A
step by step guide to cataract removal
What
does the surgery involve?
On
the day of surgery and once in the hospital you will
be given eye drops to dilate the pupil. The area around your
eye will be washed and cleansed. The operation usually lasts
about 15 minutes and is painless as it is usually performed under
a local or topical anaesthetic.
The
technology used is a machine called a phacoemulsifier (phaco).
Contrary to popular belief, a laser machine is not used.
The surgeon makes a micro-incision on the side of the cornea,
no more than 3.5mm and inserts a tiny probe into the eye.
This ‘phaco’ device emits ultrasound waves
that soften and break up the cloudy lens. It is then removed
by suction. Once removed the original lens is replaced
by a lens implant which is folded, and inserted through
the tiny incision. It then unfolds once in place in the
eye. As there are no stitches, this means you can return
home the same day and look forward to a rapid and pain-free
recovery.
How
long will the surgery take?
The
operation itself will take up to 15 minutes depending on the
complexity of the case. However you will need to allow to be
in the hospital for about 3-4 hours. You will need someone to
collect you or we can arrange transport for you.
What
happens after the operation?
After the operation you will rest for a while and have refreshments.
Once the surgeon has seen you, you can go home. You will be
given a dressing pack to swab the eye clean the following day,
and some antibiotic and anti-inflammatory eye drops to apply
at home after the surgery.
How
quickly will my vision be restored?
Your vision will be slightly blurred for a few days while your
eye heals. It is usual to feel some discomfort until your eye
settles but there should be no pain. Any discomfort can be
relieved by taking paracetamol. After a couple of days you
will start to notice a significant improvement in your vision.
You will see the surgeon again after 2 weeks and will visit
your optometrist for new glasses after 4 weeks.
You
can quickly return to many everyday activities, although heavy
lifting or other strenuous activities should be avoided for a
week. The healing eye needs time to adjust so that it can focus
properly with the other eye, especially if the other eye has a
cataract. Ask your surgeon or optometrist when you can resume
driving.
What
will my vision be like after my eye has healed?
Once
you have been given your new glasses, you may notice that everything
seems a lot brighter than you remember. Colours may be sharper
and may have a blue-ish tinge. Or, in bright sunlight you may
feel you are looking through rose-coloured glasses. These colour
tinges are normal and are because you are now looking at the
world through a clear lens that is no longer cloudy. Within
a few months your brain will get used to your new clear vision
and these colours should go away.
These
paintings were given to us by two cataract patients,
who are artists. The paintings represent what the patients
remember seeing during the surgery. The vivid colourful lights
are very typical of patient’s visual experience. Both
patients
are delighted with the results of their surgery.
Can
I have both eyes done at once?
If
you have cataracts in both eyes, the surgeon will not remove
them both at the same time. You will need to have each done
separately, although they can both generally be done within
about 2 – 4 weeks.
What
are the risks of cataract surgery?
Your Consultant has performed many thousands of cataract operations.
Grange Eye Consultants ensure that the technology and products
used for the surgery are of the highest standards available.
The surgery can be carried out at the hospital of your choice
(please see our Locations
section). These hospitals are all modern, comfortable private
hospitals and provide excellent patient care.
Although
the vast majority of patients achieve excellent results without
complications, it should not be forgotten that cataract removal
is a surgical procedure. As with all forms of eye surgery, cataract
removal has risks and whilst we make every effort to minimise
them they cannot be totally eliminated.
| The
most common risks associated with the cataract operation
are: |
| i. |
Retinal
Detachment – occurs when the retina detaches
from its normal position and can result in severe loss
of vision if surgical correction is not successful.
The approximate risk of a retinal detachment in the
general population is 0.01 % per year. Someone who
is hyperopic has a smaller risk than this, whereas
a myopic patient has a slightly higher risk than this. |
| ii. |
Infection
- every time there is an incision made in an eye for any
reason it is possible to get an infection inside the eye
which has the potential to cause severe visual loss. This
problem is extremely rare and our rate of endophthalmitis
is less than 0.03%. After the cataract operation, to help
protect against infection eye-drops are prescribed which
must be used as directed |
| iii. |
Macular
Oedema – is an accumulation of fluid at the central
retina which can cause temporary or permanent reduction
in vision after surgery. The postoperative eye-drops
also help to reduce this risk. |
iv. |
Floaters – are often
noticeable immediately after surgery but usually become
less noticeable with time. |
v. |
Posterior
Capsule Opacification (PCO) – is thickening of
the residual lens membrane which supports the lens implant.
Approximately 25% of patients will, at some stage, notice
a reduction in their vision due to PCO. It may occur
months or even years after surgery and is easily and
quickly dealt with by outpatient laser treatment. |
| vi. |
Other
possible complications include tearing of the lens
capsule (<1%) which could mean that it is more difficult
to implant an intraocular lens. There are other extremely
rare complications which your surgeon will discuss
with you prior to surgery. |
How
long does the implant last?
The lens implants we use are left in place for life.
Can
a cataract come back?
Once
you have a lens implant (intra-ocular lens or IOL as it is
called) you cannot develop another cataract in that eye. However,
it is quite common for the membrane that holds the lens in
place to develop some cell regrowth in the first 18 months
after surgery. Should this occur, it is easily and painlessly
removed in seconds using a small laser beam in the surgeons
consulting rooms. This technique is called a YAG laser capsulotomy
and is a simple outpatient procedure.
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