The actual procedure - clear-corneal phacoemulsification and synthetic-lens implantation - can take as little as five minutes. Clear-corneal phacoemulsification is painless. At first, all you'll feel is the surgeon's hand resting against your cheek.
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Patients sometimes ask if they will see the surgery being performed. The answer is no. You might see bright lights or kaleidoscopic colors, as in a light show, but the experience won't be unpleasant.
- After the doctor makes a tiny incision at the edge of the cornea, using a gem-quality diamond instrument, he or she will put more anesthetic into the eye. No needles are used in clear-corneal phacoemulsification.
- As described, the doctor will use a handheld ultrasound device to break up the hard nucleus and suction out the fragments and the lens cortex, leaving the posterior capsule in place to support the new lens. At this stage you might feel a few drops of cool water running down your face. The water is used during surgery to keep the eye cool.
- The new lens, or IOL, is inserted. After inserting the lens, the doctor will administer more eye drops - additional anesthetic, antibiotic, and anti-inflammatory medication - for your comfort and safety.
In the recovery room, a nurse will check your blood pressure again, give you something to eat or drink, and monitor you for a half hour to an hour or so. Then you can go home and take a nap. You'll receive special sunglasses to wear on the way home, since your pupil will be dilated and highly sensitive to bright light.
It will take an hour or so for your eye to recover from the anesthetic drops. During this time, it's normal for the affected eye to see only black and possibly a few shadows. When your vision returns, it will be blurry but will gradually improve over the course of the day.
At home, use the prescribed eye drops as instructed, first washing your hands thoroughly with regular soap. You probably won't have any discomfort at all. Most patients don't even need Tylenol, but it's okay to take an over-the-counter pain pill if you're slightly uncomfortable.
By evening, if you're rested and your vision allows, go out for dinner with friends. They'll be amazed that there's no redness or puffiness in the eye that was operated on and that you can already see well enough to be out and about. You'll go to the doctor's office for a short follow-up visit the day after surgery. Your vision will be fairly good, but, to be on the safe side, have someone drive you to and from the appointment.
Guidelines for Care at Home
Once you've seen the doctor in your next-day follow-up visit, you can go home and relax for another day or two, or go back to your normal routine right away, with a few exceptions:
- For the first few days, don't wear eye makeup. If you use mascara, buy a fresh tube to use when you start wearing eye makeup again. The fresher your cosmetics, the less likely they are to contain harmful bacteria.
- For one week, avoid heavy lifting (more than fifty pounds) and other strenuous activities that might elevate your blood pressure.
- It's okay to resume moderate exercise after a few days, but avoid breath holding (as when lifting weights, since holding your breath can raise your eye pressure) and jarring activities (such as running on concrete) for several days. If you're a workout buff, ask your ophthalmologist what forms of exercise are safe and how soon you can resume your full routine.
- Continue to use the antibiotic and anti-inflammatory eye drops until your doctor says it's okay to stop - usually a few weeks after surgery.
- Stay out of swimming pools, hot tubs, Jacuzzis, steam baths, and saunas for two weeks. Showering and bathing are fine.
- Avoid rubbing your eye for four weeks.
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