Cataract Surgeries

Cataract surgery will function to remove your cloudy natural lens, and to then have it substituted with another artificial lens, known as intraocular lens (IOL), that will serve to clear the vision. 

Risks

Surgery is the only way to remove a cataract, and a surgery will be recommended when the cataract becomes disabling to any extent, preventing you from living your life normally. Any surgery can carry certain risks, problems or complications. Some of the risks are as follows:

  • Eye bleeding.
  • Eye infection.
  • Retinal swelling.
  • Having a detached retina.
  • Damage to other parts of your eye.
  • Pain that does not get better with over-the-counter medicine.
  • Experiencing a blurry vision.
  • Seeing dark shadows, halos or glare.
  • Loss of Vision.
  • The IOL implant may become dislocated, moving out of position.

Cataract surgery does not restore vision that has been lost to other eye conditions, such as glaucoma, macular degeneration, or diabetic retinopathy.

For further details on this matter, refer to your ophthalmologist who will discuss the matter with you in detail, enclosing all the potential risks and benefits related specifically to your condition.

Can my vision go back to being cloudy after the surgery?

Even after the surgery is done, your vision can go back to being blurry or cloudy, in a period ranging between a few weeks, to a few years. This condition is known is “posterior capsular opacification”, and it happens after the eye heals from the surgery, as the posterior capsule membrane itself becomes cloudy. When this happens, a laser procedure called YAG laser can prove helpful, and it can help to restore clear vision.

How do I choose between Traditional and Laser-Assisted Cataract Surgery?

Traditional cataract surgeries are very safe, effective and commonly-done surgeries, and whereas laser-assisted cataract surgeries can have benefits in specific cases, they’re not usually covered by insurance plans, as they cost more than traditional surgeries. Choosing between traditional and laser-assisted surgeries can be discussed with your ophthalmologist. Moreover, you may very well want to take the opinion of another eye surgeon.

How Is Traditional Cataract Surgery Done?

In Traditional cataract surgery, also known as Phacoemulsification, your surgeon will look through a special microscope. Then he will create tiny incisions near the edge of your cornea, with the help of a scalpel. The surgeon would then use these incisions to reach the lens in your eye. And with the help of Ultrasound, he will break up the lens with the cataract and remove it. Then he will put your new artificial lens into place.

How Is Laser-Assisted Cataract Surgery Done?

First, the surface of the eye is mapped by using a special camera/ultrasound device that’s used to gather information about your lens. Then, the computer device is programmed with the specific information sent it it, allowing it to specify the exact size,,depth and location for incisions. In some cases, the surgeon may user a laser for making the corneal incision and the capsule opening, and in other cases, the cataract may be softened with energy from the laser itself . Ultrasound is then used to break the lens into small pieces that get suctioned out. After that, the IOL is inserted in the eye. When the surgery is done, there’s no need for any stitches to heal the incision. 

What are the conditions for Laser-assisted Cataract Surgery?
  • Having a case of astigmatism.
  • Desiring to correct the case of astigmatism during the surgery.

In such a situation, the laser would correct the astigmatism by creating specific incisions in the cornea in order to reshape it.

Moreover, laser surgery can be an option if you want to opt for a premium len, such as a toric or a multifocal IOL, to correct astigmatism.. In general, surgeons are better able to see and map the lens capsule through laser cataract removals. Moreover, laser surgery helps them to more precisely place the opening in the capsule. This is very important when using a premium lens, as it allows for better-centering of the IOL.

Which Type of Cataract Surgery Has a Shorter Recovery Time?

There is no difference in recovery time after either type of cataract surgeries. Some people notice their vision clearing almost immediately. Others are still experiencing vision problems after a few weeks or months. Usually, patients would need 3 months to achieve full recovery from the cataract surgery.

What are the benefits of Laser Cataract Surgeries?

Laser surgery allows the surgeon to make very precise incisions more quickly and more accurately, as it provides a higher level of correction than traditional surgery. It can also reduce the amount of ultrasound energy that is needed for softening the lens before surgery.

That being said, as per the latest studies, laser surgery doesn't seem to result in fewer complications, nor does it seem to provide better outcomes. In fact, the outcome of your surgery is heavily dependent on your surgeon's level of skill as well as his experience.

Instructions & Guide to Cataract Surgery

Pre–operative instructions:
  • The patient should be fasting 8 hours prior to the surgery time for general anesthesia and 5 hours prior for Local anesthesia, without consuming any food or drink.
  • Should be in the hospital at least 1 hour before the surgery.
  • For diabetic patients, any medication for controlling blood sugar levels should be stopped (injections and tabs).
  • Patients with diseases other than diabetes (hypertension, heart and thyroid) should continue their prescribed medications on time, using a small quantity of water along with pills (1/4 cup of water). Then they continue their fasting unless the patient has been advised by the doctor to stop the medication.
  • It is advisable that the patient is accompanied by relatives or friends as he will not be able to drive or walk alone after the surgery.
  • The patient should continue fasting for at least 4 hours after the surgery. Patient using warfarin or aspirin should inform the doctor before the surgery.

During Surgery:
  • Your eye will be numbed with eye drops or with an injection around the eye. You may also be given a medicine to help you relax.
  • You will be awake during surgery. You may see light and movement during the procedure, but you will not see what the doctor is doing to your eye.
  • Your surgeon looks through a special microscope. He creates tiny incisions (cuts, created by blade or a laser ) near the edge of your cornea. The surgeon uses these incisions to reach the lens in your eye. Using very small instruments, he or she will break up the lens with the cataract and remove it. Then she puts your new lens into place.
  • Usually your surgeon will not need to stitch the incisions closed. These “self sealing” incisions will close by themselves over time. A shield will be placed over your eye to protect it while you heal from surgery.
  • You will rest in a recovery area for about 15–30 minutes. Then you will be ready to go home.

Post–operative Guidelines:
  • Attending the clinic in morning after the surgery.
  • Keeping the eye open or closed as advised by the surgeon.
  • Redness in the eye is normal and will subside with the time.
  • Avoid rubbing the eye even if it is bothering you.
  • Try to have some rest in the days following the surgery.
  • Avoid any heavy physical activity that may affect your eye (attending the gym, lifting heavy weights, and sexual activities) at least 2 weeks after the surgery.
  • Avoid long bed rest, and try to walk as it’s a helpful activity.
  • If the eye drops finished before the time set by the doctor, you can repeat it.
  • There is no specific diet to follow after the surgery, but healthy foods like fruits, vegetables and milk products are advised.
  • Avoid getting soap or water directly in to the operated eye; and when you are taking a bath, just swab the eye gently.
  • You can take a shower with shower-head tilted backwards (like hair dresser washing hair); as for swimming it should be avoided for 2 weeks.
  • During prayer avoid prostration until the doctor advises you to do so.
  • Avoid smoking and smoking areas.
  • Avoid coughing and constipation by treating it as soon as it starts.
  • Never wipe up the eye with anything unless it’s closed.
  • You can watch television with other eye.
  • Vision after surgery will be different from patient to patient.

FAQs

How is lens power determined before cataract surgery ?

The measurement of the shape of the cornea and length of the eye and few other factors will be tested to help choose the right power of lens.

What is the risk of not removing my cataract?

The risk of not removing the cataract is living with unclear vision that is known to result in fall incidents. In addition, if you choose to wait too long, cataract surgery will become more difficult once cataract becomes very dense.