Cataract Surgery: A Comprehensive Guide for Patients
Cataract surgery is a common and highly effective procedure to restore vision impaired by cataracts. Ohio Valley Eye staff will walk you through all aspects of cataract surgery, from understanding the condition and procedure to recovery and long-term care.
Understanding Cataracts
Before delving into the surgery, it’s crucial to understand what cataracts are and how they affect vision.
What is a Cataract?
A cataract is a clouding of the eye’s natural lens. The lens, located behind the iris, works like a camera lens to focus light onto the retina. As we age, proteins in the lens begin to break down and clump together, causing the lens to become cloudy.
Symptoms of Cataracts:
– Blurry or hazy vision
– Increased difficulty with night vision
– Sensitivity to light and glare
– Fading or yellowing of colors
– Frequent changes in eyeglass or contact lens prescription
– Double vision in a single eye
Cataracts typically develop slowly and may not disturb eyesight early on. However, as they progress, they can significantly impact vision and quality of life.
What is Cataract Surgery?
Cataract surgery is a procedure to remove the cloudy lens of your eye (the cataract) and replace it with an artificial lens called an intraocular lens (IOL). This outpatient procedure typically takes less than an hour and is performed by an ophthalmologist.
Types of Cataract Surgery:
1. Phacoemulsification: The most common type, where ultrasound waves are used to break up the lens before removal.
2. Extracapsular Cataract Extraction: Used for advanced cataracts, where the lens is removed in one piece.
3. Laser-Assisted Cataract Surgery: Uses femtosecond laser technology to assist in parts of the procedure.
When is Cataract Surgery Needed?
Your eye doctor may recommend cataract surgery if:
– Cataracts interfere with your daily activities such as reading, driving, or watching television
– Your vision problems can’t be corrected with glasses or contact lenses
– You need to manage other eye conditions that require a clear view of the back of the eye
– Cataracts are affecting your ability to perform your job or enjoy hobbies
It’s important to note that cataract surgery is the only proven way to treat cataracts in adults. The decision to have surgery is typically made when the benefits outweigh the potential risks.
Before the Surgery
Preparation
Your ophthalmologist will:
– Perform a thorough eye exam, including dilation to examine the back of your eye
– Measure your eye to determine the right IOL power (a process called biometry)
– Discuss IOL options with you, including monofocal, multifocal, and toric lenses
– Provide instructions on medications and fasting before surgery
– Advise you on any medications you should stop taking before surgery
You may be asked to use antibiotic eye drops for a few days before surgery to prevent infection.
Choosing Your IOL
There are several types of IOLs available:
1. Monofocal IOLs: Provide clear vision at one distance (usually far vision)
2. Multifocal IOLs: Offer clear vision at multiple distances
3. Toric IOLs: Correct astigmatism as well as nearsightedness or farsightedness
4. Accommodating IOLs: Change shape within the eye, allowing focus at different distances
Your choice will depend on your lifestyle, visual needs, and budget, as some advanced IOLs may not be covered by insurance.
Dr. David Malitz is one of the first surgeons selected for Alcon’s FDA-approved, multifocal IOL, PanOptics(R) Trifocal Implant, and is highly experienced in this new technology.
Questions to Ask Your Surgeon
– What type of IOL is best for my lifestyle and visual needs?
– What are the potential risks and complications specific to my case?
– How long will the recovery take, and when can I return to normal activities?
– Will I need glasses after surgery?
– How many cataract surgeries have you performed?
– What measures are taken to prevent infection?
Remember to arrange for someone to drive you home after the procedure, as you won’t be able to drive immediately after surgery.
The Cataract Surgery Procedure
1. Anesthesia: Your eye will be numbed with drops or an injection. You’ll remain awake but may receive a sedative to help you relax.
2. Pupil Dilation: Eye drops will be used to dilate your pupil.
3. Incision: The surgeon makes tiny incisions near the edge of your cornea. These are usually self-sealing and don’t require stitches.
4. Lens Removal: Using ultrasound (phacoemulsification), the cloudy lens is broken up and removed. In some cases, the entire lens may be removed in one piece.
5. IOL Insertion: The artificial lens (IOL) is inserted through the same incision and positioned in place.
6. Completion: In most cases, no stitches are required. A protective shield may be placed over your eye.
The entire procedure usually takes 10 to 15 minutes per eye, but your appointment may last several hours including preparation and recovery.
After the Surgery
Immediate Post-Op
– You’ll rest in a recovery area for 15-30 minutes
– Your eye may feel gritty or slightly tender
– Vision may be blurry at first, but should start improving within a few days
– You’ll receive detailed aftercare instructions
Recovery Period
– Full recovery typically takes about four weeks
– Many people notice improved vision within a few days to a week
– You’ll have follow-up appointments to monitor your progress, typically the day after surgery, after a week, and after a month
Aftercare Instructions
1. Don’t drive for at least 24-48 hours after surgery
2. Avoid bending at the waist or lifting heavy objects (over 25 pounds) for 1-2 weeks
3. Don’t rub or press on your eye
4. Wear eye protection as instructed by your doctor, especially when sleeping
5. Use prescribed eye drops as directed to prevent infection and reduce inflammation
6. Avoid getting soap or water directly in your eye when bathing
7. Avoid swimming or using a hot tub for at least two weeks
8. Wear sunglasses when outdoors to protect your eye from UV light and glare
Potential Risks and Complications
While cataract surgery is generally safe, potential risks include:
– Infection (endophthalmitis): Occurs in about 1 in 1000 cases
– Bleeding inside the eye
– Retinal detachment: More common in people with high myopia
– Glaucoma: Temporary increase in eye pressure
– Secondary cataract (posterior capsule opacification)
– Dislocation of the artificial lens
– Swelling of the cornea or retina
– Drooping eyelid (ptosis)
These complications are rare and can usually be treated successfully if caught early. It’s crucial to attend all follow-up appointments and report any unusual symptoms to your doctor immediately.
Results and Outlook
Cataract surgery improves vision in about 97% of cases. Most people experience:
– Clearer, brighter vision
– Better color perception
– Improved ability to read and perform daily tasks
– Reduced dependency on glasses (depending on the IOL chosen)
– Improved night vision and reduced glare sensitivity
Full visual recovery can take several weeks as your eye heals and adjusts to the new lens.
Secondary Cataracts
Some patients (up to 20%) may develop a secondary cataract, also known as posterior capsule opacification (PCO). This occurs when the back of the lens capsule, which was left in place to support the IOL, becomes cloudy.
Symptoms of PCO are similar to the original cataract and may include:
– Blurry vision
– Glare or halos around lights
– Difficulty reading or seeing fine details
PCO can be easily treated with a quick, painless laser procedure called YAG laser capsulotomy. This creates an opening in the cloudy capsule, restoring clear vision.
Long-Term Care
After cataract surgery, it’s important to:
– Continue regular eye exams to monitor your overall eye health
– Protect your eyes from UV light by wearing sunglasses outdoors
– Maintain a healthy lifestyle, including a balanced diet rich in eye-healthy nutrients
– Control other health conditions like diabetes that can affect eye health
– Report any changes in vision to your eye doctor promptly
Cataract surgery is a life-changing procedure for many patients, restoring clear vision and improving quality of life. While the thought of eye surgery can be daunting, modern cataract surgery is safe, effective, and typically results in significant improvement in vision and quality of life. If you’re experiencing vision problems due to cataracts, consult with an ophthalmologist to determine if cataract surgery is right for you.