What to Expect Before, During, and After Cataract Surgery

Cataract surgery is one of the most common and successful medical procedures performed worldwide. If you’ve been diagnosed with cataracts and are considering surgery, it’s natural to have questions about the process. Understanding what to expect at each stage – before, during, and after – can help ease any anxieties and ensure a smooth experience.

Before Your Cataract Surgery

The preparation phase is crucial for a successful outcome.

1. Comprehensive Eye Exam: Your ophthalmologist will conduct a thorough eye examination to confirm the presence of cataracts, assess your overall eye health, and measure your eye. These measurements are essential for selecting the correct intraocular lens (IOL) power that will replace your cloudy natural lens. This is also the time to discuss your lifestyle and vision goals (e.g., whether you want to reduce dependence on glasses for distance, near, or both).
2. Discussion of IOL Options: There are various types of IOLs available, including monofocal (single-focus), multifocal, extended depth of focus (EDOF), and toric (for astigmatism). Your surgeon will explain the pros and cons of each, helping you choose the lens that best suits your vision needs and budget.
3. Medical Clearance: You may need to visit your general practitioner for a general health check-up to ensure you are fit for surgery. This is particularly important if you have underlying health conditions like diabetes or heart disease.
4. Medication Review: Inform your surgeon about all medications, supplements, and vitamins you are taking. You may be asked to stop certain medications, particularly blood thinners, for a few days before surgery.
5. Pre-Operative Instructions: You’ll receive specific instructions regarding fasting (typically nothing to eat or drink after midnight the night before surgery) and what to wear. You might also be given antibiotic eye drops to start using a few days prior to the procedure to prevent infection.
6. Arranging for a Ride: You will not be able to drive yourself home after surgery, so arrange for someone to pick you up.

During Your Cataract Surgery

Cataract surgery is typically an outpatient procedure, meaning you go home the same day. It’s relatively quick and largely pain-free.

1. Arrival and Preparation: Upon arrival at the surgical center, you’ll check in, and a nurse will prepare you. This includes reviewing your information, possibly taking your vital signs, and administering dilating eye drops to widen your pupil.
2. Anesthesia: Local anesthesia will be used to numb your eye. This might be in the form of eye drops, an injection around the eye, or a combination. You may also receive a mild sedative to help you relax. You will be awake but relaxed and comfortable.
3. The Procedure: The surgery itself usually takes about 15-30 minutes per eye.
   • Your surgeon will make a tiny incision in your cornea.
   • A small instrument is inserted to break up the cloudy lens (cataract) using ultrasound (phacoemulsification) or, in some cases, a laser.
   • The fragmented pieces are then gently suctioned out.
   • Finally, the new, clear intraocular lens (IOL) is carefully inserted and positioned to replace the natural lens.
   • The incision is usually self-sealing and rarely requires stitches.
4. Post-Procedure: After the surgery, a shield or patch may be placed over your eye for protection. You’ll spend a short time in a recovery area while the sedative wears off.

After Your Cataract Surgery

Recovery from cataract surgery is generally quick, but following post-operative instructions is vital for optimal results.

1. Immediate Recovery (First Few Hours/Days):
   • Vision: Your vision may be blurry or hazy immediately after surgery, but it should begin to clear within hours. Some mild discomfort, itching, or a gritty feeling is normal.
   • Eye Protection: Keep the protective shield on as instructed, especially when sleeping, to prevent accidental rubbing or pressure on the eye.
   • Eye Drops: You will be prescribed antibiotic and anti-inflammatory eye drops. It is crucial to use these exactly as directed to prevent infection and reduce inflammation.
   • Activities: Avoid rubbing or pressing on your eye, heavy lifting, bending over excessively, and strenuous activities for a few weeks. You can usually resume light activities like reading or watching TV soon after.
2. Follow-up Appointments: You’ll have several follow-up appointments with your surgeon, typically within 24-48 hours, then a week later, and then about a month later. These visits are essential to monitor your healing, check your vision, and ensure there are no complications.
3. Long-Term Recovery and Vision:
   • Most people experience significant improvement in vision within a few days, with full healing taking about 4-6 weeks.
   • While your new IOL provides clear vision, you might still need glasses for certain tasks (e.g., reading if you chose a monofocal lens). Your surgeon will advise you when it’s safe to get a new glasses prescription, if needed.
   • A common long-term occurrence is a “secondary cataract” or posterior capsular opacification (PCO), where the membrane behind the IOL becomes cloudy. This is easily treated with a quick, painless laser procedure (YAG capsulotomy) in the office.

Cataract surgery is a safe and highly effective procedure that can dramatically improve your vision and quality of life. By understanding each phase, you can approach your surgery with confidence and look forward to a clearer, brighter world.