You will be given an oral medication prior to the procedure to help you relax during your surgery. Before you are taken into surgery, the area around your eye will be cleansed and drops will be put into your eye to dilate the pupil.
In the preoperative area, the nursing staff will prepare your eye for surgery with a combination of dilating, antiseptic, and anesthetic eye drops. You will usually be offered a Valium pill to take by mouth to reduce your anxiety in the pre-op area.
Patients Are Given Sedatives and Local Anesthesia
In addition, local anesthetic will be administer via eye drops to numb the pain and ensure the surgical procedure goes by smoothly. In general, the sedatives cause patients to feel groggy during the surgery, though otherwise free from worry.
Since cataract surgery is an outpatient procedure, lasting only about an hour or less, you will remain awake and receive local anesthesia in the form of eye drops or a needle-based block most of the time. In most cases, you receive a sedative or other medications to help you relax.
When the eye is completely numb, an instrument will be used to hold your eye open while the procedure is completed. This instrument ensures that you will not blink during cataract surgery. Cataract surgery is one of the safest, most successful surgeries involving the eye.
How painful is cataract surgery? Most people feel little or no pain during or after cataract surgery. You'll receive a topical anesthetic (eye drops) to numb your eye during the surgery. Shortly after surgery, your eye may feel gritty or slightly tender, but over-the-counter pain medicine should improve this.
For face-to-face surgery, the patient sits upright and comfortable on the surgical chair. The microscope is rotated forwards to face the eye, and the surgeon sits (or stands) facing the patient.
How long does cataract surgery take? Cataract surgery takes 10 to 20 minutes to complete, depending on the severity of the condition.
How long should you wear an eye shield after cataract surgery? People may need to wear an eye shield for 1 week after surgery.
You will be provided with a protective shield for your eye that should be worn during sleep (even naps) for at least the first week after your cataract surgery. This will help you avoid rubbing your eyes and/or causing an accidental injury to your eye while it is in the recovery phase.
Most people see better 1 to 3 days after surgery.
Endophthalmitis is a serious complication of cataract surgery involving microorganisms that gain entry into the eye. Risk factors for the development of endophthalmitis include rupture of the posterior capsule or the need for anterior vitrectomy during the procedure, age greater than 85 years, and male sex.
Don't: Eat or Drink Right Before the Surgery
While under sedation, there is a chance of stomach acid going into your lungs, which can cause damage.
Some Don'ts: Things to Avoid
Avoiding eating and drinking before your surgery. Don't wear makeup to the surgery appointment, and avoid wearing makeup until your ophthalmologist allows it so that you can better prevent infection. Avoid getting irritants in your eyes.
An eye holder gently keeps the lid open during the procedure to prevent blinking. Although this may sound alarming, there is usually little to no sensation from the lid holder because the eye gets numbed before its use.
Tape the patient's head to the operating room table before starting the surgery. I use paper tape to gently hold the patient's head in place during the procedure. Place it over the forehead and use a tape that is gentle and will not damage delicate skin.
During surgery, your eye doctor will remove the cloudy lens from your eye and replace it with an artificial lens (called an intraocular lens, or IOL). The surgery lasts about 1 hour and is almost painless. Usually, you'll be awake during cataract surgery.
The "big 3" potential problems that could permanently worsen vision after cataract/IOL surgery are: 1) infection, 2) an exaggerated inflammatory response, and 3) hemorrhage. Fortunately, these are quite rare nowadays, occurring less than 1% of the time.
“Floppy iris syndrome and iris prolapse are among the most challenging things to deal with during cataract surgery,” Dr. Weinstock notes. “Using bimanual phaco and bimanual irrigation and aspiration is a great way to deal with this situation.
After your cataract surgery, you'll be provided with an eye shield to protect your eye from dust, grime and anything else that could irritate your eye or cause infection. Sleeping on your back instead of your side can reduce the possibility of your eye shield slipping while you're wearing it overnight.
“High eye pressure can interfere with the incision before it fully heals,” says Eghrari. “Positions that put your head below your waist, such as bending over, can also increase eye pressure and should be avoided initially after surgery.”
Avoid heavy lifting, exercise, and other strenuous activities. Exercise can cause complications while you're healing. You're at higher risk of having an accident if you're doing anything physically taxing. So take it easy for a while!
If you're unable to get hold of them, visit your local optometrist or GP, or go to a hospital emergency. Red flags include: Loss of vision, whether increasing blur or entire areas of black/grey in your visual field. Any discharge from the eye.
Protective glasses are prescribed after cataract surgery. But for the purpose of reading, you can use your old glasses for up to 3 weeks until the refractive power of the operated eye stabilises, after which your doctor will prescribe new glasses.