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Introduction
The symptoms of early cataract may be improved with new
eyeglasses, brighter lighting, anti-glare sunglasses, or
magnifying lenses. If these measures do not help, surgery
is the only effective treatment. Surgery involves removing
the cloudy
lens and replacing it with an artificial lens.
A cataract needs to be removed only when
vision loss
interferes with your everyday activities, such as driving,
reading, or watching TV. You and your eye care
professional can make this decision together. Once you
understand the benefits and risks of surgery, you can make
an informed decision about whether cataract surgery is
right for you. In most cases, delaying cataract surgery
will not cause long-term damage to your eye or make the
surgery more difficult. You do not have to rush into
surgery.
Sometimes a cataract should be removed even if it does not
cause problems with your vision. For example, a cataract
should be removed if it prevents examination or treatment
of another eye problem, such as
age-related macular
degeneration or diabetic retinopathy.
If you choose surgery, your eye care professional may
refer you to a specialist to remove the cataract.
If you have cataracts in both eyes that require surgery,
the surgery will be performed on each eye at separate
times, usually four to eight weeks apart.
Is cataract surgery effective?
Cataract removal is one of the most common operations
performed in the United States. It also is one of the
safest and most effective types of surgery. In about 90
percent of cases, people who have cataract surgery have
better vision afterward.
Are there different types of cataract surgery?
There are two types of cataract surgery. Your doctor can
explain the differences and help determine which is better
for you:
- Phacoemulsification, or phaco
A small incision is made on the side of the
cornea, the
clear, dome-shaped surface that covers the front of the
eye. Your doctor inserts a tiny probe into the eye. This
device emits ultrasound waves that soften and break up
the lens so that it can be removed by suction. Most
cataract surgery today is done by phacoemulsification,
also called "small incision cataract surgery."
- Extracapsular surgery
Your doctor makes a longer incision on the side of the
cornea and removes the cloudy core of the lens in one
piece. The rest of the lens is removed by suction.
After the natural lens has been removed, it often is
replaced by an artificial lens, called an intraocular
lens (IOL). An IOL is a clear, plastic lens that
requires no care and becomes a permanent part of your
eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see
the new lens.
Some people cannot have an IOL. They may have another
eye disease or have problems during surgery. For these
patients, a soft contact lens, or glasses that provide
high magnification, may be suggested.
- Clear Cornea
Cataract Surgery
What are the risks of cataract surgery?
As with any surgery, cataract surgery poses risks, such as
infection and bleeding. Before cataract surgery, your
doctor may ask you to temporarily stop taking certain
medications that increase the risk of bleeding during
surgery. After surgery, you must keep your eye clean, wash
your hands before touching your eye, and use the
prescribed medications to help minimize the risk of
infection. Serious infection can result in loss of vision.
Cataract surgery slightly increases your risk of retinal
detachment. Other eye disorders, such as high myopia
(nearsightedness), can further increase your risk of
retinal detachment after cataract surgery. One sign of a
retinal detachment is a sudden increase in flashes or
floaters. Floaters are little "cobwebs" or specks that
seem to float about in your field of vision. If you notice
a sudden increase in floaters or flashes, see an eye care
professional immediately. A retinal detachment is a
medical emergency. If necessary, go to an emergency
service or hospital. Your eye must be examined by an eye
surgeon as soon as possible. A retinal detachment causes
no pain. Early treatment for retinal detachment often can
prevent permanent loss of vision. The longer the retina
stays detached, the less likely you will regain good
vision once you are treated. Even if you are treated
promptly, some vision may be lost.
Talk to your eye care professional about these risks. Make
sure cataract surgery is right for you.
What if I have other eye conditions and need cataract
surgery?
Many people who need cataract surgery also have other eye
conditions, such as age-related macular degeneration or
glaucoma. If you have other eye conditions in addition to
cataract, talk with your doctor. Learn about the risks,
benefits, alternatives, and expected results of cataract
surgery.
What happens before surgery?
A week or two before surgery, your doctor will do some
tests. These tests may include measuring the curve of the
cornea and the size and shape of your eye. This
information helps your doctor choose the right type of IOL.
You may be asked not to eat or drink anything 12 hours
before your surgery.
What happens during surgery?
At the hospital or eye clinic, drops will be put into your
eye to
dilate the
pupil. The area around your eye will be
washed and cleansed.
The operation usually lasts less than one hour and is
almost painless. Many people choose to stay awake during
surgery. Others may need to be put to sleep for a short
time. If you are awake, you will have an anesthetic to
numb the nerves in and around your eye.
After the operation, a patch may be placed over your eye.
You will rest for a while. Your medical team will watch
for any problems, such as bleeding. Most people who have
cataract surgery can go home the same day. You will need
someone to drive you home.
What happens after surgery?
Itching and mild discomfort are normal after cataract
surgery. Some fluid discharge is also common. Your eye may
be sensitive to light and touch. If you have discomfort,
your doctor can suggest treatment. After one or two days,
moderate discomfort should disappear.
For a few days after surgery, your doctor may ask you to
use eyedrops to help healing and decrease the risk of
infection. Ask your doctor about how to use your eyedrops,
how often to use them, and what effects they can have. You
will need to wear an eye shield or eyeglasses to help
protect your eye. Avoid rubbing or pressing on your eye.
When you are home, try not to bend from the waist to pick
up objects on the floor. Do not lift any heavy objects.
You can walk, climb stairs, and do light household chores.
In most cases, healing will be complete within eight
weeks. Your doctor will schedule exams to check on your
progress.
Can problems develop after surgery?
Problems after surgery are rare, but they can occur. These
problems can include infection, bleeding, inflammation
(pain, redness, swelling), loss of vision, double vision,
and high or low
eye pressure. With prompt medical
attention, these problems usually can be treated
successfully.
Sometimes the eye tissue that encloses the IOL becomes
cloudy and may blur your vision. This condition is called
an after-cataract. An after-cataract can develop months or
years after cataract surgery.
An after-cataract is treated with a laser. Your doctor
uses a laser to make a tiny hole in the eye tissue behind
the lens to let light pass through. This outpatient
procedure is called a YAG laser capsulotomy. It is
painless and rarely results in increased eye pressure or
other eye problems. As a precaution, your doctor may give
you eyedrops to lower your eye pressure before or after
the procedure.
When will my vision be normal again?
You can return quickly to many everyday activities, but
your vision may be blurry. 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. Ask your
doctor when you can resume driving.
If you received an IOL, you may notice that colors are
very bright. The IOL is clear, unlike your natural lens
that may have had a yellowish/brownish tint. Within a few
months after receiving an IOL, you will become used to
improved color vision. Also, when your eye heals, you may
need new glasses or contact lenses.
If you suspect a cataract, call our
office to schedule a complete eye examination.
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