Cataract Removal

Complete eye examAn A-scan, which is a test using either ultrasound or a special laser, to determine the strength of the replacement lensAdminister eyedrops During ProcedureAnesthesia, sedative, ultrasound probe (phacoemulsification technique only) AnesthesiaUsually local sedation by injection Description of the ProcedureThere are two main types of cataract removal. The large majority of cataract surgeries are performed using the phacoemulsification technique. Phacoemulsification Technique:An ultrasound probe breaks the cloudy lens into tiny fragments. The fragments are vacuumed out through a tiny incision. An intraocular lens implant is inserted to replace the natural lens that was removed. Because the incision is tiny, stitches are often not necessary and visual improvement is usually noted relatively soon after surgery. Extracapsular Technique:The cataract is removed as one entire piece. This requires a larger incision and stitches. An intraocular lens implant is inserted to replace the natural lens that was removed. Recovery is usually slower, due to the larger incision. The stitches sometimes need to be removed, which is usually done in the office.After both procedures, the surgeon usually places a patch over the eye. After ProcedureYou will need to have an eye examination. You will be given eye drops.

How Long Will It Take?The process takes less than 1 hour. Will It Hurt?Most patients report no significant pain during the procedure. You may feel pulling or pressure sensations. Possible Complications Cataract surgery usually has few complications. However, no surgery is without risk. Complications can include, but are not limited to: Postoperative inflammation or infectionRetinal detachmentDislocation of intraocular lens implantClouding of lens capsuleBlindness (rare)Increased eye pressureMacular diseaseDecreased visionDouble visionDroopy eyelidNeed for more surgery or laser Average Hospital StayThe process is done on an outpatient basis. You will be home the same day. Postoperative Care After surgery, your doctor will give you specific instructions on how to care for yourself. This may include such steps as: RestAvoid any strenuous activity, including lifting and bending, until cleared by your doctor.You will wear a patch on your eye after your surgery. Do not remove the patch until instructed by your doctor.You'll probably be given an antibiotic and anti-inflammatory eyedrops to use for several weeks after your surgery. Use these eyedrops as prescribed and store them as advised by your pharmacist or doctor. Most anti-inflammatory drops need to be shaken very well prior to each time you put them in your eyes.Do not drive or operate machinery until advised by your doctor.Take only non-aspirin containing medications for minor pain, unless advised otherwise by your physician.Your doctor may ask you to wear an eye shield at night.Wear dark glasses when you go outside. OutcomeYou should notice improvements in your vision, although at first your vision may actually be worse than prior to the surgery. Every patient and every eye heals differently. One eye may heal quicker or slower than the other. Since each lens is individually fitted for each patient, you will likely need weaker glasses or contacts, or possibly none at all, after this procedure.

Although your doctor may allow you to resume your usual activities within several days, your eye will continue to heal for several weeks. It is best to avoid heavy lifting and bending. Make it a habit to wear ultraviolet-protecting sunglasses when you are outside. Call Your Doctor If Any of the Following OccursSigns of infectionChange in visionVisual symptoms, such as floaters, flashing lights, or reduced visual fieldPain or blood in the eyeRedness, swelling, increasing pain, excessive bleeding, or dischargeAny other symptoms RESOURCES: American Academy of Ophthalmologyhttp://www.aao.org American Society of Cataract and Refractive Surgery (ASCRS)http://www.eyesurgeryeducation.com CANADIAN RESOURCES: Eyesite.cahttp://www.eyesite.ca Health Canadahttp://www.hc-sc.gc.ca/index_e.html References: Agency for Health Care Research and Policy website. Available at: http://www.ahrq.gov/ . American Academy of Ophthalmology website. Available at: http://www.aao.org . Last reviewed March 2008 by Alexander J. Anetakis, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.