What Happens During Cataract Surgery? Know What To Expect

The thought of cataract surgery can be frightening, even if you know that it’ll fix your cataract-related vision problems. As cataracts are a natural occurrence associated with ageing, cataract surgery is an extremely common procedure. Despite this, exactly what happens during cataract surgery may still be a bit of a mystery. If understanding what happens during cataract surgery might help allay your fears, keep reading.

Is Cataract Surgery Necessary?

In the early years of a cataract, it can be quite reasonable to defer cataract surgery. You may be experiencing mild cataract symptoms such as:

• A hazy or cloudy sensation to your sight
• Difficulty doing near work in low lighting, such as reading, writing, or sewing
• Increased sensitivity to glare, such as when driving at night
• Seeing colours as dull or altered
• A change in your spectacle or contact lens prescription

The vision problems you experience as a result of your cataract may be easily addressed by improving the lighting when trying to see fine detail at close distances, or by updating your glasses or contact lenses. If you’re still able to achieve the legal requirements for holding a driver’s licence, you may be able to postpone cataract surgery for quite a number of years. However, eventually, you will find that these temporary workaround solutions are no longer adequate for relieving your vision problems. At this point, you may want to discuss the option of cataract surgery with your optometrist or ophthalmologist. 

What Happens During Cataract Surgery?

Prior to being booked in for cataract surgery, your ophthalmologist will conduct a comprehensive eye exam. This is to measure your visual acuity, assess the cataract, and examine the eye for any other conditions that may limit the success of the surgery or increase your risk of complications. For example, if you have vision problems that are caused by retinal disease, your ophthalmologist will counsel you to manage your expectations from the surgery. During this appointment, you will also have a discussion about your choice of intraocular lens. An intraocular lens is an artificial lens that is implanted into the eye once the cataract has been removed. The power of this lens can be calculated to correct your eye’s prescription, leaving you with excellent sight at long distances without needing glasses. Alternatively, you may decide you prefer to be short-sighted after your cataract surgery, which gives you excellent reading vision; to see clearly from far away, you will then need glasses. You may also consider a premium intraocular lens, such as a multifocal or an extended depth of focus implant. These types of implants will provide you with both long and near or intermediate vision. 

On the day of your cataract operation, you will be advised to have someone drive you to the clinic (and home after). This is because your eye will be dilated. Widening the pupil allows your surgeon to gain clear access to the cataract sitting behind it. Typically, the dilation is achieved through pharmaceutical eyedrops, but occasionally a further intervention may be needed if the eyedrops aren’t enough to widen the pupil. 

Your eye will be numbed through a local anaesthetic injection, topical anaesthetic eyedrops, or a combination of both. Cataract surgery is not performed under general anaesthesia except in exceptional circumstances. However, if you’re feeling anxious, you can be offered a mild sedative. The eye area will be disinfected, and you’ll have a sterile drape placed over your face.

Once you’re comfortable, the surgeon will ask you to fixate on a target overhead. An incision is then made in the cornea, the transparent tissue at the front surface of the eye. Through this incision, other instruments can be inserted to reach the cataract. The membrane that holds the cataract, known as the capsular bag, is gently torn open. The cataract can then be broken into smaller pieces that may then be suctioned out of the eye. While these steps have traditionally been performed with manual instruments, some surgeons may use a femtosecond laser instead. This is known as femtosecond laser assisted cataract surgery, or FLACS. Once the cataract has been extracted, the intraocular lens is usually inserted straight into the capsular bag. The incision in the cornea is designed to self-seal, so doesn’t typically need stitches. 

What Happens During the Cataract Surgery Post-Op Period?

After your cataract operation, you will be sent home with a protective eye shield. Your surgeon will also give you instructions on how to optimise your healing. Be sure to follow these instructions as they’re designed to give your eye the best chance of recovering and avoiding any complications.

Don’t expect your vision to be clear immediately. However, within a couple of days, many people notice their sight is already better than prior to having cataract surgery. Over the following 4 to 6 weeks, you can expect your sight will continue to change slightly, as the corneal incision heals and the intraocular lens settles into the capsular bag. 

Your eye may be red, puffy, and sore for a few days after your surgery. For some, the gritty, dry sensation can last for a few weeks. At no point should your eye become increasingly red or sore, or start producing discharge. If you notice any of these symptoms, or if your vision deteriorates, seek medical attention immediately. 

You’ll have at least two or three post-op examinations with your surgeon. This is to check your vision and ensure the eye is healing appropriately. At one of these appointments, your surgeon will advise when you can return to driving and work, and when it’s appropriate to return to your optometrist to update your glasses.

Contact us today on (03) 9070 3580.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Cataract surgery: everything you need to know.
https://www.allaboutvision.com/en-au/conditions/cataract-surgery/

15 things you need to know about cataract surgery.
https://visioneyeinstitute.com.au/eyematters/15-things-need-know-cataract-surgery/

Cataract surgery.
https://www.healthdirect.gov.au/cataract-surgery