What You Should Know About the Cataract Surgery Procedure?

Around the world, every single day, approximately 60 000 eyes undergo a cataract surgery
procedure. This makes cataract surgery among the very top reasons for surgery in Australia, if not
the world. As cataracts are due to normal ageing, most people in our ageing population can assume
they will need cataract surgery at some point in the future. However, understanding exactly what is
involved during the cataract surgery procedure can leave some in the dark.

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.

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.

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