broken into pieces, but this is done mechanically with special instruments. The fragments are then removed through an incision.
Once the cataract is removed your doctor may move you to an observation area for a period of time, where you will be provided with instructions for caring for your eye over the next few days. Most patients are then discharged and may return home within the hour.
Your recovery after cataract surgery
After surgery, and a short rest in the recovery area, you will be sent home with a protective shield over your eye. (Note: you will not be able to drive, so you should have a family or family member take you home.)
During the next few weeks, you will need to administer prescription eye drops several times per day. You will also need to wear your protective eye shield whenever you're sleeping for the first week or so, to prevent you from accidentally rubbing or damaging your eye during the healing process. In addition, you should wear dark glasses to protect your eye from bright light.
You may be able to return to your normal, day to day routine as soon as the following day, although that depends on a number of factors. Certain activities, such as bending, heavy lifting, and anything which could expose your eye to water, dust or other contaminants will be off limits for a while. Your surgeon will let you know which activities are safe to resume after surgery and when. You should also consult your surgeon if you are planning to fly shortly after your surgery.
What will vision be like after surgery?
How well you will see after cataract surgery will depend on your overall eye health and the type of lens that was implanted, as well as some other factors. In many cases you may see as well or better than before you developed cataracts. If you were given a mono-vision intraocular lens however, you will probably need reading glasses, which will be prescribed after you have fully recovered and your vision has stabilized. In most cases, if you needed some vision correction before the cataract developed, you will still need some correction after surgery as well.
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