Cataract surgery: what happens?

It’s completely normal to be nervous before having cataract surgery– everyone is. In fact, it would be strange if you weren’t.

But as anyone who has had cataract surgery will tell you, there really is nothing to worry about. In fact, many people find cataract surgery so easy and pleasant that they fall asleep during the procedure! Here I’ll let you know what to expect.

What is cataract surgery?

During cataract surgery, your cloudy lens (cataract) is removed and a high-definition artificial lens is implanted. This artificial intraocular lens (IOL) lasts for life and it refocuses your vision so that you can see clearly. It is custom-selected for your eye to give you the best vision possible.

Before cataract surgery

Before scheduling cataract surgery, I will precisely measure the dimensions of your eye  using a laser scanner (optical biometry) and/or a high definition camera (topography).   These measurements are then calculated using a software programs to determine exactly what power of lens your eye requires, as we will be inserting a new intraocular lens (IOL) to replace your cloudy lens or cataract.

As your ophthalmologist, I will advise you regarding which type of intraocular lens (IOL) will best suit your lifestyle. IOLs come in many different designs, sizes and brands, and some have special features. Cataract surgery is a once-in-a-lifetime procedure, and once your IOL is implanted it is challenging to remove it. Therefore, it is important that your surgeon selects the IOL that is right for you.

Different kinds of intra-ocular lenses are available

IOLs are now available that can give you clear vision at nearly all distances without glasses. These IOLs are called ‘multifocal’ IOLs, ‘extended depth of field’ IOLs and ‘presbyopia-correcting’ IOLs.

Most patients who choose these IOLs are free from glasses for 90% of their day, but still need a thin pair of glasses for demanding visual tasks such as long-distance driving or reading small print in dim lighting (such as restaurant menus).

IOLs are fantastic options for many patients, but not every eye is suitable for them. Also, patients who choose these IOLs typically report seeing a halo around lights at night time. Most patients feel that this is a small price to pay for the enormous benefit of being free from glasses, but these symptoms may be more bothersome for certain individuals, such as those who regularly drive at night. Your ophthalmologist will be able to guide you through the different IOL options and help you to pick the lens that’s best for you.

On the day of surgery

You will be probably be feeling nervous and this is normal. As you will soon discover the experience is far more relaxing than you might imagine!

Checking in for cataract surgery

The administration team at the hospital will greet you, finalise your paperwork, and introduce you to the nursing staff who start a series of pre-operative eye drops. You will be positioned on a bed with a specially-designed headrest and offered a warm blanket.

Pre-operative preparation

The anaesthetist will meet you and ask you about your medical history and allergies. They will give you an intravenous sedative to help you feel relaxed. This ‘twilight anaesthetic’ means that you will feel absolutely no pain and you will usually have no memory of the procedure. The next thing you will remember will be having a tea or coffee in the recovery bay. It couldn’t be easier!

Removing the cataract

The cataract surgery itself usually takes less than 15 minutes. You will be able to hear your surgeon speaking to you and they might ask you to look at the light that you see. I’ve heard it described as the “modern day Woodstock”, as you get given some nice drugs and treated to a light show! So, the process itself is very relaxing. You won’t recall much of the surgery, and usually it’s over before you’ve even realised that it’s started.

Recovery

When your operation is finished you will be wheeled into the recovery area. The nursing staff will sit you up and give you something to eat and drink. They will give you some post-op instructions and explain these to you and your family. You will be able to go home as soon as you feel ready.

That night

It is normal for the eye to feel dry or to have the sensation that there is an eyelash in the outer corner. You can take simple pain killers, such as paracetemol, for this if you need to. Usually this is not necessary. Feel free to shower that night if you wish, but be sure to keep your head dry. You will need to keep a hard shield on the eye overnight to stop you accidentally rubbing it while you sleep.

The day after cataract surgery

At your first post-operative appointment, your vision and eye pressure will be checked. Even though your vision will take four weeks to reach its maximal sharpness, most patients will already start noticing that their eyesight is brighter and more vibrant by this time. You will be taught how to use your post-op eye drops and have an opportunity to ask questions.

Follow-up appointments

We will schedule post-operative appointments over the following month as required. Usually I’d see you on approximately day 1, day 7, and day 30.

Booking cataract surgery for your other eye

Most patients are so delighted with their improved vision that they can’t wait to get the second eye done as soon as possible. Because cataracts develop very slowly, you don’t realise how much vision you’ve lost until you suddenly have the vision restored! You can schedule the other eye for surgery as soon as you are ready.

Top tips for a speedy recovery

  • Rest for at least 24 hours after the operation and do not drive a vehicle. At your first post-operative check we will tell you when you can resume driving. This will depend on what your vision is like in the other eye, and how fast your surgery eye recovers. Most people can drive within a couple of days.
  • You can live your life as normal after surgery, but with a couple of small exceptions: no heavy lifting for 2 weeks, and no eye rubbing or swimming for one month.
  • Blurred vision is normal after surgery but it will improve each day. Your vision takes about four weeks to reach its maximal clarity.
  • Dry eye symptoms (irritation/watering) can be exacerbated for a couple of months after surgery but these will soon settle down.
  • It is not medically necessary to sunglasses after the surgery, but it can help if your eyes are sensitive to light after the operation.

Welcome to life without cataracts!

We live in a wonderful era where surgical and optical technology provides outcomes that are truly brilliant. The image you see will be as vibrant as that of a 30 year old. Patients frequently report that they feel more self-assured and safer driving at night or in rain, and more confident walking at dusk. Some set new goals for themselves after cataract surgery. They find renewed enjoyment engaging in activities that they had withdrawn from. The main downside of cataract surgery that my patients tell me is that they can now see the dust!

Enjoy your new vision without cataracts and live your life to its fullest.