Removal Of Cataract

Normal Side Effects 

For a few days after your cataract surgery you might experience a slight aching or tenderness of the eye. Only about 5 percent of patients are uncomfortable enough to take an over-the-counter pain reliever. Also normal and to be expected are itching, scratchiness, watering or dryness, and sensitivity to light.

As mentioned, you'll notice fluctuations in your vision for a few weeks or even longer, depending on the lens implanted and your own healing process. These changes should not be severe enough to interfere with your day-to-day activities.
 

Removal Of Cataract

Potential Complications During Surgery 

In the clear-corneal phacoemulsification procedure, the incision is minuscule and no needles are used, making complications during surgery relatively rare. Complications such as rupture of the capsule, perforation of the eye, bleeding from the choroid, and damage to a nerve were much more common in past years, when cataract surgery was more invasive.

Retained Cataract Fragments
 
Very rarely, fragments of the cataract fall into the vitreous cavity, the space between the lens and the retina, and may have to be removed surgically to prevent inflammation.
 
Potential Complications After Surgery 

Complications from cataract surgery occur in only a tiny percentage of patients. The risks are almost nil in the hands of an excellent surgeon. When rare complications do occur, however, a few can be serious and might require immediate medical attention.
 
Be sure to ask your doctor what you should do - both during and after office hours - if you have symptoms of potentially serious complications.
 
Infection 

Fewer than one-tenth of 1 percent (0.1%) of cataract-surgery patients get endophthalmitis, a bacterial (or occasionally fungal) infection of the inner eye. Symptoms can include pain, loss of vision, and excessive redness. If not treated immediately, the condition might damage the vision. The usual treatment is injection of antibiotics into the eye. Rarely, vitrectomy - removal of the vitreous - is necessary to control the infection.

Retinal Detachment
 
In about one-half of 1 percent (0.5%) of patients, vitreous fluid seeps through a tear in the retina after cataract surgery, separating the retina from the back of the eye. Extremely nearsighted patients are at greater-than-normal risk for retinal detachment.
 
Symptoms include a shower of new floaters, much like a swarm of bees, in the vision, or extensive flashes of light, akin to fireworks. The most distinctive symptom is complete or partial loss of vision in the affected eye. Patients report feeling as if a curtain is moving across their field of vision.
 
Like infection, retinal detachment is a medical emergency. If you have symptoms of either, you should seek treatment immediately, day or night.
 
Inflammation
 
Slight inflammation within the eye is normal for a day or two after surgery. Very unusual is prolonged inflammation of eye membranes (uveitis) or the macula (cystoid macular edema, caused by accumulation of fluid in the retina). These can usually be managed using anti-inflammatory eye drops. Corneal edema, an inflammation of the cornea, may in extreme cases require a cornea transplant. Report any eye pain, tenderness, or swelling in your ophthalmologist immediately. 

Lens Shifting
 
Rarely, the implanted lens shifts or rotates within the eye. It can be replaced surgically, although wearing thin eyeglasses usually solves the problem.
 

Incorrect Prescription
 
A capable, experienced eye surgeon will carefully formulate the prescription for your lens using measurements of the cornea and the length of the eye. This formulation is more difficult if you are extremely farsighted or nearsighted or if you've had LASIK or another type of refractive surgery - all of which underscores the importance of finding the best ophthalmologist available, ideally one who specializes in cataract surgery. If it turns out that the lens is too strong or too weak, the solution is to perform additional surgery to improve the focusing or rarely to replace it surgically. To find out more, you can check out Removal Of Cataract.
 

Eye Surgery Cataract

Vision Immediately after Surgery 

Don't be surprised if your vision fluctuates for several days as the eye heals and the pupil returns to its normal size. Your eyesight might seem to be getting worse, then better, off and on for a few weeks. As mentioned, you'll notice fluctuations in your vision for a few weeks or even longer if you have had an accommodating lens implanted. This is normal and expected.

Eye Surgery Cataract

Inside the eye there will be swelling and inflammation. These symptoms should subside within a week, but each patient is different. Younger patients, in theft fifties or sixties, and those with milder cataracts, heal more quickly than patients who are older or whose cataracts were extensive. Be assured, however, that the amount of time it takes your eye to heal won't change the ultimate outcome.

You'll see everything more clearly - including any preexisting floaters, those little objects in the vitreous humor that float across your field of vision. So if occasionally you notice something that looks like a gnat hovering at the edge of your field of vision, it's nothing to be concerned about.
 
Results of Cataract Surgery
 
After your eyes have healed and your brain and muscles have adjusted to the implanted lenses, your world will be brighter and clearer. You'll be able to focus better. Objects won't appear distorted-ghosting and double vision, though possibly not eliminated completely, will no longer be a problem. Colors will appear richer and more distinct. Contrast will be sharper.
 
You'll see well enough to work, to move around independently, and to enjoy the activities that you might have put on hold. You'll be less dependent on eyeglasses - you might not need them at all. Ideally, you'll be able to read the newspaper in good light. You probably won't be able to read the tiny print on products such as sweetener packets without a magnifying glass, but that's okay. Cataract surgery isn't a fountain of youth, but it does improve your vision. Being in your sixties, seventies, eighties, or nineties, and having the vision of a forty-year-old, is an amazing thing in itself.
 
As mentioned, your vision will fluctuate for a few weeks or longer, depending on the type of lens implanted. Even so, within twenty-four hours your eyesight will be markedly improved - so much so that you'll probably be eager to schedule surgery for the other eye at your follow-up visit to your doctor. Cataract surgery is a low-risk procedure, and complications are rare. Still, you should be aware of possible side effects and potential problems.

Risks and Side Effects of Cataract Surgery 

The success of surgery is greatly dependent on the skill and experience of your surgeon. It's important that you make a careful, informed choice regarding your surgeon and that you follow his or her instructions for aftercare, including follow-up visits.

No replacement lens, however sophisticated it might be, is as good as a young, healthy, crystal clear natural lens. Though your vision will almost certainly be better than before your surgery, it will not be as sharp as a teenager's. Nighttime halos and glare, double vision, and ghosting might not be eliminated altogether.

Even so, by replacing a clouded natural lens - which is only going to get worse over time - with a clear, durable, state-of-the-art synthetic lens, you will see images more vividly than you have for years (including those occasional dots in your field of vision - tiny fragments known as floaters). You'll enjoy greater independence and a wider range of activities. And all this will be possible with less dependence - maybe even no dependence - on eyeglasses. To find out more, you can check out Eye Surgery Cataract.

 

Cataract Laser Surgery

During the Procedure
 
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.

Cataract Laser Surgery

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. 

After Surgery 

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. 

To find out more, you can check out Cataract Laser Surgery.