Although people with early cataracts can improve their vision by using eyeglasses, magnifying lenses, or stronger lighting, the only way to help people with more advanced cataracts is surgery. When you consider whether to have surgery, it will depend on how much the cataracts affect your vision. For example, if you have difficulty driving at night due to glare symptoms from oncoming headlights, then it may be time to consider cataract surgery.
Cataract surgery involves removing the clouded lens and then replacing it with an intraocular lens implant inserted during surgery.
What are the different types of cataract surgery?
There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:
- Phacoemulsification: A small (2.4 mm) incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your surgeon inserts a tiny ultrasound instrument that breaks up the lens so that it can be removed by suction. Modern cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.” This is also known as “no patch, no stitch cataract surgery”. Dr. Feinerman performs phacoemulsification (modern cataract surgery).
- Extracapsular surgery: This is the “old fashioned” type of cataract surgery, which is generally not performed by Dr. Feinerman. The surgeon has to make a longer incision (about 12 mm long) on the side of the cornea to remove the cloudy core of the lens in one piece. The rest of the lens is removed by suction.
After the lens is removed, it is replaced by an intraocular lens (IOL). An IOL is the lens that replaces your natural lens during cataract surgery. Currently, almost all cataract patients have intraocular lenses placed at the time of surgery. The type of lens can be chosen by the doctor in consultation with the patient. A patient may choose either a standard monofocal lens for distance vision only, or upgrade to a premium IOL for both near and far vision.
For example, If one elects to implant a premium IOL such as the crystalens®, or ReSTOR®, then the patient could choose to have both good distance and good near vision with less dependency on glasses or contact lenses. Dr. Feinerman will help you decide which lens technology works best for your eyes.
What happens before surgery?
At your initial consultation, your doctor will perform some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right IOL for your specific eye.
As with most surgeries, you will be asked not to eat or drink anything 6 hours before your cataract surgery.
What happens during surgery?
At the surgery center drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed. The operation usually lasts less than 20 minutes and involves minimal discomfort. Many people choose to stay awake during surgery. Others may want to be put under “twilight” sedation for a short time. All patients are given eyedrops to numb the eye. It’s truly amazing, but the eyedrops alone are usually sufficient to allow for the surgery to be performed with minimal to no discomfort.
Cataract surgery is generally safe, but it carries a small risk of infection, inflammation and bleeding. Cataract surgery also slightly increases the risk of retinal detachment. Thus, if you notice any redness, pain or decreased vision after cataract surgery you should contact your surgeon.
What happens after surgery?
After the operation, a clear plastic shield may be placed over your eye. You can usually go home about 30 minutes after the procedure; but since a sedative is given, someone else will need to drive.
Mild discomfort is normal after cataract surgery. Some tearing is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, the mild discomfort should disappear.
For a few days after surgery, your surgeon will ask you to use eyedrops to help healing and decrease the risk of infection. Ask your surgeon how to use your eye drops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.
When you are home, try not to pick up objects heavier than 20 pounds for a few days. Avoid swimming for 2 weeks. You can shower (but don’t put your face into the jets), walk, climb stairs, and do light household chores.
In most cases, healing will be complete within a few weeks and you can resume all of your normal activities. Your doctor will schedule follow up exams to check on your progress.
When will my vision be normal again?
You can return quickly to many everyday activities, but in some instances your vision might be somewhat blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.
You may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you should become used to the improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.
Choosing Your Cataract Surgeon
Selecting an Orange County cataract surgeon can be difficult if you are not properly educated about cataracts, cataract surgery and advancements in new technology. We hope our website has provided some great insight on cataract surgery. Although cataract surgery is one of the most performed medical procedures it is highly suggested that you carefully select an Orange County surgeon with a high level of experience and who is using the latest techniques and technology.