Cataract removal
 
Having a cataract operation
 
Your specialist has recommended that the cataract affecting your eyesight is removed. This leaflet provides some information and advice about the procedure. However, you should always follow the instructions of your own specialist.

If you have any unanswered questions, please do not hesitate to ask your specialist or nurse for more information. It's natural to feel anxious, but often knowing what to expect can help.
 
What is a cataract operation?
 
This involves taking out the cloudy lens and replacing it with a clear, artificial implant.

The most common cataract operation is known as 'phacoemulsification'. The procedure usually takes 15-20 minutes and is most often performed as a day case, without the need for an overnight stay.

Cataracts typically occur in both eyes, but they are usually treated one at a time, to allow the first eye to recover.
 
About the operation
 
You will normally move from your room to the operating theatre on foot or in
a wheelchair, depending on your fitness.
 
Anaesthetic
 
Your operation usually takes place under a local anaesthetic. This means you will not feel any pain during the procedure, but you will be awake.

In some cases, anaesthetic drops are applied to the outer part of the eye. This causes the eye to sting briefly. In others, an injection into the eye or the area around the eye is used. This will be a sharp sensation that passes quickly.

During the operation you will be asked to lie on the operating table with your head held in a fixed position. You will not be able to see out of the eye that is being treated, but you will be aware of a light.

A nurse will stay with you to provide reassurance and to ensure that you feel as relaxed and comfortable as possible.

During the operation, the surgeon works with very fine instruments while looking at the eye through a microscope. The procedure involves a tiny incision at the edge of the cornea. This incision is often so small that no stitches are required.
 
Preparing for your operation
 
Once at the hospital, you may be asked about your medical history and any previous experience of hospital treatment. Your answers will help them in planning your care whilst you are in hospital.

Before you come into hospital, you will be asked to have a bath or shower and remove any make-up, nail varnish and bulky or sharp jewellery. Rings and earrings that you'd prefer not to remove can usually be covered with adhesive tape.

If you are having a local anaesthetic, there is no need to go without food and drink.
 
At the hospital
 
After your admission, a nurse will explain how you will be cared for during your treatment. Your surgeon may also visit you to explain the procedure in more detail. This is a good time to ask any outstanding questions about your treatment.

The nurse will help you get ready for theatre. This will include giving you some eye drops that dilate the pupil. These may temporarily affect your vision.
 
Consent
 
You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead. Many patients feel uncomfortable with the idea that a procedure may involve risks, but to make an informed choice, you need to know about the possible risks before you give consent.
 
What are the risks?
 
Having a cataract removed commonly performed and generally safe operation. However, all surgery does carry some element of risk. This can be divided into the risk of side-effects and the risk of complications.
 
Side-effects
 
These are the unwanted but mostly temporary effects of successful treatment. Examples of side-effects include an itchy or sticky eye and blurry vision for a few days after the operation. The eye may also ache, but this generally settles down within 10-14 days. It's also possible that the eyelid or eye will be bruised, but this will heal in the normal way.
 
Complications
 
This is when there are problems during or after the procedure. Most people are not affected. Possible complications of a cataract operation include tearing of the structure behind the lens. This may sometimes result in reduced vision. It's also possible for the cataract to be lost into the back of the eye, requiring a further operation.

The most common complication occurs when the lens casing, which is left in the eye to support the implant, becomes cloudy. This is called 'posterior capsular opacification' and results in reduced vision similar to a cataract. The condition begins gradually, about two years after the operation. A relatively simple laser treatment can be used to correct it.

Your risk of complications will depend on your general health and on any other eye conditions that you may have. You should ask your surgeon to explain how these risks apply to you.
 
After your operation
 
You will be taken back to your room or the day care ward where you can rest on a chair or bed. When you feel ready, you can drink and eat as normal and light refreshments will be provided. You should regain feeling in your eye within a few hours.

Once you are comfortable, you will be able to go home. You will need to be careful when moving around because it's hard to judge distances with one eye covered.
 
Going home
 
It is preferable to have someone to take you home and stay with you for the first 24 hours, especially if it's your only good eye that has been treated. On discharge, your nurse will give you some further information on caring for your eye and putting in the eye drops that your surgeon will prescribe for you.

It is important to continue using these as advised as they help to prevent infection and promote healing.

You will be given a 24-hour contact telephone number for the hospital and a follow-up appointment. Most surgeons see their patients again within week of the operation.
 
After you return home
 
Your surgeon will give advice that's specific to you. This may include how long to use eye drops and, if applicable, when you can resume driving.

In general, you should take it easy for the first two or three days after the operation. However, you will be able to perform your normal activities including moving around and bending down. Try not to touch or rub your eye.

As you must keep soap and shampoo out of your eyes, it's sensible to avoid washing your hair for the first few days.

In the first few weeks after the operation, avoid heavy lifting as this can increase
the pressure in the eye and could put a strain on the healing scar.

If you suffer more than mild pain, or you experience loss of vision or increasing redness of the eye, you should contact the hospital for advice.
 
Further information
 
Medem
http://www.medem.com/MedLB/sub_detaillb.cfm?parent_id=30&act=disp.cfm

MayoClinic.com
http://www.mayoclinic.com/invoke.cfm?id=DS00050&si=1017

American Society of Cataract and Refractive Surgery
http://www.ascrs.org/
 
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
 
 
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