What’s It Like: To get cataract surgery - Ralph B. Hester III, MD

What’s It Like: To get cataract surgery 

There are two types of cataract surgery: phacoemulsification and extracapsular surgery.

BY JACLYN COSGROVE | Published: September 9, 2012 

Q: Why get cataract surgery?
A: A cataract is a clouding of your eye’s lens. Most patients suffering from the development of a cataract will go to the ophthalmologist and say something to the effect of “I can’t see.” It might be that they can’t see to drive, especially at night. People generally think they need new glasses, but sometimes their issue is that they have developed a cataract in one of their eyes. More than half of Americans by age 80 either have a cataract or have had the surgery to repair this common vision problem. In 90 percent of cases, people have better vision after the surgery. There are some types of cataract that aren’t age related, including secondary cataract, traumatic cataract, congenital cataract and radiation cataract. Smoking, prolonged sun exposure and diabetes are things thought to increase the risk of developing cataracts.

Q: What happens?
A: There are two types of cataract surgery: phacoemulsification and extracapsular surgery. You should talk with your doctor about which procedure is right for you. In general, during a cataracts procedure, you will be lightly sedated and might sleep through the surgery. A medical professional will give you an injection to numb your eye and keep the eye from moving during surgery. There’s an alternative method where, instead of an injection, a doctor will use drops to numb your eye. Your surgeon will start a series of incisions that, in some procedures, will be about two millimeters. This will allow your doctor the ability to enter your eye. Your lens is behind your eye’s iris. Your lens is what becomes cloudy as you age, causing the cataract. Doctors will go in and remove the cloudy lens and leave what looks like a cellophane bag in place. That bag will soon house an artificial lens, usually what’s known as an intraocular lens, that the doctor will place in your eye. The operation generally lasts less than an hour.

Q: Does it hurt?
A: It shouldn’t hurt during the procedure or afterward. You might feel some itching or mild discomfort. Fluid discharge is common as well. You should talk with your doctor about how to best care for your eye after the surgery.

Q: What’s the risk?
A: There are the general risk factors that are associated with any surgery, such as bleeding and infection. In rare instances, the lens might not come out completely and could take a second procedure. Another rare occurrence is for a patient to suffer a detached retina. Symptoms of retinal detachment include seeing specks that float about your field of vision. Although a retinal detachment doesn’t cause pain, it is an emergency. You should contact your doctor immediately if you develop symptoms of a retinal detachment.

Q: What’s the recovery time?
A: Your doctor might recommend you take at least one day off work. Sometimes, you can return to work or your usual routine within two days of your surgery. Generally, you will heal within eight weeks. The bigger the incisions made during your procedure, the longer your recovery time could be. The time it takes for you to notice results will depend on the severity of the cataracts.

Q: Any follow-ups?
A: After surgery, your doctor will want to check on how you’re recovering. This might mean checkup appointments at various time intervals. The lens, if placed properly, is good for life, and the new lens generally doesn’t get clouded. In rare instances, a patient has had to have a lens replaced because it was removed from a trauma event, such as an air bag during a car accident.

Source: Dr. Ralph Hester of Dean McGee Eye Institute; The National Eye Institute; The Mayo Clinic.

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