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What to Expect Before, During, and After Cataract Surgery Treatment

Jan 14th 2013 at 8:25 PM

Ageing brings along eye changes that can adversely affect vision. A cataract is one of the most common eye conditions that occur among older adults. This is a clouding of the natural lens which gradually occurs over time. As the lens becomes cloudier, vision gets hazier. Without surgery, a cataract sufferer can in some cases totally lose their vision.

The old techniques of cataract surgery involved removing the entire lens in one piece using a large incision on the cornea, or the transparent front part of the eye. Maintaining the lens intact was critical so surgery was delayed until the cataract was far advanced or ripe for surgery. When the cataract is ripe, it becomes very hard and this makes it easier to remove the lens without breaking it into pieces. After surgery, the patient had to wear very thick glasses in order to see clearly.

The evolution of cataract surgery has allowed smaller incisions, availability of lens implants to replace the clouded lens, and quicker recovery period. There is no way to prevent or treat cataracts with medication. The only treatment is surgical removal.

Before cataract removal, one has to undergo tests a week or so before the surgery. The patient will be subjected to an ultrasound test to measure the size and shape of the eye. This will help in choosing the right type of lens implant to use. The lens will be chosen based on the length of the eye and the curvature of the cornea.

A complete medical history along with a physical examination will be done. It is important to inform the doctor of any prescription medication being taken. Some drugs can increase the risk of bleeding during surgery and the doctor may advise temporarily stopping the medications in preparation for cataract removal.

There are preoperative instructions to be followed. This includes fasting after midnight the day prior to the surgery, meaning no food or drink should be taken 12 hours prior to the procedure. Since it is an outpatient procedure, arrangements should be made with family regarding transportation after surgery.

During the cataract surgery, the eye surgeon will be accompanied by several other people who will assist him. The surgical team will wear scrubs, masks, and gloves to maintain a sterile environment. A nurse may start intravenous fluids and will be there to monitor the heart rate. A drape is usually placed so that only the eye to be operated on is visible. The most common cataract procedure is called phacoemulsification wherein the surgeon makes a very tiny incision in the front part of the eye. A needle thin probe that transmits ultrasound waves is inserted and this breaks up the cataract. The lens fragments are then suctioned out gently, after which an artificial lens is placed permanently. Most often, there is no need to close up the tiny incision as this will eventually heal by itself. The procedure takes less than 30 minutes for most patients. The eye surgeon will leave a bandage or shield over the operated eye.

After a short stay in the recovery area, the patient is ready to be driven home by a companion. Prescription eye drops need to be administered several times daily during the next few weeks. Sunglasses need to be worn to protect the eye against bright light. An eye shield is also worn while sleeping for a week after surgery. During the healing period, there can be a slight blurring of vision that can continue even after weeks following treatment. For at least a week after surgery, strenuous activities and heavy lifting should be avoided. Other things to avoid during this period are exposure to dust, heavy bending and exercise, and splashing water into the eyes. It is important to follow the correct

Before deciding on surgery, a thorough consultation with the eye surgeon should be done regarding the most suitable type of cataracts. For older patients with the beginnings of cataracts and coexisting refractive errors such as severe short sightedness or long sightedness, refractive lens exchange is another option.

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