May 2021 - Armadale Eye Clinic

Before Cataract Surgery

Any eye specialist doing his or her due diligence will conduct a comprehensive eye and vision
examination before taking you under the knife with cataract surgery. During this consultation, you
may also like to discuss the costs involved and any concerns you may have. An important part of this
appointment will also be discussing what sort of intraocular lens you would like to have replace the
cataract once it’s removed – this may be a monovision implant, multifocal, or extended depth of
focus lens. Some intraocular lens implants are even designed to be able to change their depth of
focus to mimic the eye’s natural focusing ability, a type of implant known as an accommodating
intraocular lens. Your ophthalmologist will be able to talk you through your options and help you
decide what sort of implant will best suit your visual needs.

During this examination, the ophthalmologist will want to assess your functional vision. This will
involve reading letters on a standard chart but may also include a test of your contrast sensitivity,
which uses letters of increasingly faint print, as well as measuring your near reading vision. You will
also have your eye health examined, which includes using specialised equipment to directly visualise
the cataract and other structures of the eye. It’s important for the ophthalmologist to rule out any
other eye diseases that may impact the outcome of your cataract surgery, whether it’s a disease like
macular degeneration that may limit your post-operative visual acuity or a retinal tear that needs to
be addressed before undergoing the cataract surgery procedure.

The Cataract Surgery Procedure

Cataract surgery is performed as a day procedure and you will typically be able to go home on the
same day.

performed cataract surgery procedure melbourne

Your eye will be prepared for surgery by being numbed with a local anaesthetic, either using a local
nerve block injected around the eye or a topical anaesthetic in the form of an eye drop. It is not
common for cataract surgery to be performed under general anaesthesia but for patients who are
unable to comply with instructions due to a mental disability or are unable to lie still for an adequate
amount of time, a general anaesthetic may be administered. It is more common for a light sedative
to be offered for patients who are feeling anxious or restless.

The eye surgeon will ask you to fixate on a target light overhead, which helps to keep your eye
steady during the procedure and your eyelids may be gently held open using an instrument known
as a speculum. The surgeon then makes a small incision in your cornea, which is the transparent
dome at the front of the eye. Through this incision, the eye surgeon can then insert the tools
necessary to access the lens of the eye, which is where cataracts form. The lens sits behind the
coloured iris.

There are two types of cataract surgery – femtosecond laser-assisted cataract surgery and
conventional phacoemulsification. During femtosecond laser-assisted cataract surgery, a computer-
guided laser is used to tear a gap in the lens capsule, which contains the lens, as well as break up the
cataract into smaller fragments by using less energy compared to phacoemulsification. With a
conventional cataract operation, a handheld tool is used to tear open the lens capsule and an
ultrasonic device used to fragment the cataract. Regardless of which technique is used to break the
cataract into small pieces, a handheld device is used to suction the fragments out of the eye. The
surgeon will then insert the chosen intraocular lens through the incision into the lens capsule.
There is an ongoing debate about whether femtosecond laser-assisted cataract surgery provides
significantly better outcomes than traditional phacoemulsification to justify the much higher costs
for all patients. Although using a computer-guided laser allows more accuracy compared to
handheld tools, in the long-term, many studies have concluded that both methods are effective,
safe, and provide similar visual outcomes.

After Cataract Surgery

The corneal incision created during the operation is designed to self-seal without stitches. Most
people will find their vision is immediately much clearer after the operation compared to when the
cataract was still there, but your vision is still expected to stabilise further over the coming weeks.

Your ophthalmologist will give you a list of post-operative instructions and prescription eye drops to
use while the eye is healing. You will be advised to wear a protective eye shield at night to avoid
accidental eye rubbing, avoid any contaminants in the eye such as dirt or pool water, and avoid any
strenuous activity.

Although some discomfort is expected after surgery, including the eye feeling dry or gritty and some
glare sensitivity, if you are concerned that something is not right, you should contact your
ophthalmologist immediately.

Call us now on (03) 9070 5753 today for a consultation.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second
opinion from an appropriately qualified health practitioner.

Cataract surgery is one of the most commonly performed surgical procedures in Australia. Although
a scalpel coming towards your eye can be a pretty daunting sight, cataract surgery is considered a
very safe, highly successful operation. However, as with any surgical procedure, there is a necessary
period of recovery from cataract surgery that comes after you leave the operating theatre.

Cataract Surgery

Ask around your friends or family members over the age of 60 and you’re likely to encounter at least
a few who have had cataract surgery in one or both eyes. Cataract surgery in Australia is a
reasonably straightforward operation and can be accessed either via the public or private health
system.

Prior to undergoing the operation, you will have a consultation and thorough eye examination with
the ophthalmologist. This is to assess the cataract and its effects on your vision, as well as ensure
there are no other eye diseases that may limit the success of the cataract surgery or cause further
complications during your cataract surgery recovery. During this consultation, the doctor can also
discuss with you what sort of intraocular lens implant will work best for your visual needs and
lifestyle. The intraocular lens will replace the cataract once it’s been extracted.

Cataract surgery is performed as a day procedure under local anaesthesia around the eye. A small
incision is created in the cornea (the front surface of the eye) to allow other instruments to access
the cataract sitting behind the coloured iris. The cataract is broken into smaller fragments that can
be suctioned out, and then the intraocular lens is implanted in its place and the corneal incision
allowed to self-seal.

After the procedure, your eye surgeon will give you a list of instructions on how to ensure your
recovery from cataract surgery is as smooth as possible.

What to Expect After Cataract Surgery?

Immediately after you’ve undergone the eye operation, your vision is likely to feel a little cloudy and
blurry due to some normal post-operative swelling in the cornea. Despite this, you may already feel
your vision is much better than before the procedure, depending on how advanced your cataract
was, to begin with. Colours may feel more vibrant and lights a little (or a lot) brighter. It’s normal to
experience some glare sensitivity for up to several months as your eyes readjust to all the light now
unhindered by the cataract opacity.

Some people will also experience some degree of temporary dry eye after cataract surgery. This is
also normal even if you didn’t have dry eyes before the surgery and is due to the disruption of the
corneal nerves during the procedure.

Your eye may feel a bit sore and red during the first few days of your cataract surgery recovery.
Many people will feel their vision is quite clear within a few days of the procedure but you can
expect that it may continue to change and stabilise over the following 4 to 6 weeks. After this time,
once your ophthalmologist has given you the all-clear, you may see your optometrist to update your
glasses as necessary.

How to Optimise Recovery from Cataract Surgery?

Cataract surgery recovery is typically uneventful but its course can vary from individual to individual,
depending on your body’s healing response. Also depending on your hobbies, work, and general
visual demands and expectations, you may feel your full recovery from cataract surgery is longer or
shorter compared to someone else’s.

It’s important to follow your eye doctor’s post-operative instructions to make your cataract surgery
recovery as smooth as possible. Here are some tips to help your eye heal after cataract surgery.

Protect your eye. After the operation, you’ll have a clear plastic shield taped over your eye. It’s likely
your eye doctor will recommend you keep this on the eye for a night or two to ensure you don’t
accidentally rub it while sleeping. After the shield comes off, it’s still important to keep the eye clean
and protected. This means avoiding dirty, dusty environments, or getting makeup and soaps in the
eye. You may be advised to avoid swimming pools, saunas, and spas for a week or two as these
water sources contain many pathogens that can cause an eye infection.
Use your prescription eye drops. Your eye specialist will give you a prescription for a few different eyedrop medications. These will include one or two anti-inflammatory drops and a preventative antibiotic drop. Your dosing regime may taper slowly over the following 3 to 4 weeks but it’s important not to suddenly stop the medications early even if your eye feels okay. You may also choose to use a preservative-free lubricant eye drop for comfort if your eye feels dry or gritty after the surgery.
Avoid strenuous activities. Like any surgical procedure, it’s a good idea to avoid physically exerting yourself after the operation. For a few weeks, you may be advised against intensive exercise or lifting heavy objects. Activities that may raise the pressure inside the eye, such as bending over or coughing, should also be avoided if possible.
If something doesn’t feel right, contact your eye specialist. Even if the operation itself was uneventful, there is always a slim chance of a complication occurring during the post-operative period. If you experience increasing pain or redness, if these symptoms are unusually prolonged, or if there is any discharge from the eye or decrease in vision, contact your ophthalmologist immediately.

Call us now on (03) 9070 5753 for a consultation.