Cataract surgery usually takes about 10 to 20 minutes and most people go home from hospital a few hours later. It is usually performed with a local anaesthetic, which means you will be awake during the operation but you won't feel any pain.
The local anaesthetic may involve drops and an injection or just drops. For your surgery your face will be covered by a sheet, which helps to keep the area around your eye clean during the operation. To remove the cataract, the ophthalmologist needs to remove the natural lens in your eye and replace it with a synthetic lens implant.
Cataracts are removed by a technique called phacoemulsification. This technique uses high frequency sound energy to break up your cataract. Micro-incisional cuts are used, so you don't need any stitches, and this helps to speed up your recovery from the surgery. The ophthalmologist uses a microscope to get the best view of your eye as possible.
The lens in your eye is made up of different layers and the outside layer is called the lens capsule. During the operation, the ophthalmologist cuts through the front of the lens capsule so they can reach the lens inside. Using the same instrument, the ophthalmologist can break up the cataract inside your eye, and remove it using suction. Your lens capsule is kept in place so that the artificial lens implant can be placed inside it. The tiny implant is folded so that it can be put into the eye through the same instrument that is used to remove the cataract. Once it reaches the right position, the ophthalmologist unfolds the artificial lens so that it sits in the right place inside the lens capsule.
As you are awake during the operation, you will be able to hear what is happening in the operating room.
You can also communicate with the ophthalmologist and the nurses who are on hand to reassure you.
Your eye will be covered with a dressing, which stays in place when you go home, normally a few hours later. Your eye may begin to feel sore once the local anaesthetic starts to wear off. The pain isn't usually too bad and you can take a painkiller tablet, such as paracetamol, to help.
The dressing, which is put on in the hospital, usually needs to stay on your eye overnight, but you should be able to take it off the following morning. Your eye may look bloodshot, but this will improve over the next few days.
Immediately after the operation some people can tell that their sight has improved straight away however if your cataract was quite mild you might not notice a big change in your vision. Either way, your sight may not be as good as you expect for the first week after the operation, as the eye is still recovering from the surgery and will probably be a little swollen.
Immediately after the surgery you will be given eye drops. It is important to take these drops as the ophthalmologist recommends and to complete the course. If you have problems using the drops you should let your GP know, as they may be able to arrange some help for you.
Most people have no problems after the surgery and they are up and about as normal the next day. If your eye is very painful or your vision suddenly gets a lot worse, then you should let the hospital know as soon as possible as this may mean they need to see you again.
Cataract surgery is generally very successful. Only about three per cent of people who have cataracts experience complications.
Before being offered a cataract operation the ophthalmologist will talk you through the potential risks specific to your situation
After surgery, you can usually go back to your everyday activities as soon as you feel able.
Apart from taking eye drops, you can usually carry on as normal but you may need to avoid the following for the first week to ten days:
- Rubbing your eye. You may have to wear an eye shield (patch) when you are sleeping
- Swimming (until your ophthalmologist says you can) to avoid contact with dirty water while your eye is healin
- Strenuous exercise, contact sports and heavy lifting. Everyday lifting like light shopping is usually fine, but heavy lifting like moving furniture is best avoided
- Wearing eye makeup until your surgeon is happy with your recovery
You also need to take extra care:
- When it is windy or dusty outdoors, in case something blows in your eye, but you don't need to stay indoors
- Washing your hair - avoid soapy water in your eye.
When should I have new glasses
The lens that is implanted in your eye is usually designed to give you clear distance vision without needing glasses. Sometimes this is not quite achieved and you will need a pair of distance glasses to fine tune the focus and get the best possible distance vision.
In most cases an eye test, can be done four to six weeks after the operation, this will be performed by your own optometrist.
If you have cataracts in both eyes, the period between having the first and second operation can be difficult. This is because your eyes will not be balanced in terms of glasses and correction for any short or long sight you may have. Normally, people wait until they have a second operation before getting new glasses. This avoids the need to buy glasses that would only be useful for the short time between the operations.
Most people find they can manage with their old reading glasses. The gap between the two operations is usually less than four weeks so most people can manage.