Cataract Surgery – Things You Should Know

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cloudy eyeMost people in their 50s or older hear the news some or the other times from their doctors that they have cataracts. In a cataract, the lens inside the eye is clouded, leading to loss of vision which cannot be rectified with aids like contact lenses, eyeglasses or corneal refractive surgery such as LASIK. Though cataract might sound fierce, modern cataract surgery is known for getting the patient’s vision back successfully and also reducing the dependence on eyeglasses. Here we will know the basics of cataract surgery like how to prepare for the procedure, what to know from your surgeon, recovery, etc.

Most events of cataracts are related to aging process and elderly people are commonly the victims of cataracts. Prevalence of cataracts is also found to be on a rise every year. However, fortunately cataract surgery has much more advanced today and has become the most effective and the safest procedure. Every year, millions of people undergo cataract surgery with excellent results.

Basics of Cataract Surgery

As mentioned earlier, the lens inside the eye becomes cloudy in cataract, and in cataract surgery it is removed and substituted with an artificial lens because of which vision becomes clear. The artificial lens is called IOL or Intra-Ocular Lens.

Cataract surgery is typically done on an outpatient basis and doesn’t need an overnight stay in the clinic.

Nowadays, an ultrasound high-frequency device is used in most cataract surgeries. This device breaks the cloudy lens into tiny pieces and then the pieces are removed from the eye using suction. This technique is known as Phacoemulsification or only “phaco” and it requires only a small incision as compared to that taken in earlier cataract removal surgeries. Because of this, healing becomes faster and chances of any complications like retinal detachment are eliminated.

Once all the pieces of the cloudy lens are removed, the eye surgeon implants a clear intraocular lens carefully behind the iris and pupil, exactly on the same spot where your natural lens was. In some special cases, the IOL is placed before the iris and pupil; but this is not very common.

The removal of cataract and insertion of IOL are completed by the eye surgeon by closing the incision which may or may not need a stitch. Next, a protective shield is positioned over the eye to defend it in the initial days of recovery.

cataract surgery

Laser Cataract Surgery

Lately, numerous femtosecond lasers have been approved by the US FDA to utilize in cataract surgery done in the US. These lasers are similar to those used for creating the corneal flap during all-laser LASIK. They have obtained approval for being used during the following steps in a cataract surgery, and thus lessening the requirement of surgical blades and other such tools:

  • Forming corneal incisions to let the surgeon access the lens
  • Taking out the lens’s anterior capsule
  • Fragmenting the cataract because of which less phaco energy is needed to break and remove it
  • Forming the peripheral corneal cuts to lessen astigmatism (if required)

Laser cataract surgery is quite new and increases the cost of cataract surgery considerably, mainly because of the pricey laser which can cost between $300,000 and $500,000 and other considerable costs related to the use as well as maintenance of this technology.

How to Prepare for Cataract Surgery and How to Choose an IOL?

Before you undergo cataract surgery, your optometrist and/or eye surgeon will conduct a thorough eye examination to check the general health of your eyes, assess whether there are any reasons for not performing the surgery and recognize any risk factors.

Also refraction will be done to determine the exact amount of farsightedness, nearsightedness and/or astigmatism present in the eyes before surgery.

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Extra measurements of the eyes will be taken to decide the length of eye and curvature of cornea. The measurements are useful to the surgeon for choosing the correct power of the IOL and provide you the best vision after surgery.

These days, several types of IOLs are available, among which you can choose depending upon your particular needs. Apart from IOLs that rectify farsightedness and nearsightedness, toric IOLs that rectify astigmatism also are available today.

If you don’t have a problem in wearing eyeglasses after the surgery, usually a monofocal lens implant is used. Generally, only reading glasses are needed to be used part-time with monofocal IOLs. However, if prescription glasses are required (often in case of cataract surgery in only one eye), your eye surgeon will prescribe you new glasses after about a month of surgery.

If you don’t want to depend much upon glasses after the surgery, there is a way to rectify presbyopia and lessen the need for reading glasses and it involves adjustment of the power of one of your monofocal lenses by your eye surgeon (in case of the cataract surgery performed in both eyes) which gives you a monovision correction, resembling the monovision with contact lenses.

One more option is to choose one of the various advanced IOLs that correct presbyopia to enhance your reading vision without having to giving up distant vision. The presbyopia-rectifying IOLs include multifocal IOLs and accommodating IOLs; both of these types are meant to offer a bigger range of vision than the traditional monofocal IOLs after cataract surgery.

Keep in mind that anyone cannot be a good candidate for these top IOLs and selecting presbyopia-rectifying IOL will increase the cost of your cataract surgery significantly, as this additional cost of sophisticated lens implants doesn’t come under the coverage of insurance plans.


Recovery after Cataract Surgery

A simple cataract surgery usually lasts only for about 15 minutes. But to prepare for the surgery and also for a short post-operative appraisal and instructions for recovery before leaving, you will need to spend 90 minutes or so at the clinic or hospital.

You should bring someone to drive you home after the surgery. You should not try to drive till you give a repeat visit to your eye surgeon after the surgery and s/he confirms that you can drive safely.

Medicated eye drops will be prescribed to you which are to be used many times every day for some weeks after the surgery. Also, you will have to wear the protective shield on eye/s for about a week while sleeping. And throughout the recovery period, you have to wear a specialized pair of sunglasses to protect your eyes from sunlight as well as other bright light.

During the healing period, you may find some redness in the eye and blurred vision during first some days or even weeks.

redness of eye

At least during the first week of your recovery, you should avoid:

Heavy lifting and other strenuous activity
Exercising, bending or similar activities that may strain your eye during the healing period
Water that may come in contact with your eyes causing infection. So, you will have to keep your eye/s covered while bathing or showering. You will also have to avoid swimming for at least two weeks.
Exposing your eye/s to dust, dirt or any substance that can cause infection

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