How is The Surgery Done?
Under an operating microscope, a small incision is made into the eye. Microsurgical instruments are used to fragment and suction the cloudy lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place. A plastic intraocular lens implant will be placed inside the eye to replace the natural lens that was removed. The lens implants are very small and come in a range of focusing powers. The power used in your eye is chosen based on your needs and some measurements of your eye. Most commonly a foldable lens implant is used, so it can be placed through a smaller incision. The implant unfolds inside the lens capsule and is held in place by spring-like projections, called haptics. The small incision is "self-sealing" and usually requires no stitches. It remains tightly closed by the natural outward pressure within the eye. This type of incision heals fast and provides a much more comfortable recuperation.

When is The laser Used?
Once removed, cataracts will not grow back. But some patients may experience clouding of a thin tissue, called the capsular bag that holds the intra-ocular lens. If this blurs your vision, a clear opening can be made painlessly in the center of the membrane with a laser, a procedure called a capsulotomy. Laser surgery is never part of the original cataract operation.

Before Surgery
Once you and your ophthalmologist have decided that you will have your cataract removed, a physical examination is necessary so that he or she may be alerted to any special medical risks. Ask your ophthalmologist if you should continue your usual medications. You may need some testing prior to surgery, such as blood work, EKG or chest x-ray. Your eye will be measured to determine the proper power of the intraocular lens that will be placed in your eye during surgery.

The Day of Surgery
Surgery is done on an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery. You will be asked to arrive at the surgery center about an hour prior to your procedure. Upon arrival for surgery, you will be given eye drops and meet the anesthesiologist who will help you through surgery. You will be given intravenous medication to make you more relaxed. A local anesthetic will make the operation painless. Though you may see light and movement, you will not be able to see the surgery while it is happening, and will not have to worry about keeping your eye open or closed. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. The procedure itself takes about 10 minutes. When the operation is over, the surgeon will place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home. You should plan to have someone else drive you home.

Following Surgery
You will need to use the eye drops as prescribed. Be careful not to rub or press on your eye. Use over-the-counter pain medicine if necessary. Avoid very strenuous activities for 1 week. Continue normal daily activities and moderate exercise. Ask your doctor when you can begin driving. Wear eyeglasses or shield for about 1 week.

Will Cataract Surgery Improve My Vision?
Over 98% of cataract surgeries improve vision, but a small number of patients may have problems. Infection, bleeding and swelling or detachment of the retina are some of the more serious complications that may affect your vision. Call your ophthalmologist immediately if you have any of the following symptoms after surgery:
   • Pain not relieved by non-prescription pain medication
   • Loss of vision
   • Nausea, vomiting or excessive coughing
   • Injury to the eye

Realistic Expectations
Even if the surgery itself is successful, the eye may still not see as well as you would like. Other problems with the eye, such as macular degeneration (aging of the retina), glaucoma and diabetic damage may limit vision after surgery. Even with such problems, cataract surgery may still be worthwhile. If the eye is healthy, the chances are excellent that you will have good vision following removal of your cataract.
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Copyright © 2009 Robert C. Arffa, M.D., 1370 Washington Pike, Bridgeville, PA 15017