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Cataract Surgery |
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Cataract Surgery |
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A cataract is a painless clouding of the lens of the eye. Cataracts generally
develop over a long period of time, gradually worsening the eyesight. They can
eventually lead to blindness. Cataract surgery removes the cataract and can
greatly improve vision.
Why have cataract
surgeries?
Cataracts cloud the lens in the eye and may reduce your
vision. For some people, this loss in vision is mild enough to get along fine
with glasses or contact lenses. The time to consider treatment is when your
vision has become noticeably worse and this is interfering with your everyday
activities such as work and hobbies.
Surgical removal of your cataract is the
only way to restore or maintain your vision.
The most common cataract
operation is known as phacoemulsification. In this operation, the lens is broken
down into tiny pieces which are removed through a small incision in the eye. The
lens is replaced with an artificial one.
What are the
alternatives?
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So far, no medication or diet has been found to slow down the growth of
cataracts, and there is no medication that can clear a clouded lens.
Wearing
glasses may improve vision for people with the early stages of cataract
development, but your cataract will probably get worse over time so this will
provide only a temporary solution.
Left untreated, the lens will eventually
become so clouded that it is impossible to see any detail at all, although some
light will always be distinguishable. |
| What happens before cataract
surgery? |
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Your surgeon will discuss how to prepare for your operation. He or she will
also discuss your options for the type of artificial lens replacement you will
have fitted.
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| What should I expect in
hospital? |
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Cataracts typically occur in both eyes, but they are usually treated one at a
time, to allow the first eye to recover. There is usually an interval of several
weeks or months between each operation.
Your exact length of stay in hospital will depend on the type of surgery you
are having.
Phacoemulsification is most often performed as a day-case,
without the need for an overnight stay in hospital.
Before surgery you will talk to your surgeon about the operation and you will
be asked to sign a consent form. This confirms that you understand the risks,
benefits and possible alternatives to the procedure and have given your
permission for it to go ahead. This is a good time to ask any unanswered
questions about the operation.
Your surgeon will examine your eye. Drops will
be placed in your eye to dilate (widen) your pupil. This makes it easier for
your surgeon to see the lens inside your eye. It will not be possible to see out
of your eye as it is being treated, but you may be aware of light and
movement. |
| The operation |
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The operation usually lasts around 15 to 20 minutes.
Cataract surgery is usually done under a local anesthetic which numbs the
area but you will be awake. If needed, your anesthetist can also give you an
injection of a sedative, which will make you feel relaxed and possibly drowsy.
Less commonly, the operation is done under a general anesthetic. This means
that you will be asleep throughout the procedure and will feel no pain.
During the operation, you will lie in a reclined position in a special chair.
The surgeon will work with very fine instruments while looking at your eye
through a microscope.
Once the anesthetic has taken effect, your surgeon
will make a tiny incision on the surface of your eye. This incision is usually
so small that no stitches are needed.
Your surgeon will use ultrasound energy to break up the cloudy lens
(cataract), which can then be removed through a small tube. The lens sits inside
a sac of thin tissue called a capsule. This is kept in place to support an
artificial replacement lens, which will be inserted through the same
incision.
An artificial lens (the intraocular lens) will be put into your eye
after the cataract is removed. It is folded to help insert it through the tiny
incision. The intraocular lens will be unfolded once it is in your eye. The lens
is made from plastic or silicone and remains permanently in your eye. |
| After the operation |
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After the operation, your eye is likely to be covered with a protective pad.
You will need to wear this for a few hours.
Your operation will usually be a day-case and you will be able to go home
once you have made a full recovery from the anesthetic. It is a good idea to
have a friend or relative stay with you for the first 24 hours (especially if
it's your only good eye that has been treated).
Sensation usually returns to the eye within a few hours. Improved vision is
usually noticed within a few days, although complete healing may take several
months.
Before discharge, you will be given eye drops to help prevent
infection and promote healing. Your surgeon will also give you advice about how
long to use eye drops and, if applicable, when you can resume driving.
You
will be given a 24-hour contact telephone number for the hospital and a
follow-up appointment will be made. Most surgeons see their patients again
within one to three weeks of the operation.
It may be helpful to wear
sunglasses or a hat when you leave the hospital as your eye may be sensitive to
the sun. |
| Recovering from cataract
surgery |
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Take it easy for the first two or three days after the operation. If you have
questions about what you can and can't do, ask your surgeon or nurse for
guidance.
You can resume normal activities such as moving around and bending down, but
be careful because it's hard to judge distances with one eye covered.
There are some important things to remember while recovering from cataract
surgery.
- Try not to touch or rub your eye.
- Keep soap and shampoo out of your eyes (it's sensible to avoid washing your
hair for the first few days).
- In the first few weeks after the operation, avoid heavy lifting or strenuous
exercise as this can increase the pressure in your eye and could put a strain on
your healing scar.
- If you suffer more than mild pain, or you experience loss of vision or
increasing redness of your eye, you should contact your hospital for advice.
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| Deciding to have a cataract
removed |
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Cataract surgery is a commonly performed and generally safe surgical
procedure. For most people, the benefits in terms of improved vision are greater
than any disadvantages. However, in order to make a well-informed decision and
give your consent, you need to be aware of the possible side-effects and the
risk of complications.
Side-effects are the unwanted but mostly temporary
effects of a successful procedure. For cataract surgery, side-effects
include:
- an itchy or sticky eye and blurry vision for a few days after the operation
- aching of the eye, which generally settles down within a few days
- bruising of the eyelid or eye, which will heal normally
Complications are unexpected problems that can occur during or after the
procedure. Most people are not affected. The main complications of any operation
are bleeding during or soon after the procedure, infection and an abnormal
reaction to the anesthetic. In a small number of cases, complications can lead
to reduced vision or blindness.
Specific complications of cataract surgery
are rare but can include the following.
- After phacoemulsification, the lens casing that is left in the eye to
support the implant may thicken and become cloudy. This is called posterior
capsular opacification and begins gradually, usually months or years after the
operation. It results in reduced vision similar to a cataract. A relatively
simple laser treatment can be used to correct it.
- The lens capsule may tear, which can result in reduced vision.
- A bit of the lens with the cataract may be displaced into the back of the
eye, requiring another operation to remove it.
- You may have bleeding inside your eye.
- The implant may dislocate, requiring a further operation.
- Your retina may be damaged during the operation, which could make you blind
in that eye, but this is rare.
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