Proceeding with cataract surgery

On the day of surgery

Cataract surgery is almost always done as a day procedure. It is unnecessary to stay overnight but you will need to put aside half a day. Prior to the procedure you will meet with an anaesthetist, who will perform a full assessment of your general health and discuss issues relating to the anaesthetic.

Anaesthesia

Cataract surgery is done under local anaesthetic. The anaesthetist is present throughout the procedure to monitor your well-being.

You will lie flat for approximately 20 minutes and may have some sensation of the procedure, although this is not painful. It is important to understand that there is often some sensation since some patients have the expectation they will experience none. You will feel the Dr Connell resting his hand on your forehead and you will be able to communicate fully with him.

Many patients have minimal recollection of the procedure and are pleasantly surprised by how comfortable they felt.

After the surgery

At the completion of the procedure you will be given some food, a cup of tea or coffee and allowed to travel home with your eye covered with a clear protective shield. Vision in the other eye will be unchanged but you will need someone to accompany you.

It is normal to have a foreign-body sensation, similar to sand in the eye. The eye will also water and tears will roll down the face. Paracetamol should be taken if there is any discomfort.

Drops are typically instilled for four weeks, initially four times per day and then reduced.

The power of the eye is altered by the procedure and the new lens. Vision is typically stable within four weeks of the procedure.

Recovery

Follow-up arrangements will be made clear prior to surgery.

Most patients recover relatively quickly and are able to resume normal activities within a few days, although this varies on a patient’s individual circumstances. 

Patients will ultimately consult their optometrist for any glasses they require and ongoing care thereafter.

Should I have one or both eyes done?

Most patients will have the surgery on one eye, followed a few weeks later by the second.

In some circumstances, the second eye may be cataract-free or the cataract may be small and not visually significant. In such cases the surgery is postponed.

Posterior capsulotomy

After removal of cataract, small fibres of cortex are removed from the internal part of the capsular bag. The capsular bag lining is very thin (approximately 10µm thick, or one hundredth of a millimetre) and transparent. On a microscopic level, small numbers of fibres are left resulting in very small opacities on the capsule which, in most cases, are of no visual significance. In many cases they disappear in the months following surgery. 

In some patients these fibres are visually significant and impact on their day-to-day vision. The patient might elect to have these removed with a relatively simple procedure performed in the clinic called a YAG capsulotomy

After instillation of local anaesthetic drops, a laser breaks down the capsule, removing any opacities obscuring the visual axis. 

If indicated, this is typically done any time beyond six months after the procedure.