This information sheet will help you decide whether to have cataract surgery. You may wish to discuss it with a relative or carer. If you have any further questions, please contact the surgery during office hours.
If your eye surgeon has recommended cataract surgery it is because the lens in your eye has become cloudy making it difficult for you to see well enough to carry out your usual daily activities.
If the cataract is not removed, your vision may stay the same for a while but then slowly worsen. The rate of deterioration varies considerably amongst patients. Waiting for a longer period of time will not make the operation more difficult, unless your eyesight becomes so poor that all you can see is light and dark.
The purpose of the operation is to replace the cloudy lens (cataract) with an artificial lens (implant) inside your eye. Most cataracts are removed by a technique called phacoemulsification. The surgeon makes a very small incision in the eye, softens the lens with ultrasound waves and removes it through a small tube. The back layer of the lens is left behind. An artificial lens (implant) is then inserted to replace the cataract. Sometimes a small stitch is placed in the eye but this is only rarely.
The operation is performed at either Toowoomba Surgicentre Day Hospital where you will be required to stay for 3-4 hours or St Vincent’s Hospital for overnight admission.
Following your admission, dilating and local anaesthetic drops will be administered in your eye. The Anaesthetist will check that your eye is numb and for patients who are feeling nervous, may give you some mild sedation. You will not be able to see what is happening, but you will be aware of a bright light.
During the operation you will be asked to keep your head still, and lie as flat as possible. The operation normally takes 7-12 minutes, but may take up to 45 minutes. An eye pad and/or shield will be placed over your eye to protect it.
Following the operation, you will be taken to recovery where you will have morning/afternoon tea. Once the Nurses feel your situation is stable you will be discharged home.
After The Operation
It is normal to feel some discomfort (itching, sticky eyelids, mild discomfort and some fluid discharge) after the operation and you can take the appropriate pain medication for this if needed. After 1-2 days even mild discomfort should disappear. In most cases, healing will take about 3-6 weeks after which new glasses can be prescribes by your Optician.
You will need to use eye drops post-operatively to reduce inflammation. Do not use any eye drops immediately following the operation until instructed by Doctor/Nurse the next day.
Certain symptoms could mean that you require prompt treatment. Please contact the surgery immediately if you have any of the following symptoms:
- Excessive pain not relieved by general medication
- Dramatic loss of vision
- Increasing redness of the eye
- After the operation you may read or watch TV almost straight away, but your vision may be blurred. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract.
The Likely Hood Of Better Vision
- The vast majority of patients have improved eyesight following cataract surgery
- Many patients say they have heard stories of people being disappointed in their outcome from cataract surgery. The most common cause of this is the presence of
co-morbidity. That is, the presence of another eye disease which is limiting the potential vision.
Common conditions such as diabetes, glaucoma or age-related macular degeneration may limit your quality of vision even after successful surgery. We will discuss this with you if your prognosis or outcome is unsure or guarded.
Benefits And Risks Of Cataract Surgery
The most obvious benefits are greater clarity of vision and improved colour vision. Because lens implants are selected to compensate for existing focusing problems, most people find that their eyesight improves considerably after surgery but will need to replace their glasses.
However, you should be aware that there is a small risk of complications, either during or after the operation.
Some Possible Complications During The Operation
- Tearing of the back part of the lens capsule with disturbance of the gel inside the eye that may sometimes result in reduced vision
- Loss of all or part of the cataract into the back of the eye requiring a further operation which may require a general anaesthetic
- Bleeding inside the eye
Some Possible Complications After The Operation
- Bruising of the eye or eyelids
- Raised intra-ocular pressure inside the eye
- Clouding of the cornea
- Incorrect strength or dislocation of the implant
- Swelling of the retina (macular oedema)
- Detached retina which can lead to loss of sight
- Infection in the eye (endophthalmitis) which can lead to loss of sight or even the eye
- Allergy to the medication used
Complications are rare and in most cases can be treated effectively. In a small proportion of cases, further surgery may be needed. Very rarely some complications can result in blindness.
The most common complication is called ‘posterior capsular opacification’. It may come on gradually after months or years. When this happens, the back part of the lens capsule, which was left in the eye to support the implant, becomes cloudy. This distorts the light reaching the retina. To treat this, the eye specialist uses a laser beam to make a small opening in the cloudy membrane in order to improve the eyesight. This is a painless outpatient procedure, which normally takes only a few minutes.
We hope this information is sufficient to help you decide whether to go ahead with surgery.