What is cataract surgery?

A cataract is an eye condition where the natural lens inside your eye becomes cloudy and
reduces the quality of your vision. Cataract surgery is one of the commonest
operations performed in the UK with over 400,000 performed every year. Surgery is
performed using microscopic instruments through tiny keyholes made through the
cornea. The cornea is the clear window at the front of the eye just in front
the coloured iris. These keyholes are usually self-sealing (no stitches
required).

Once the natural lens is removed an intraocular lens implant is usually inserted to
allow the eye to focus. The choice of implant is discussed before your
operation (there is another information sheet available about selecting lens
implants).

What is it like to have cataract surgery?

Surgery is usually performed as a daycase - this means you come and go the same day without
an overnight stay. Surgery usually takes between 10-20 minutes. It can be
longer, particularly if there has been previous eye problems, injury or
surgery. On the day of surgery, you arrive at the admission ward and have eye drops to enlarge your
pupils. A series of health and safety checks are performed. You will have a
mark placed above your eye confirming the operation side and you will sign a
consent form as the final agreement to proceed with surgery.

After these checks you are taken to the treatment room for the anaesthetic (making the
eye comfortable) and then the operation takes place. During the operation you
are lying on a bed with a sterile tent covering your face. The tent is air
conditioned and sticks to the eyelids of the eye having surgery. You cannot
really see or feel much during surgery. Some people describe seeing coloured
lights usually towards the end of surgery as the lens implant is positioned. Afterwards
you return to the ward to prepare to go home. You will be given eye drops to
take home. You may have a pad covering the eye, which you can remove at home
the following morning.

What anaesthetic will I have?

This is discussed in clinic before surgery. Surgery is frequently performed ‘with local anaesthetic’. This involves having the eyeball numbed with an anaesthetic given as eye drops or an injection around the eyelid. Sometimes, in addition to local anaesthetic a sedative can be given to help relax you. In this situation, you are still awake and can talk and hear voices but you might
not have a clear memory of the operation.

Surgery can be performed whilst asleep, known as ‘general anaesthetic’- this is subject to
additional health checks. With general anaesthetic you must not eat 6 hours
before surgery and you can only drink clear fluids (no milky drinks) after this
time. You cannot eat or drink 2 hours before surgery when having general
anaesthetic

Will I have stitches after my operation?

It is rare to use stitches during routine cataract surgery. If stitches are used they are
typically removed in the outpatient clinic 2 or 3 months after surgery. This is
performed with numbing eye drops and is usually quick and painless.

Complications from cataract surgery

Modern cataract surgery, particularly in eyes with no other health problems, offers
good chances of improving vision. Recovery is often in the order of days rather
than weeks. Some eyes become more inflamed than expected and this delays recovery and requires a
prolonged course of eye drops for up to 3 months, but rarely longer. Some eyes
have previously undetected eye problems which become apparent once the cataract
has been removed. This can prevent full restoration of vision.

Serious complications are thankfully rare. The need for further surgery to manage
complications (such as retinal detachment, corneal decompensation, bleeding or
infection) occurs around 1 in 300 cases. Blindness as a complication of surgery
occurs around 1 in 1000 cases.

Recovery from cataract surgery

The eye can recover fast from cataract surgery with improvement in vision usually in the
first few days. It may take the brain longer to adjust to the new focus in the
eye. When cataracts are present in both eyes, it is not unusual for people to
have surgery on both eyes a few weeks apart. Often glasses will be required for reading or distance (depending on the lens implant selected). It is normal to get glasses fitted by your local optician 4 weeks after surgery.