Cataract Surgery

What is a cataract ?

Within your eye is a lens which focuses the light onto the film of the eye, the retina. This allows one to see clearly.  

As we all get older this lens becomes cloudy and this is called a cataract. A cataract blocks and disperses some of the light entering the eye making the vision blurred and foggy.

During cataract surgery we remove most of your lens using a special technique using ultrasound energy (phaco-emulsification) and then insert a new lens in the bag (capsule) of your old lens. This new lens is clearer than your old cataract lens and therefore allows light to pass to the back of the eye and results in clearer vision. Patients usually appreciate  a brighter, clearer image with colours being more distinct following the surgery.

Why is cataract surgery needed?

Cataract surgery is usually needed when the symptoms of blurring and fogging become bad enough to cause problems. In many patients a cataract is present but as they have no symptoms we do not operate on it. If you notice blurring of vision you should have your eyes tested by an optometrist (optician) who will be able to tell whether you have a cataract or not. The optometrist will then discuss the degree to which the cataract is affecting your vision and if you agree, refer you for surgery.

The time to do the surgery is when your symptoms are such that you are happy to take the risks of the surgery (see below). A cataract usually develops in both eyes at approximately the same time although one eye is usually worse than another. We always do one eye at a time as this is safer. 

What happens on the day of cataract surgery ?

As the surgery is usually done with you awake you can eat and drink as normal before the surgery. You must take all your medications as you usually would on the day of surgery. It is probably better if one does not wear make up on the day of surgery.

Please bring any inhalers, angina sprays and all your tablets with you in case they are required. If you are on anti-coagulation please bring your anti-coagulation book and have an up to date result (usually within a week of surgery). 

Eye drops will be put in your eyes to enlarge your pupil. You will be taken in theatre and asked to lie down flat. As your operation is done under local anaesthetic you will be awake throughout the procedure. The local anaesthetic will numb the eye so you should not feel any pain during the surgery. 

The surgery is done as a day case so you will be free to go home later that day. You will need someone to take you home as you will be unable to drive. 

Post operative Instructions for cataract surgery

After the surgery you will be given instruction on how to put in your eye drops, These are usually for a month after your operation. You will be provided with a shield to wear at night for a couple of weeks so that you do not rub your eye while you are asleep. 

If you wish to watch TV or read you can. You do not strain the other eye. You will usually be seen following the surgery for a check up. 

The vision in most patients improves within a day or so, but for some people it may take longer. Your vision should be improving within a few days. You will probably not be able to see very clearly for reading until you obtain new glasses at about one month after the operation

Cleaning

Do not clean the eye itself with tissues or towels etc. You may remove any debris from the eyelid with a clean tissue.Hair washing is allowed after a couple of days but try to avoid soap in eye and therefore bathing may be more sensible than showering for the first week. If your eye becomes sticky, bathe with cooled, boiled water using a tissue or cotton wool. Eye make-up should be avoided for two weeks.

Glasses

You will need new glasses after the surgery, We usually suggest you go for an eye test after approximately five weeks following the surgery. Until them you may use your old glasses, or no glasses if you can see better without them.

Activities

Within a day or so you can start your normal activities. Most people normally take a week off work but please discuss this with your surgeon. Gentle activity is encouraged (light housework, walking) but avoid heavy or vigorous exercise such as heavy gardening, tennis, moving furniture etc. for the first two or three weeks. You may drive after four to five days if your vision is adequate and you feel comfortable to do so. Swimming and contact sport should be avoided for 4 weeks. 

What are the risks and complications of cataract surgery?

Although cataract surgery is usually safe there is a small risk of complications, either during or after the operation. Complications are usually treatable, possibly requiring further surgery. In a few cases serious problems such as infection, bleeding or retinal detachment occur which may result in irreversible visual loss. For this reason if your cataract is causing you no problems it is usually advisable to delay having any surgery. 

It is not unusual for your eye to feel a little uncomfortable for a few days after the surgery. A mild painkiller that you would usually take, such as paracetamol is adequate in most cases.

Please contact the hospital urgently if you have

• moderate pain
• sticky or the become more red eye
• vision becomes blurred

If you are unable to contact the Peterborough hospital or are far away please go immediately to the local accident and emergency department.