Cataract surgery is an operation to remove a cloudy lens in your eye and replace it with an artificial one. This will help you see more clearly.
If you have a cataract, the lens inside your eye is cloudy. Cataracts usually develop slowly over many years and your vision will start to be affected as your cataract gets worse. Cataracts can eventually interfere with daily activities, such as reading, watching television and driving.
You can have your cataracts removed at any stage – you don’t necessarily need to wait until your eyesight is bad. If you drive for example, you may wish to have surgery sooner than someone who doesn’t drive. If your ophthalmologist (a doctor who specializes in eye health, including eye surgery) thinks you may need cataract surgery then it is the time to go for it.
If you have cataracts in both eyes, it’s usually best to remove them one at a time, starting with your eye that’s most severely affected. You can have the second operation once you’ve recovered.
Preparation for cataract surgery
Your ophthalmologist will discuss the pros and cons of having cataract surgery with you. They’ll measure your eye and check your vision so they can decide which artificial lens will be best for you. They’ll also ask about your general health and if you have any other problems with your eyes or vision. This will help them assess your risk of complications after surgery.
Cataract surgery is usually done as a day-case procedure, which means you have the operation and go home on the same day.
You’ll usually have cataract surgery under local anesthesia. This means you’ll be awake during the procedure but won’t feel any pain. Your surgeon will use anesthetic eye drops or an injection to completely block pain from your eye and the area around it.
Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you’re fully informed so you feel happy to give your consent for the operation to go ahead. You may be asked to do this by signing a consent form.
What will happen on the day of cataract surgery?
In cataract surgery, your surgeon will remove your cloudy lens and replace it with a new artificial one. If it’s going to be a straightforward procedure, it usually takes about 15 to 30 minutes.
You’ll need to be able to lie reasonably flat and still during the surgery. Your surgeon will put some drops in your eye to widen your pupil and relax your eye muscles. They’ll also put local anesthetic eye drops into your eye or inject your eye with a local anesthetic. Your eye may burn or sting for a few seconds after the anesthetic, but many people don’t feel anything at all.
Once the anesthetic takes effect, your surgeon will make tiny cuts on the surface of your eye. You’ll be awake and see some movement, but you won’t be able to see any details. You won’t feel any pain either but may feel some touch and pressure.
The surgeon will remove a cataract in an operation called phacoemulsification. The doctor will use an instrument that uses ultrasound (sound waves) to break up your cloudy lens. The doctor will remove the broken lens from your eye leaving behind the capsule it sat in. Then he will put the new artificial lens into the empty capsule, where it will stay permanently. The surgeon will leave your eye to heal naturally without stitches.
Aftercare for cataract surgery
You can usually go home within an hour or so, as soon as you have been given some eye drops and advice about what to do after you leave. After you’ve had a local anesthetic, it may take several hours before the feeling comes back into your eye. Ask your family or a friend to take you home as you won’t be able to drive yourself.
If you have a dressing, keep it in place overnight to protect your eye. You may be able to remove the dressing yourself the following day but check with your surgeon. Your hospital may give you a plastic shield, which you’ll need to wear at night for the first week.
Your eye may feel a bit sore at first as the anesthetic wears off and you’ll be offered pain relief. You may be given antibiotic eye drops to use at home to help prevent an infection. It’s important to complete the whole antibiotic course. You may also be given steroid eye drops to help control any swelling in your eye. Follow your surgeon’s advice about how often to use the drops. You usually need to use them for at least two weeks.
Recovery for cataract surgery
Your eye may look red and bruised at first and feel a bit itchy and gritty, but this should disappear after a couple of days. Lights and colours may seem unusually bright too. Your vision should start to get better within a day or two, but your eye may take a few weeks to heal completely.
Looking after your eye
To help your eye recover after your surgery:
try not to touch or rub your eye for a few weeks
keep soap, shampoo and dirty water out of your eyes
don’t do any heavy lifting, bending or strenuous exercise for the first few weeks
don’t wear eye make-up, use hair spray or drive 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 – wear an eye shield or glasses
it’s best to get the all-clear from your surgeon first at your check-up appointment
Once you get home after your surgery, your eye will be a bit sore and watery so it might not feel comfortable to read or watch TV. But you should be fine to do these the next day.
Returning to normal
Most people recover quickly from cataract surgery, but you may feel more tired than usual for a few days. It usually takes about two to six weeks to make a full recovery, but this varies from person to person so follow your surgeon’s advice.
If you need to travel by air, you can do so 24 hours after your operation, but check with your surgeon before you make any plans. Remember to take your eye drops with you when you go away.
If you have a cataract, replacing your cloudy lens with a new one is the only way to restore your vision. But you may not need to have surgery straightaway.