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Cataract Surgery

Treatment

During the early-stage of cataracts, vision may improve by updating glasses, better lighting or antiglare lenses. However, when cataracts reach the later-stage, surgery is the only treatment. Cataract surgery involves removing the affected lens and replacing it with an artificial intraocular lens. There is usually no immediate urgency in having cataract surgery done. Cataracts do not reoccur after they have been removed.

 

Pre-Operative Checklist

A clinical examination is required to assess if you need cataract surgery:

  1. Pre-surgical consultation: An assessment of the retina is necessary to dismiss other retina diseases prior to cataract surgery.
  2. Biometry: this test provides the measurement to determine the most suitable artificial lens you will need for the surgery. The exact power of the lens may be difficult to predict. The artificial lenses are made to provide the clearest vision at a fixed distance. Therefore, prescription glasses may often be needed after surgery, especially for reading and occasionally for improved distance vision.
  3. Medical and surgical history.
  4. Medications and supplements you are taking.
  5. Drug and food allergies, such as latex.
  6. Previous problems with anaesthetic.
  7. Consent form and a financial quote.
  8. Fasting from food 6 hours prior to surgery, drink water up until 2 hours prior to surgery is strongly encouraged.

 

Surgery

Cataract surgery is a day surgery procedure and performed under local anaesthesia. The anaesthetist will have a consultation with you prior to surgery. You will require an escort to ensure you arrive home safely. You will need to fast from food for 6 hours prior to surgery, drinking water up until 2 hours prior to surgery is strongly encouraged.

There are a few different techniques used to perform cataract surgery. At Sydney Retina Clinic & Day Surgery, phacoemulsification is the most common technique. It involves making a small incision into the eye then a small probe is inserted and used to soften and break the cloudy lens into smaller pieces to allow for removal by suction. An intraocular lens (IOL) is then inserted into the eye.

 

Post-operative care

Your eye will be covered with an eye pad and shield which needs to stay in place until your first post-operative visit. You will be monitored for 30 minutes after the surgery. The recovery nurse will go through the post-operative care instructions with both yourself and your escort. You will be required to see your treating Ophthalmologist on the following day. Mild discomfort and pain may be experienced after the anaesthetic wears off. This is usually relieved by over-the- counter medications such as paracetamol. Please contact us immediately if you are experiencing increasing pain or bleeding from your eye.

 

Post-operative visits

There are three visits after the surgery:

  1. One day after the surgery. The clinic nurse/orthoptist will remove the dressing, check your visual acuity and intraocular pressure. The nurse/orthoptist will also go through the post-operative eye drop regime and double check the drops for you. It is necessary to wear a protective eye shield to bed for one week. It is also advised that you do not go swimming or get water in the operative eye for two weeks to help reduce the risk of an infection in your eye. It is important to avoid any heavy lifting or strenuous activities for up to one month after surgery. Your treating Ophthalmologist will check your eye.
  2. One week after the surgery, the clinic nurse/orthoptist will check your visual acuity, intraocular pressure and discuss reducing your eye drops. Your treating Ophthalmologist will check your eye and lens.
  3. One month after surgery, both of your eyes will be checked. This will require dilation of both eyes. Your treating Ophthalmologist will advise you to update your glasses after surgery if required. A scan may or may not be necessary at this appointment.
  4. Your treating Ophthalmologist will individualise your care as necessary.

 

What are the risks associated with the surgery?

Like any surgery, there are associated risks. These include:

• Infection.
• Bleeding.
• Inflammation of the eye.
• Macular swelling and decreased vision.
• Increased intraocular pressure.
• Retention of a lens fragment.
• Dislocation of the replacement intraocular lens.
• Swelling and clouding of the cornea.

 

Pre-existing eye conditions

Pre-existing eye conditions may contribute to less than satisfactory vision outcomes such as macular degeneration, or other serious eye conditions. In such cases, even if the cataract surgery is successful, the vision improvement may be minor.