Cataract surgery is the most commonly performed surgery in the United States and is considered a routine surgery. Cataract typically develops as we age and it’s a result of sun damage. Our eyeballs are designed with a lens in each eye (right behind the colored iris) and one of the jobs of the crystalline lens is to absorb most of the UV light that is exposed so it doesn’t damage the retina or the back of the eye. In the process of absorbing the harmful UV light, the lens “bakes”, ages, hardens, loses its clarity, and turns yellow!
The first thing you would notice in the cataract journey is changes in the prescription after it’s been stable for a few years. Then you may notice that your vision seems dimmer at night, or that you have to use the flashlight function on your phone when you read the menu at a restaurant, and oh does everybody have their brights on?! At that point, your doctor is aware of your developing cataract but you may not be ready yet for cataract surgery.
When the cataract starts to affect your day-to-day life, maybe you don’t drive at night anymore, or you’re having trouble distinguishing colors, or you didn’t pass the test to renew your license at the DMV, that’s when your optometrist should start recommending cataract surgery.
You may have a thousand questions, you may be terrified, or you may be excited to see well again. All emotions are acceptable. Let’s dive deep into the experience of having cataract surgery.
Pre-op: there is some prep work needed before cataract surgery. A thorough exam is needed to determine if you have an ocular surface disease (blepharitis, Demodex, dry eyes, corneal dystrophies …etc.) Such conditions must be managed before surgery to ensure a good level of comfort and satisfying vision post-surgery.
Other ocular conditions that must be managed before cataract surgery are glaucoma, retinal issues, diabetic retinopathy, and many more.
In our practice, our patients who underwent dry eye therapy before cataract surgery show much higher levels of satisfaction with the results.
The second step is lens selection. After your surgeon removes the natural crystalline lens, s/he will replace it with a new synthetic lens. The lens is made for your eye with your prescription, so depending on the complexity of your prescription and your daily needs there are typically three types of lenses recommended
1- Single vision lenses: will allow you to see things well at far distances, but you may need reading glasses to see near.
2- Toric lenses: are a perfect option for patients with astigmatism, they correct the distance vision and the astigmatism, minimizing your need for glasses
3- Multifocal lenses: If you want to ditch glasses altogether then multifocal IOL are a great option for you.
The day of surgery: at this point, you’ve probably been on drops for 1-2 weeks and you’re ready to see. Get good sleep, take a deep breath, and remember your surgeon has performed that surgery probably hundreds if not thousands of times. Due to the use of anesthesia, you shouldn’t drive 24-48 hours after the surgery. Ask a friend or a relative to drive you home after surgery.
You will be tired that day, so rest and take it easy. You should have 1-4 different kinds of drops along with a schedule, follow the schedule closely. Keep your eye covered overnight with the clear patch typically provided by your surgeon.
Don’t rub your eye, don’t forget your drops, and report to your doctor immediately if you have excessive redness, pain, or tearing.
Post-operative care: follow-ups are scheduled typically 1 day, 1 week, 1 month, and 3 months post-surgery. The purpose is to catch any complications and address them on time. Bring your drops, your questions, and your concerns to every appointment, and call your doctor if something were to come up between appointments.
Some people end up with a minor glasses prescription after surgery, which is typically finalized 2-3 months after the surgery. The second surgery is typically scheduled 1-2 weeks after the first one. The surgery doesn’t have to be repeated as the implant (IOL) is synthetic and it doesn’t change or age. Most people are pain-free and can appreciate the results within 24 hours of the surgery.