Cataract surgery: what to expect during the surgery (2023)

Cataract surgery, also known as lens replacement surgery, is a routine treatment for cataracts, or the clouding of the lens of the eye. In the procedure, a surgeon makes a small incision in the eye's cornea, removes the defective lens, and replaces it with a prosthesis called an intraocular lens (IOL). A relatively quick and painless outpatient surgery - the surgery itself usually takes between 15 minutes and an hour - patients can usually go home the same day.This treatment is very well tolerated and very successful in correcting this problem; However, success also depends on the pre- and post-treatment of the patient. When undergoing this procedure, it is important to listen carefully to the healthcare provider; The more you know, the better off you will be on the day of your cataract surgery.

Before the operation

On the day of cataract surgery you should allow between three and six hours total and make sure you have transportation arranged as you will not be able to drive afterwards. If you have cataracts in both eyes, you will need two separate treatments. The necessary tests and diagnostics have already been done, so the main task before surgery is to make sure you are ready. Cataract surgery is performed while the patient is awake, and the preparation involves several steps:

• Initial examination:Usually, the first step is for a nurse or other professional to sit with you and confirm your medical information and make a quick health assessment. Be sure to let them know if there are any changes or new developments.
• Eye drop:Before the procedure, you will be given eye drops to dilate the eye. You may also need to take prescribed eye drops in advance of the procedure to prevent inflammation and infection of the area.
• Anti-anxiety medication:Talk to your doctor if you're feeling particularly concerned about the procedure; They can prescribe special medications to help you relax.
• Local anesthetic:Since the procedure is not performed on the "sleeping" patient (general anesthesia), a local anesthetic must be administered to numb the area. This is also done with eye drops or, in some cases, with an injection. After administration, you will be asked to relax in the operating room for about 30 minutes to allow the medication to take effect. In some cases, an IV line can be placed in your hand.

It is important that you should sit still during the procedure, but the doctor will advise you on how to raise any concerns.

during the operation

You will be awake and lying on your back (face up) on an operating table. The procedure itself takes between 15 and 45 minutes. During the operation, your face and shoulders will be covered with towels to ensure the area is clean and hygienic, and the doctor will use a special microscope to get a closer look at the area.The main idea here is to safely remove the clouded lens and replace it with an IOL; This is performed by a specialized healthcare provider called an ophthalmologist, as well as support staff. In some cases, an anesthesiologist is also present.

Depending on the extent of the cataract, two main types of cataract surgery are indicated. These are listed below:

• Cataract surgery with small incisions:Once the eye is anesthetized, the ophthalmologist makes a tiny incision on the cornea and inserts a special, small probe. This device emits ultrasonic waves that break open the damaged lens so the pieces can be removed, a process known asPhakoemulsification. After these are removed, the healthcare provider implants the IOL; This permanent implant is well tolerated and can correct other vision problems such as:Astigmatism(an irregular shape of the lens that causes blurred vision). The incision does not need to be sewn up. This approach is most popular in the US.
• Extracapsular:In cases where the cataract is so advanced that phacoemulsification is likely to be ineffective, this approach involves a slightly larger incision. This allows the surgeon to physically remove the lens using special tools. Because the incisions for this type of surgery are larger, sutures are usually required after the IOL is placed.

Cataract surgery is painless apart from the injection of drugs or anesthetics. In rare cases, usually when the patient is a young child or is neuroatypical, general anesthesia may be used, putting the patient to sleep.Be sure to talk to your doctor about your options.

After the operation

Immediately after cataract surgery, the ophthalmologist will perform a quick assessment and exam, and the affected eye will usually be covered with eye protection. You'll be taken to a recovery room and allowed to rest while the sedative drugs and anesthetic wear off. Here are some other tips to keep in mind:

• No driving:You should not drive a motor vehicle until your eye has healed. Your doctor will tell you when it is safe to do so.
• Don't touch your eye:Avoid touching or rubbing your eye as much as possible in the weeks following surgery.
• Resumption of activity:You may need to take a break from physical activity for at least a few days after cataract surgery. Again, your healthcare provider will provide you with a timetable for when to resume such activities.

In most cases, you will be given special eye drops and pain-relieving medication to help you recover. All in all, it takes about eight weeks to fully recover from cataract surgery. During this time, be sure to contact your doctor if you experience any of the following:

• Strong pain:While some discomfort is to be expected after this procedure, if you are experiencing pain in and around your eye despite the medication you are taking, be sure to consult your doctor.
• Problemsymptome:If you experience redness, swelling or blurred vision in the post-op period, something may have gone wrong. Therefore, be sure to inform your doctor.
• Deterioration of visual acuity:If your vision keeps getting worse after the operation - especially if you experienced an initial improvement - this can also be a sign that the operation did not go completely well.

There are no dietary restrictions after this surgery. Most people are usually advised to wait before resuming physical activity. Wait for your doctor's approval before returning to exercise or any strenuous physical activity.

As the staff will tell you, you will need to schedule a follow-up appointment afterwards to ensure your eye is healing appropriately. During this time, it is absolutely essential that you follow the healthcare provider's instructions and be in solid communication with the medical staff. Depending on the case, this can take place as early as one day after the operation, but this appointment usually takes place a week after the operation.

In particular, on rare occasions, the IOL can become cloudy, a condition called secondary cataracts. In these cases, an additional procedure is performed with a laser, called a yag capsulotomy.Since the problem here is basically that the prosthetic lens has thickened, this treatment uses a laser light to create a small opening to remove the clouded capsule.

A word from Verywell

When it comes to cataract surgery, it's important to remember that this is a very common procedure and is usually well tolerated. The vast majority of patients are satisfied with the procedure. Complications can arise, so risks and benefits of surgery should be discussed with your doctor to make an informed decision. If you are undergoing this procedure, you should also communicate with the hospital staff and your loved ones. With your support you will help to achieve the best possible result.