Cataracts are a common cause of blurred vision. When a cataract is visually significant it can affect reading, watching television and driving, especially at night. When cataracts are the cause of the reduced vision, surgery is often advised, as vision usually continues to deteriorate as cataracts progress.
The surgical treatment of cataracts involves a day surgery operation performed with local anaesthesia. The operation or phacoemulsification (as it is called) removes the cataract through a very small incision in the eye. Once the cataracts is removed, an intraocular lens (IOL) is inserted through this small incision. The IOL unfolds inside the eye into the correct position. The incision then seals itself or is closed with one or two sutures which are usually removed postoperatively after a few weeks. Following surgery, the eye will be padded overnight. You will be reviewed later the same day or the following day and pad will be removed. The plastic shield should be worn at night for the first week following surgery to prevent any trauma to the eye. You will be required to use eye drops following surgery. The eye drops are usually required for one month.
It is common to have double vision for the first 24 hours after surgery. The vision is often blurred for several days after surgery (sometimes longer). It is common for the eye to feel uncomfortable or gritty in the first week, and this can continue for several weeks after surgery. Rarely, severe pain can occur after surgery, and this may indicate a complication such as elevated intraocular pressure (IOP) or an infection. You need to contact the hospital or practice if this occurs.
Following your eye surgery you should keep the eye clean and dry. Showering and washing hair is fine the day after surgery, however you should avoid getting water in the eye for the first two weeks. You should also avoid prolonged coughing, straining, bending or heavy lifting for one month following surgery. Swimming should be avoided for two months following surgery. You may walk about and perform your usual daily activities after a few days as long as care and hygiene is maintained.
CONCERNS AND EXPECTATIONS
Post-operatively, you can expect a change in your refraction (optical strength of your eye). This may affect your vision looking through your old glasses. Please ask your doctor about your likely visual results both with and without spectacles before your surgery. Many patients will have a reduced need for spectacles for looking in the distance. Reading may still require spectacles, even if a multifocal IOL has been inserted in your eye. Rarely, unexpected refractive outcomes can occur, which sometimes require further intervention.
Many patients experience black spots or floaters in their vision after surgery. These are usually not significant however mention them to your doctor on your next visit should you experience them.
Haloes, glare and distortion of lights usually occur if multifocal IOLs are inserted. This is a result of the designs of these IOLs. These symptoms usually improve, however not always. The benefit of these IOLs (improved near vision without spectacles), is also a result of the IOL design. Sometimes regular (monofocal) IOLs can also cause these symptoms. Other visual phenomena, such as dark crescents in the peripheral vision, can occur. Again, these are the result of IOL design, and usually improve over time.
Colours are brighter and contrast is enhanced usually after surgery. You may find you are more sensitive to sunlight after surgery. This is normal. Wearing good quality sunglasses will help.
Some people notice grittiness as the wound heals (as mentioned above). This settles with time. In some patients, the posterior capsule thickens with time causing clouding and a reduction of vision. This requires treatment by YAG laser. The laser procedure is non- painful and gives an almost immediate improvement in vision.
For more information, please see “What to expect after cataract surgery” on this website.