St. Aloisius Medical Center
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Cataract Surgery (Ophthalmology)

Cataract surgery successfully restores vision in an overwhelming majority of cases. Find out what cataract surgery involves, including what to expect afterward and rare complications.

During cataract surgery, an eye doctor (ophthalmologist) removes the clouded lens from your eye and, generally, replaces the lens with an artificial lens. Cataract surgery is very successful in restoring vision – more than 95 percent of people who have a cataract removed have no complications and enjoy improved vision.

When is the best time for cataract surgery?

The decision to have cataract surgery is one that you and your eye doctor should make together. You’ll probably have plenty of time to consider and discuss your options. In most cases, waiting to have surgery won’t harm your eye. If your vision is still quite good, you may not need cataract surgery for many years, if ever. In younger people or people with diabetes, however, cataracts may progress rapidly, making the need for surgery more immediate.

Base your decision on the degree of vision loss and how much the cataract affects your daily life. Can you see to do your job and drive safely? Do you have problems reading or watching television? Is it difficult to cook, to shop, do yardwork, climb stairs or take medications? How active are you? Do vision problems affect your level of independence?

The answers to these questions are different for each person. An older person who isn’t very active may have less need for sharp vision than does a younger person who needs to drive a car and earn a living. Some people with only minor vision loss from a cataract might want surgery because of problems with glare or double vision. Sometimes a cataract should be removed even if it doesn’t cause major problems with vision – for example, if it’s interfering with the treatment of another eye problem, such as age-related macular degeneration, diabetic retinopathy or retinal detachment.

If you have cataracts in both eyes and decide to have surgery, your ophthalmologist typically schedules two separate surgeries. This allows time for the first eye to heal before the second eye surgery takes place.

What happens during cataract surgery?

Typically, two things happen during cataract surgery – the clouded lens is removed, and a clear artificial lens is implanted. In some cases, however, a cataract may be removed without implanting an artificial lens.

Before surgery, your eye doctor measures the size and shape of your eye to determine the proper power of the lens implant. The measurements are made with a painless ultrasound test. Cataract surgery is typically an outpatient procedure that takes less than an hour. Most people are awake and need only local anesthesia. On rare occasions some people may need general anesthesia.

After cataract surgery

Surgical incisions are very small, and no sutures are required. If all goes well, you’ll heal fast and your vision will start to improve within a few days. If your surgery requires a larger incision and sutures, full healing can take up to eight weeks.

Normally you can go home on the same day of your surgery, but you won’t be able to drive, so make sure to arrange for a ride home. It’s also a good idea to make sure you have necessary help because your doctor may limit activities such as bending and lifting for a few days. You’ll typically see your eye doctor the next day, the following week and then again after a month so that he or she can check the healing progress.

It’s normal to feel itching and mild discomfort for a couple of days after surgery. Avoid rubbing or pressing on your eye. Clean your eyelids with tissue or cotton balls to remove any crusty discharge. You may wear an eye patch or protective shield the day of surgery. Your doctor may prescribe medications to prevent infection and control eye pressure. After a couple of days, all discomfort should disappear. Often, complete healing occurs within eight weeks.

Contact your doctor immediately if you experience any of the following signs or symptoms after cataract surgery.

¦ Vision loss

¦ Pain that persists despite the use of over-the-counter pain medications

¦ Increased eye redness

¦ Light flashes or multiple spots (floaters) in front of your eye

¦ Nausea, vomiting or excessive coughing

Most people need to wear glasses after cataract surgery. Astigmatism – a focusing problem that occurs when your cornea isn’t curved evenly in all directions – is a common result of the surgery but is less of a problem when the procedure involves a small incision. Your doctor will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses.

If you have cataracts in both eyes, your doctor will treat one eye at a time, and it’s usually a month or two before you can schedule surgery for the other eye.