Modern day cataract surgery is a life-changing procedure.
It is performed as an outpatient procedure. On the day of surgery, the patient will show up 1–2 hours before the surgery in order to get ready. The nurse will administer eye drops, check blood pressure, and possibly start an IV. Relaxing medicine will be administered so that the patient will be as relaxed as they want to be, but not unconscious. This type of anesthesia is often referred to as “twilight” anesthesia.
The patient is then brought to the operating suite where the cataract is removed and the new lens is implanted. During surgery, the patient will experience swirling lights of colors and patterns. They will also hear the hum of the machines in the room, as well as the voice of the surgeon letting them know what to expect next. The procedure is entirely painless. Many people report enjoying the light show during the surgery. Sometimes, due to the anesthesia, patients do not remember the surgery at all.
Some patients will elect to have advanced technology used in their surgery called refractive cataract surgery. Intraoperative technology analyzes the eye once the cataract is removed; this allows the surgeon to precisely pick the power of the lens that must be implanted in order for the patient to see their very best without glasses following cataract surgery.
The incisions made during cataract surgery are small and created in such a way that they are self-sealing. For that reason, sutures are usually not necessary following cataract surgery.
Laser Cataract Surgery
Laser-assisted cataract removal is a tool that is used when patients want to have a refractive outcome from their cataract surgery. That means that they would like to no longer need glasses or contact lenses following cataract surgery. When this is the case, laser-assisted cataract removal may be performed.
This technology utilizes a femtosecond laser to perform some of the crucial steps of cataract surgery, such as opening the lens capsule and fragmenting the lens nucleus, which are traditionally performed using a handheld surgical blade. The laser is also able to create precise relaxing incisions in the cornea, which have the effect of reducing astigmatism.
Laser cataract surgery takes an already safe and precise procedure and makes it more accurate, more predictable, and better than ever before.
Recovering From Cataract Surgery
Recovery from cataract surgery is relatively quick. The average patient achieves drastically better vision within the first 24 hours of the procedure. Mild corneal swelling or inflammation is normal. This may result in hazy vision for the first few days following cataract surgery. As the eye heals, the vision may fluctuate slightly for the first few weeks, after which the vision stabilizes.
Medicated eye drops are used to prevent infection or inflammation. Eye drops are taken four times per day for the first week and then slowly weaned over the next few weeks. For 14 days following cataract surgery, the patient should abstain from heavy lifting, straining, swimming, and eye rubbing. Additionally, eye shields should be worn after surgery to prevent accidentally rubbing or bumping the eyes.
Cost of Cataract Surgery
In patients that have undergone previous laser vision correction surgery such as LASIK, SMILE, PRK, or RK, cataract surgery is still safe and effective. It is important to mention to your surgeon if you have had laser vision correction surgery in the past. If the surgeon is unaware of a history of refractive surgery, it may skew the lens calculations and require the patient to wear strong eye glasses following cataract surgery (or have a second procedure to improve results). When the surgeon is made aware of your surgical history, they will be able to account for the changes in the lens calculations and accurately predict the lens implant that is required.
A history of refractive surgery adds complexity to the surgery planning. Additional diagnostic tests and measurements must be calculated in order to provide the best vision without glasses following cataract surgery. After viewing your test results, your surgeon will recommend the best lens options for your desired outcomethe best lens options for your desired outcome.
Risks of Cataract Surgery
The most common risks following cataract surgery are swelling and inflammation. Most people experience corneal swelling and inflammation to some degree. Usually it clears up within the first few days with healing and use of medicated eye drops. If these issues persist, they could make the vision blurry for an extended period of time and require additional medications. In severe cases, corneal edema could require an additional surgery to clear up the vision.
Infection is a rare but important risk factor following cataract surgery. Medicated eye drops are used to prevent infection, but if it were to occur, infection could result in decreased vision and/or the need for additional medications, procedures, and surgeries.
Retinal detachment may occur in <0.2% of patients following cataract surgery. People who are at higher risk of developing a retinal detachment following cataract surgery are those who are very nearsighted or who have a complex cataract surgery. Your surgeon will review your relative risk of retinal detachment with you prior to your surgery. Symptoms of retinal detachment may include seeing flashing lights, a shower of new floaters (which may look like a swarm of bees or gnats), or a curtain blocking the vision. If any of these symptoms occur, it is important to contact your surgeon immediately.
Retinal swelling, also known as cystoid macular edema, is an infrequent side effect of cataract surgery which can delay the improvement of vision. Retinal swelling is more common in patients who have diabetes, inflammatory eye disease, or a history of retinal issues such as epiretinal membrane. If retinal swelling occurs, a prolonged course of eye drops or additional procedures may be required to help the body resolve the swelling.
A rare complication of cataract surgery would involve the lens implant being dislocated from its intended position. This can occur in eyes with weak zonules (the fibers which hold the lens capsule in place). Weak zonules can be caused by a history of eye trauma or, in some cases, genetic predisposition. Lens dislocation is also possible following complex cataract surgery. If a lens dislocation were significant, it may diminish the vision and require additional surgery.
Cataract Surgery FAQ
During the procedure, patients do not see the surgeon, the surgeon's hands/instruments, or anything else in the room. What patients see during the procedure is swirling lights of different patterns and colors. Interestingly, everyone sees something slightly different.
Not at all! The eye will be entirely numb through the use of numbing eye drops.
Most patients report enjoying the procedure. There will be medication administered to help with relaxation. Patients are instructed that their job is to relax and enjoy the show.
Visual recovery occurs most rapidly in the first 24 hours, then slowly over the next few weeks. Physical recovery takes two weeks. During that time, patients should avoid heavy lifting, straining, eye rubbing, and swimming.
For detailed information, see our article all about intraocular lens (IOL) implants.
When a patient is using medical insurance, they are required to have the surgery done on different days for each eye. When the patient is paying for their surgery out of pocket, they may elect to have the surgery done on each eye on the same day.
5 Reasons You Should Choose Heart of Texas Eye Institute for Cataract Eye Surgery
- Personalized Care — Our surgeons spend time getting to know every patient and their specific needs before planning vision correction surgery. Every person is unique, and therefore every surgery plan is unique. We ensure that patients receive their desired outcomes by very clearly discussing their goals and what to expect following laser vision correction surgery.
- Customer Service — Every step in your journey to better vision is given deep consideration. We offer convenient scheduling with our online self-scheduler, continuous access to your personal surgery counselor, and efficient use of your time in our modern, beautiful office. These are just a few of the touch points that will make your experience at Heart of Texas Eye Institute pleasant and enjoyable.
- Technology — We are dedicated to providing the very best and most up to date diagnostic and treatment options. This allows us to customize the best treatment plan to meet each specific patient’s needs. For this reason, we are the first practice in central Texas to provide SMILE, which we offer along with every other modern vision correction option, including blade-free, all-laser LASIK, PRK, ICL, and RLE.
- Experience — Both of our board-certified ophthalmologists have combined experience of over 100,000 procedures, fellowship training in cornea and refractive surgery, and are industry leaders in refractive surgery.
- Flexible — We accept many forms of payment, including cash, check, and credit. We offer great financing options through Alphaeon Credit and Care Credit. Furthermore, you can use your Flex Spending Account (FSA) for laser vision correction!