Your surgeon will explain how to prepare for your operation. He or she will also discuss your options for the type of artificial lens you will have fitted.
You may have a pre-operative assessment. An ophthalmologist (a doctor who specialises in eye health, including eye surgery) will measure your eye and vision. These tests help to decide which artificial lens will be best for you, so your vision is as good as possible after the surgery.
Cataract surgery is usually done as a day case. This means you have the procedure and go home the same day.
The operation is usually done under local anaesthesia. This completely blocks pain from the area around your eye and you will stay awake during the procedure. You may be given the local anaesthetic as eye drops or an injection.
You can also have cataract surgery done under general anaesthesia, although this is less common. If you have a general anaesthetic, you will be asleep during the operation.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
Removing the cloudy lens and putting a new lens inside your eye is the only way to restore your vision.
Glasses or other visual aids may help you to see better in the short-term. However, they can’t be used to treat a cataract and if your vision becomes poor they may not help.
The operation usually takes around 30 minutes.
You will have eye drops put in to widen your pupil and relax the muscles in your eye. This makes it easier for your surgeon to examine your eye and remove the lens. He or she will also put local anaesthetic eye drops into your eye and place a clean drape over your face. The drape will make a small tent over your face so you can still breathe and speak easily.
Once the anaesthetic has taken effect, your surgeon will make tiny cuts on the surface of your eye. Although your eye is open and you will be awake, you won’t be able to see the instruments being used, however you may see light and some movement. You won’t feel any pain.
Your surgeon will use a special instrument to break up the cloudy lens. You may hear a soft buzzing sound when it’s being used. He or she will remove the broken lens from your eye leaving behind the capsule it sits in. The new artificial lens is then put in, where it will stay permanently.
Your surgeon will usually leave your eye to heal naturally without stitches.
After a local anaesthetic, it may take several hours before the feeling comes back into your treated eye. Your eye is likely to be covered with a protective pad, which you will need to wear overnight.
You may need pain relief to help with any discomfort as the anaesthetic wears off. You may be given antibiotic eye drops to use at home to help prevent an infection. You may also be given steroid eye drops to help control inflammation in your eye.
You will usually be able to go home when you feel ready. However, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.
If you have been prescribed antibiotic eye drops, it’s important to complete the whole course.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
You should start to get feeling back in your eye after a few hours. Your vision should start to improve within a few days, however it may take a few weeks to heal completely.
There are some important instructions to follow for the first 10 days after cataract surgery. The main ones are listed below.
- Don’t touch or rub your eye. If you’re a restless sleeper you can wear an eye patch at night to protect your eye.
- Keep soap and shampoo out of your eyes.
- Don’t do any heavy lifting or strenuous exercise for the first few weeks after the operation, as this can increase the pressure in your eye and could put strain on your healing scar.
- Don’t wear eye make-up, drive or go swimming until your surgeon tells you it’s safe to do so.
- If you go out when it’s windy, protect your eye from grit and dust.
See your GP if you have any symptoms, including:
- severe pain
- loss of vision
- redness in your eye that continues to get worse
It usually takes about two to six weeks to make a full recovery from cataract surgery, but this varies between individuals, so it’s important to follow your surgeon’s advice.
Once your eye has healed, you may need to have an eye test and new prescription glasses.
As with every procedure, there are some risks associated with cataract surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of cataract surgery include:
- an itchy or sticky eye and blurred vision
- mild pain, discomfort and bruising of your eyelid or eye
- sensitivity to bright light
- reduced central vision that usually returns to normal after treatment
Complications are when problems occur during or after the operation.
The most common complication of cataract surgery is called posterior capsule opacification (PCO). This is when cells from the removed lens are left behind after surgery and begin to grow back. This causes problems with your vision similar to having a cataract. You can have laser treatment to correct the problem.
Other complications of cataract surgery are rare but can include:
- an eye infection
- a tear in your lens capsule
- problems with the new lens, such as the wrong type of lens used or problems with its position in your eye
- a detached retina
If any of these complications occur, you may need to have another operation.
Will I be able to see or feel anything happening during cataract surgery?
Local anaesthesia, and eye drops you’re given to relax your eye, mean that you will see and feel very little during the operation.
Your surgeon will use eye drops to widen your pupils and relax the muscles in your eye and these cause your vision to blur. This means you probably won’t be able to see clearly through your affected eye. You may vaguely see movement, but won’t be able to make out any of the detail. Your eye that isn’t being operated on will be covered.
Local anaesthesia completely blocks the pain from your eye area. You may feel a light pressure from the instruments used in the operation and the surgeon’s hands.
Usually, your surgeon will explain what is happening during the operation, and often, a nurse will sit with you to make sure you’re comfortable and relaxed.
After cataract surgery, how long will my artificial lens last?
The artificial lens used to treat a cataract is designed to last for many years and shouldn’t need to be replaced.
The artificial lens will be made of silicone or plastic (acrylic polymers). These materials should last for many years.
An artificial lens very rarely needs replacing. The most common complication of cataract surgery (posterior capsular opacification) is treated with laser surgery so the lens won’t need to be replaced.
What is the difference between the types of lenses used for cataract surgery?
The main difference between the types of artificial lens used in cataract surgery is their ability to focus on objects. Some lenses can help you to see things in the distance, as well as close up.
The artificial lenses used in cataract surgery come in different strengths, in the same way that the lenses in glasses do. The three types of artificial lens used in cataract surgery are explained below.
- Monofocal lens. This is the most commonly used lens in cataract surgery. These lenses are set at one level of vision, usually distance vision. This means you will probably need to use reading glasses as well for focusing on things that are close up.
- Multifocal lens. This type of lens allows you to see both near and distant objects.
- Accommodating lens. This changes shape within your eye, in a similar way to the natural lens in your eye, allowing you to focus on both near and distant objects.
Multifocal and accommodating lenses are usually only available if you’re being treated privately, rather than through the NHS. If you have one of these lenses, you’re less likely to need to wear glasses. However, multifocal lenses may be more likely to cause you problems with your vision, such as seeing rings around lights (halos) and problems seeing in bright light (glare).
Talk to your surgeon about the type of lens that is most suitable for you.
What if I'm unable to use the eye drops after cataract surgery?
Nursing staff at the hospital will show you how to use your eye drops. If you have trouble putting them in yourself, your hospital or your GP, should be able to arrange for a district nurse to help you at home.
The nursing staff will show you how to use your eye drops before you leave the hospital. You may also be shown how to put eye drops in at your pre-operative assessment, and may be given some non-medicated ones to practise using at home.
However, you may find that you need help with putting eye drops in. If a friend or relative is unable to help, your hospital may arrange for a district nurse to visit you at home. This will be arranged before you leave the hospital.
- Cataracts. RNIB. www.rnib.org.uk, published October 2012
- Cataracts. Prodigy. www.prodigy.clarity.co.uk, published September 2010
- Cataracts patient decision aid. Right Care. www.sdm.rightcare.nhs.uk, published 2012
- Cataracts. The Eyecare Trust. www.eyecaretrust.org.uk, accessed 14 November 2012
- Cataract surgery guidelines. Royal College of Ophthalmologists. www.rcophth.ac.uk, published September 2010
- Implantation of accommodating intraocular lenses during cataract surgery: guidance. National Institute for Health and Clinical Excellence (NICE), 2007. www.nice.org.uk
- Implantation of multifocal (non-accommodative) intraocular lenses during cataract surgery: guidance. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
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