What to expect before, during, and after cataract surgery?
Cataract surgery is one of the most common and effective eye procedures, offering a significant improvement in vision. Understanding the entire process can help you feel more comfortable and prepared. This guide walks you through everything you can expect before, during, and after cataract surgery to ensure that you know what’s coming every step of the way.
Before cataract surgery
Preparing for cataract surgery is an important step to ensure you are in the best health possible before your procedure. Here’s what to expect in the days or weeks leading up to the surgery.
1. Preoperative consultation & diagnosis
Before the surgery, you’ll undergo a comprehensive eye exam that includes:
- Detailed eye examination: Your eye doctor will check for cataracts and assess other conditions that could affect the surgery. They’ll ask about your overall health and any other medical conditions you may have.
- Visual acuity test: This is a test to measure the clarity of your vision.
- Eye health assessment: Your eye doctor will examine the structure of your eye, including the cornea and retina, to make sure the surgery can be performed safely.
2. Choosing the right lens implant (IOL)
One of the key components of cataract surgery is choosing the correct intraocular lens (IOL), which will replace the cloudy lens removed during surgery. There are various types of IOLs:
- Monofocal lenses: These lenses are designed to provide clear vision at a single distance, usually for distance vision. You may need reading glasses for close-up tasks after surgery.
- Multifocal lenses: These lenses provide clear vision at multiple distances, reducing the need for glasses after surgery.
- Toric lenses: These are specialized lenses for people with astigmatism, correcting vision at multiple distances.
- Extended Depth of Focus (EDoF) Lenses: These lenses are designed to provide a continuous range of vision, offering an extended depth of focus. This reduces the need for reading glasses and provides clear vision for both near and far objects, with fewer visual disturbances compared to multifocal lenses.
Your ophthalmologist will discuss these options with you, based on your lifestyle and vision needs.
3. Preoperative instructions
The doctor will provide instructions for the days leading up to your surgery to ensure everything goes smoothly:
- Medications: You may be prescribed special eye drops to prevent infection and reduce inflammation.
- Fasting: You’ll be asked to avoid eating or drinking for several hours before surgery to prepare for anesthesia.
- Arrangements: Since you’ll be sedated during the procedure, you’ll need someone to drive you home after surgery. Make sure this is arranged ahead of time.
During cataract surgery
Cataract surgery is generally a quick and minimally invasive procedure. You’ll be awake, but your eye will be numbed with local anesthesia, so you won’t feel pain during the procedure.
1. Arrival & Preparation
When you arrive at the surgical center, the medical team will guide you through the process:
- Check-in and confirmation: Your surgical team will review your medical history and confirm which eye is being operated on. A bandage or shield will be applied over your eye to keep it protected.
- Relaxation: You may be given a mild sedative to help you relax. This won’t put you to sleep, but it will make you feel calm and comfortable.
2. Anesthesia & Sterilization
- Local anesthesia: The eye will be numbed using eye drops or a local injection around the eye. This ensures you won’t feel pain during surgery, but you may feel some pressure.
- Sterilizing the eye: Your surgeon will clean the area around your eye with antiseptic to minimize the risk of infection.
3. The surgery itself
- Making an incision: The surgeon will create a tiny incision in the cornea, typically around 2-3 millimeters, which is self-healing without the need for stitches.
- Removing the cloudy lens: The surgeon will break up the cloudy cataract using ultrasound energy (phacoemulsification) and remove the fragments through the incision.
- Inserting the IOL: Once the cataract is removed, the surgeon will insert the intraocular lens (IOL) to replace the natural lens of the eye. This lens is typically folded and inserted through the small incision, then unfolded once inside the eye.
- No stitches needed: Due to the small size of the incision, stitches are usually not necessary. The wound generally heals naturally within a few days.
4. Post-surgery monitoring
After the surgery, you’ll be taken to a recovery room, where you’ll rest for about 30 minutes to an hour. Your doctor will monitor your condition and check the eye for any immediate concerns.
After cataract surgery
The recovery process is crucial for achieving optimal vision after cataract surgery. Here’s what you can expect:
1. Immediately after surgery
- Protective shield: You may be given an eye shield to protect the eye from accidental pressure or rubbing while you sleep, particularly during the first few nights after surgery.
- Vision changes: It’s normal for vision to be blurry initially, and your eye may feel a little scratchy. This should improve over time.
- Slight discomfort: Mild itching or a sensation of something in the eye is common, but it should subside within a few days.
2. Postoperative care & eye drops
After surgery, you’ll need to follow your doctor’s instructions carefully:
- Eye drops: You’ll be prescribed anti-inflammatory and antibiotic eye drops to reduce inflammation and prevent infection. Be sure to use them as instructed.
- Avoid rubbing the eye: You must avoid rubbing or pressing on the eye during the recovery period.
- No water in the eye: For a short period after surgery, you’ll need to avoid getting water in your eye, such as when showering or swimming.
3. Activity restrictions
For the first few weeks following surgery:
- Don’t rub or touch your eye: It’s important to avoid rubbing your eye to prevent infection or dislodging the intraocular lens (IOL) that was implanted during the surgery.
- Don’t engage in strenuous activities: Avoid heavy lifting, bending over, or any activity that can strain your eyes. These activities can increase intraocular pressure and interfere with the healing process.
- Don’t swim or expose your eye to water: Swimming in pools, lakes, or even exposing your eye to hot tubs is not recommended until your eye has fully healed, typically around 2-4 weeks, to reduce the risk of infection.
- Don’t drive: You should not drive until your doctor gives you the go-ahead. Vision might still be blurry for a few days, and it’s important to avoid driving until your sight improves.
- Don’t wear makeup: Avoid applying makeup, particularly around the eyes, for at least a week after surgery to prevent infection. Makeup particles can irritate your eye or introduce bacteria.
- Don’t expose your eyes to smoke or dust: Try to avoid smoky or dusty environments, as particles can irritate the eye and increase the risk of infection.
- Don’t skip your prescribed eye drops: Follow the doctor’s instructions for eye drops. Skipping them can increase the risk of infection or delay the healing process.
- Don’t ignore unusual symptoms: If you notice anything unusual, such as significant pain, sudden vision loss, flashes of light, or redness in the eye, contact your doctor immediately.
- Don’t drink alcohol excessively: Excessive alcohol can interfere with the healing process, so it’s best to avoid heavy drinking during the recovery period.
- Don’t expose your eye to trauma: Protect your eye from accidental bumps or injury. Wearing protective eyewear when doing any activity that could involve risk to the eyes, such as certain sports, is important.
4. Follow-up appointments
Your ophthalmologist will schedule several follow-up visits to monitor your progress:
- First visit: Typically within the first day or two after surgery to ensure everything is healing correctly.
- Subsequent visits: You’ll visit the doctor a few more times during the next few weeks to ensure your eye is healing properly and your vision is improving.
Common experiences during recovery
1. Gradual improvement in vision
Most patients notice a significant improvement in vision within a few days of surgery. However, it may take 4 to 6 weeks for your vision to stabilize fully.
2. Mild discomfort
Some people experience mild itching, dryness, or a feeling of something in the eye, which usually resolves on its own. Using lubricating drops will help alleviate these symptoms.
3. Adjustment to the new lens
It may take time for your brain to adjust to the new intraocular lens (IOL), especially if you opted for multifocal lenses. This adjustment period is normal and varies from person to person.
Risks & Complications after cataract surgery
While cataract surgery is highly effective and generally safe, there are potential risks and complications that patients may face during recovery. Some of these complications are temporary and resolve on their own, while others may require medical intervention. It’s essential to be aware of these risks and to follow your doctor’s post-operative instructions carefully.
Here’s an overview of the potential problems that could arise after cataract surgery:
- Blurred Vision: Immediately following surgery, some patients may experience blurred vision, which can be attributed to the healing process, swelling, or even the temporary effects of the anesthesia used during surgery. In most cases, vision improves as the eye heals.
- Dry Eyes: It’s common to experience dryness or irritation in the eyes after cataract surgery. This is due to temporary changes in tear production. Your ophthalmologist may recommend lubricating eye drops to alleviate the symptoms and help keep your eyes moist during the healing period.
- Infection: Although rare, infection is one of the most serious risks after cataract surgery. Symptoms of infection may include increased redness, pain, or a decrease in vision. If any of these signs appear, seek immediate medical attention to prevent further complications.
- Inflammation: Some degree of inflammation is normal after cataract surgery, but it usually resolves with prescribed anti-inflammatory eye drops. If inflammation persists or worsens, it may indicate a problem and requires attention from your doctor.
- Increased Light Sensitivity: Post-operative light sensitivity can occur, especially in the first few days or weeks after surgery. This sensitivity may lessen as the eye heals. Wearing sunglasses in bright environments can help provide relief.
- Glare & Halos: In some cases, patients may notice glare or halos around lights, particularly at night. This phenomenon is often temporary and tends to improve as the eye adjusts to the new lens. However, it may be more pronounced in those with multifocal lenses.
- Dislocated or Shifted Intraocular Lens (IOL): Although rare, the intraocular lens (IOL) used in cataract surgery can shift or become dislocated. This can cause blurred or double vision. In such cases, a second surgery may be required to reposition or replace the IOL.
- Retinal Detachment: Retinal detachment is a rare but serious complication that may occur after cataract surgery. Symptoms can include flashes of light, a sudden increase in floaters, or a shadow in the field of vision. Immediate treatment is necessary to prevent permanent vision loss.
- Overcorrection or Undercorrection of Vision: In some instances, the vision may be overcorrected or undercorrected after surgery. This can happen if the IOL doesn’t fully match the patient’s refractive needs. Additional corrective procedures, such as laser treatment, may be needed to fine-tune vision.
- Cystoid Macular Edema (CME): CME is a condition where fluid accumulates in the macula, causing swelling and affecting central vision. Symptoms may include blurred or distorted vision. It can be treated with anti-inflammatory eye drops, but in severe cases, further surgical intervention may be needed.
- Posterior Capsular Opacification (PCO): PCO, often called a “secondary cataract,” is a common complication that occurs months or even years after cataract surgery. It happens when the capsule that holds the IOL becomes cloudy, affecting vision. A quick and painless laser procedure, called YAG laser capsulotomy, can be used to clear the vision.
- Fluctuating Vision: In the early stages of recovery, some patients may experience fluctuating vision, where eyesight improves at times and worsens at others. This is typically part of the healing process and should stabilize over time as the eye adjusts.
- Ptosis (Drooping Eyelid): Ptosis, or a drooping eyelid, may occur after cataract surgery, especially if there was significant swelling or trauma to the eye during the procedure. If this condition persists or affects vision, further treatment or surgery may be required.
- Ocular Hypertension: In some cases, the eye pressure may increase after cataract surgery, a condition called ocular hypertension. If untreated, it can lead to glaucoma. Regular eye pressure checks are crucial to monitor this potential issue, and medications may be prescribed if necessary.
For a detailed look of common problems, check out our blog on “Common problems after cataract surgery”.
Conclusion
Cataract surgery is a safe, effective procedure that can drastically improve your quality of life by restoring clear vision. By understanding what to expect before, during, and after the procedure, you can feel confident and prepared for the surgery. Follow all post-operative instructions and attend your follow-up appointments to ensure the best possible recovery. If you have any questions or concerns, don’t hesitate to contact your ophthalmologist for personalized guidance.
With the right care, you’ll soon enjoy the benefits of clear vision once again.
Author bio
Dr. Dhwani Maheshwari, an esteemed ophthalmologist with over 8 years of experience, leads Krisha Eye hospital in Ahmedabad with a commitment to advanced, patient-centered eye care. Specializing in cataract and refractive surgery, Dr. Maheshwari has performed more than a thousand successful surgeries. Her expertise lies in phacoemulsification, a technique recognized for its precision in cataract treatment.
Dr. Maheshwari’s educational journey includes an MBBS from Smt. NHL MMC, a DOMS from M & J Institute of Ophthalmology, and a DNB in Ophthalmology from Mahatme Eye Bank Eye Hospital, Nagpur. She also completed a fellowship in phacoemulsification at Porecha Blindness Trust Hospital, further enhancing her surgical skills. In addition to her work at Krisha Eye Hospital, Dr. Maheshwari serves as a consultant ophthalmologist at Northstar Diagnostic Centre.
Under her leadership, Krisha Eye Hospital aims to bring all superspecialties under one roof, offering comprehensive eye care solutions for all vision needs.
FAQs
Cataract surgery usually takes about 15–30 minutes.
No, cataract surgery is typically painless because of local anesthesia. You may feel some pressure, but there should be no discomfort.
Most people see a significant improvement in vision within the first few days, but complete recovery takes about 4–6 weeks.
You will not be able to drive right after surgery. Once your vision improves, your doctor will let you know when it’s safe to drive.
If left untreated, cataracts can worsen and lead to significant vision impairment. Cataract surgery is the only way to restore clarity of vision.
There are different types of intraocular lenses (IOLs) used during cataract surgery, including monofocal, multifocal, toric, and extended depth of focus lenses. Your ophthalmologist will help determine the best option based on your needs.
You should avoid strenuous activities for about 2-3 weeks. Your doctor will guide you on when it’s safe to resume normal activities, including exercise and reading.
Yes, some blurriness is normal right after surgery as your eye heals. However, this should improve over the following days to weeks.
Cataract surgery is usually done on one eye at a time, with a gap of a few weeks between procedures to allow the first eye to heal and to assess the results.
To reduce the risk of complications, follow your doctor’s post-surgery care instructions carefully, avoid rubbing your eyes, and attend all follow-up appointments.