When vision problems start to arise due to cataracts that can no longer be corrected with glasses or contact lenses, it may be time to consider cataract surgery. Despite cataract surgery being the most common eye procedure around the world, not everyone understands what happens during cataract surgery and what they can expect from this procedure.
The fear of the unknown can make you feel anxious and hesitant to proceed with a cataract operation, despite knowing that it will improve your sight. Keep reading to find out what happens during cataract surgery.
What Happens During Cataract Surgery: Steps of the Operation
Cataract surgery is usually a quick, painless, uncomplicated procedure. There are a few factors that can increase your risk of complications, but your ophthalmologist will be sure to discuss these with you ahead of time, including what you might be able to do to reduce your risk.
Modern cataract surgery falls into two techniques – phacoemulsification or femtosecond laser-assisted cataract surgery (FLACS). Regardless of which method your ophthalmologist prefers to use in your circumstances, you will have your eye dilated and numbed. The dilation is done with pharmaceutical eye drops that will widen the pupil, allowing the surgeon to access the cloudy lens behind it. In some cases, the eye drops will not be sufficient to widen the pupil enough, so the surgeon may need to use other interventions, such as pupil dilating instruments. The numbing of your eye is achieved with either topical anaesthetic eyedrops or with a local nerve block injection.
Once you’ve been made comfortable on the operating table, you’ll be asked to fixate on a target overhead. This will help to keep your eye steady as the surgeon works.
A small incision will be made at the edge of your cornea. If your surgeon is using conventional phacoemulsification, this will be performed with a handheld bladed instrument; if you’re undergoing a femtosecond laser-assisted operation, it will be using the femtosecond laser.
The next step is to open the membranous capsule that holds your cloudy lens and the cataract. This is performed with either another manual tool or the femtosecond laser, depending on which technique of cataract surgery your surgeon is using.
From here, the cataract needs to be fragmented into pieces small enough to be suctioned out from the eye. The phacoemulsification technique gets its name from this step, as the term describes the use of a high-frequency ultrasound probe that breaks the cataract into tiny pieces. However, proponents of the femtosecond laser technique prefer the FLACS method because the introduction of too much energy into the eye during the phacoemulsification step has the potential to damage some anatomical structures, cause increased inflammation, and result in some vision problems post-operatively. During femtosecond laser-assisted cataract surgery, the laser is first used to fragment the cataract, and then the ultrasound probe is applied later to finish the step. The use of the laser first means that less energy is required during phacoemulsification.
Once the cataract has been removed from the eye, a clear implant known as an intraocular lens will be inserted into the capsular bag. The cornea then tends to self-seal, though in a few cases, may require a stitch. The eye will then take 4 to 6 weeks to heal and settle before you are typically discharged from the care of your cataract surgeon, back to your local optometrist.
Both phacoemulsification and femtosecond-laser assisted cataract surgeries have pros and cons. Ultimately, both result in very similar visual outcomes and safety profiles.
What Happens During Cataract Surgery: The Experience
Cataract surgery can be a daunting experience for some, mainly due to the idea of an operation on the eyes. If you are particularly anxious, your ophthalmologist can offer you a light sedative. However, rarely is general anaesthesia used, as this can increase the rate of complications and prolong the cataract recovery process.
Rarely do patients report pain or distress during a cataract operation. Instead, you may experience the sensation of pressure around your eye during the surgery. If at any point during your surgery you feel that something is not quite right, it’s important to communicate this to your ophthalmologist so they are aware that you’re uncomfortable or the operation is not proceeding as anticipated.
You will still be able to perceive light and movement during the cataract surgery procedure but your vision will be quite blurry as the operation is taking place. Once the intraocular lens has been inserted, you may find your sight is relatively clear compared to your vision problems while you still had the cataract. However, if it’s not as clear as you were hoping or expecting, remember that it will take 4 to 6 weeks of recovery before it’s time to assess your final vision. During this recovery period, your sight may fluctuate, and your eye may feel slightly gritty, dry, and glare sensitive.
When is the Right Time for Cataract Surgery?
The timing of cataract surgery largely depends on how much your vision problems are bothering you. This point can vary widely from individual to individual. You may find it helpful to have a discussion with your optometrist or ophthalmologist about your hobbies, occupation, and other visual demands, to decide whether your sight has been impacted enough by your cataracts to warrant surgical intervention.
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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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