Procedure to remove a cataract, which is a clouding of the lens of the eye

PARTS OF THE BODY INVOLVED

Eye (cornea, lens, membrane lining the eyelid)

REASONS FOR PROCEDURE

The lens of the eye, which is responsible for focusing images onto the retina, is normally transparent. If blood flow to the surrounding area is impaired, the lens begins to cloud and causes a progressive, painless loss of vision.
Cataract removal is most often performed for the following reasons:

  1. To restore normal or near-normal vision
  2. To better follow the course of diabetic retinopathy or glaucoma

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

  1. Obesity
  2. Smoking
  3. Diabetes
  4. Recent or chronic illness
  5. Heavy bleeding
  6. Infection

WHAT TO EXPECT

>Prior to Procedure
Your doctor will likely do the following:
Eye exam
Ultrasound (a test that uses sound waves to examine the eye) to measure the eye for replacement lens
Administer eyedrops
During Procedure – Anesthesia, sedative, ultrasound probe (phacoemulsification technique only)
Anesthesia - Local by injection
Description of the Procedure - There are two common cataract removal methods. In both procedures, a small incision is made in the cornea of the eye.
Phacoemulsification technique: An ultrasound probe breaks the cloudy lens into tiny fragments and vacuums them out through a tiny incision. A plastic lens implant is inserted to replace the natural lens that was removed. Because the incision is tiny, stitches are often not necessary and vision returns quickly.
Extracapsular technique: The cataract is removed as one entire piece. This requires a larger incision and stitches. A plastic lens implant is inserted to replace the natural lens that was removed. Vision recovery is slower, due to the larger incision. The stitches rarely need to be removed.
After both procedures, the surgeon places a bandage or patch over the eye.
After Procedure - Eye examination, eye drops
How Long Will It Take? Less than 1 hour
Will It Hurt? Most patients report no pain during the procedure, although you may feel pulling or pressure sensations.

POSSIBLE COMPLICATIONS:

  1. Post-operative inflammation or infection
  2. Rosy vision" (sensation of glaring light interfering with vision)
  3. Retinal detachment
  4. Dislocation of intraocular lens implant
  5. Thickening of lens capsule
  6. Blindness in operated eye (extremely rare)
  7. Secondary "after" cataracts
  8. Glaucoma
  9. Macular degeneration
  10. Average Hospital Stay - None

POSTOPERATIVE CARE:

  1. Sleep on your back with your head elevated on two pillows.
  2. During the first 24 hours, you may use cold compresses to soothe your eye; use warm compresses after this point. Use very clean washcloths for the compresses and leave them in place over your eye for 15-20 minutes at a time.
  3.  When changing the bandage or patch, clean your eye with a warm washcloth. Do not press or rub the eye.
  4. You'll probably be given antibiotic and/or anti-inflammatory eyedrops to use for several weeks after your surgery. Use these eyedrops as prescribed and store them as advised by your pharmacist or doctor.
  5. Resume driving as advised by your doctor.
  6. Take only non-aspirin containing medications for minor pain.
  7. Wear the metal shield and eye patch for at least the first 24 hours after your operation; after that point, you may be allowed to remove them during the day. However, continue to wear them when sleeping, so that you don't accidentally bump your eye in your sleep.
  8. Wear dark glasses when you go outside if light bothers your eyes.
  9. To avoid increasing the pressure in your eyes, avoid heavy lifting, bending, and strenuous exercise, unless told otherwise by your doctor.

OUTCOME

You should notice improvements in your vision. Since each implant is individually fitted for each patient and has the potential to correct both nearsightedness and farsightedness, you will likely need weaker vision correction, or possibly none at all, after this procedure.
You should be up and about within 3-5 days. Expect complete healing in about 10 weeks. Make it a habit to wear ultraviolet-protecting dark glasses when you are outside to prevent further cataract formation.

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  1. Signs of infection, including fever and chills
  2. Sudden change in vision
  3. Sharp pain or blood in the eye
  4. Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site

SOURCES:

American Academy of Ophthalmology
Agency for Health Care Policy and Research

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