What happens at a pre op appointment for cataract surgery

What to Expect During Cataract Surgery

Cataract surgery consists of the replacement of a clouded lens with an intraocular lens (IOL). We use a local anesthetic to numb your eye so your pain level should be minimal during the procedure. You’ll be awake but sleepy during surgery and you won’t be able to see what’s happening in your eye.

During surgery, you lie on your back and look at a bright light and receive local anesthesia from our board certified anesthesiologists. We firstart by creating a tiny incision in your eye near the edge of your cornea. Then we emulsify the cataract using ultrasound. We then remove the emulsified material of your old lens through the tiny incision and install your new, clear intraocular lens. This part of the procedure takes about 15 minutes, but you’ll be in the office longer to prepare your eye for surgery and afterward for a brief recovery period. Our patients worry about seeing things or feeling unpleasant sensations. Almost all patients do not feel discomfort or even remember very much about cataract surgery.

Is Cataract Surgery Safe?

Cataract surgery is one of the most common procedures conducted. Each year, more than 4 million Americans and 20 million people worldwide undergo surgery to remove cataracts. These surgeries are among the safest in modern medicine. They allow millions of patients to regain a higher quality of life thanks to clearer vision. The cataract specialists at SightMD strive to give our patients the very best results in every clinical setting.

In routine cataract surgery, our board-certified eye surgeons perform cataract surgery through microscopic incisions using eye drops and IV sedation to numb the surface of the eye. Our patients stay in their own clothes and return home a short time after completion of the cataract surgery. We do not routinely use needles, stitches or even an eye patch following surgery.

Recovery from Cataract Surgery

Once your new IOL is in place, it becomes a permanent part of your eye and provides improved vision for the long term. After cataract surgery, you won’t be able to drive right away, so be sure to arrange for a friend or family member to take you home. Since doctors perform this one eye at a time, it may take several weeks before your eyes feel normal after the procedure. Mild discomfort, including itchiness or slight but persistent pain, is possible following cataract surgery. Additionally, there may be some degree of fluid discharge, and the eyes will be sensitive to light and touch for a couple of days after treatment. To reduce such discomfort and promote healing, medicating eye drops are prescribed. You may experience distorted vision as your eyes get used to the artificial lens put in the eye. It may take up to a month before your eyes are completely adjusted.

During recovery, it is important to follow all instructions given to you by your cataract surgeon. Letting your eyes fully heal is the most important step when you are recovering from cataract surgery. You should do your best to keep water out of your eyes. When showering, do your best to keep water out of your eyes by keeping them closed.

Can I Exercise After Surgery?

You should also avoid any strenuous activities that may increase your eye pressure. This includes intense exercising, bending over at the waist, and any contact sports, at least for the first week. Your doctor at SightMD will give you a full list of instructions on how best to begin the recovery process after cataract surgery.

Complications After Surgery

Complications related to cataract surgery include:

· infection

· swelling

· loss of vision

· double vision

· pressure on the eye

These are rare and can be avoided through expert care and precise planning. Patients can return to normal activities within a couple of days; complete healing may require up to four weeks.

Better Vision After Cataract Surgery

If you suffer from a cataract (or two), and require surgery to correct the condition, you likely are experiencing compromised vision. Through cataract surgery and the use of intraocular lenses, your vision can be dramatically improved. Because a cataract is a clouding of the lens, vision can’t be corrected using eyeglasses or contact lenses. Cataract surgery with IOLs restores the clarity of vision lost through the passage of time. The impact such improved vision can have on a person’s life is hard to qualify.

Contact SightMD today to schedule an appointment with one of our doctors to discuss your vision health at one of our convenient locations!

Overview

Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens. Normally, the lens of your eye is clear. A cataract causes the lens to become cloudy, which eventually affects your vision.

Cataract surgery is performed by an eye doctor (ophthalmologist) on an outpatient basis, which means you don't have to stay in the hospital after the surgery. Cataract surgery is very common and is generally a safe procedure.

Why it's done

Cataract surgery is performed to treat cataracts. Cataracts can cause blurry vision and increase the glare from lights. If a cataract makes it difficult for you to carry out your normal activities, your doctor may suggest cataract surgery.

When a cataract interferes with the treatment of another eye problem, cataract surgery may be recommended. For example, doctors may recommend cataract surgery if a cataract makes it difficult for your eye doctor to examine the back of your eye to monitor or treat other eye problems, such as age-related macular degeneration or diabetic retinopathy.

In most cases, waiting to have cataract surgery won't harm your eye, so you have time to consider your options. If your vision is still quite good, you may not need cataract surgery for many years, if ever.

When considering cataract surgery, keep these questions in mind:

Can you see to safely do your job and to drive?
Do you have problems reading or watching television?
Is it difficult to cook, shop, do yardwork, climb stairs or take medications?
Do vision problems affect your level of independence?
Do bright lights make it more difficult to see?

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Risks

Complications after cataract surgery are uncommon, and most can be treated successfully.

Cataract surgery risks include:

Inflammation
Infection
Bleeding
Swelling
Drooping eyelid
Dislocation of artificial lens
Retinal detachment
Glaucoma
Secondary cataract
Loss of vision

Your risk of complications is greater if you have another eye disease or a serious medical condition. Occasionally, cataract surgery fails to improve vision because of underlying eye damage from other conditions, such as glaucoma or macular degeneration. If possible, it may be beneficial to evaluate and treat other eye problems before making the decision to have cataract surgery.

How you prepare

Food and medications

You may be instructed not to eat or drink anything 12 hours before cataract surgery. Your doctor may also advise you to temporarily stop taking any medication that could increase your risk of bleeding during the procedure. Let your doctor know if you take any medications for prostate problems, as some of these drugs can interfere with cataract surgery.

Antibiotic eyedrops may be prescribed for use one or two days before the surgery.

Other precautions

Normally you can go home on the same day as your surgery, but you won't be able to drive, so arrange for a ride home. Also arrange for help around home, if necessary, because your doctor may limit activities, such as bending and lifting, for about a week after your surgery.

What you can expect

Before the procedure

A week or so before your surgery, your doctor performs a painless ultrasound test to measure the size and shape of your eye. This helps determine the right type of lens implant (intraocular lens, or IOL).

Nearly everyone who has cataract surgery will be given IOLs. These lenses improve your vision by focusing light on the back of your eye. You won't be able to see or feel the lens. It requires no care and becomes a permanent part of your eye.

A variety of IOLs with different features are available. Before surgery, you and your eye doctor will discuss which type of IOL might work best for you and your lifestyle. Cost may also be a factor, as insurance companies may not pay for all types of lenses.

IOLs are made of plastic, acrylic or silicone. Some IOLs block ultraviolet light. Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close.

However, many IOLs are flexible, allowing a smaller incision that requires few or no stitches. The surgeon folds this type of lens and inserts it into the empty capsule where the natural lens used to be. Once inside the eye, the folded IOL unfolds, filling the empty capsule.

Some of the types of lenses available include:

Fixed-focus monofocal. This type of lens has a single focus strength for distance vision. Reading will generally require the use of reading glasses.
Accommodating-focus monofocal. Although these lenses only have a single focusing strength, they can respond to eye muscle movements and shift focus to near or distant objects.
Multifocal. These lenses are similar to glasses with bifocal or progressive lenses. Different areas of the lens have different focusing strengths, allowing for near, medium and far vision.
Astigmatism correction (toric). If you have a significant astigmatism, a toric lens can help correct your vision.

Discuss the benefits and risks of the different types of IOLs with your eye surgeon to determine what's best for you.

During the procedure

Cataract surgery, usually an outpatient procedure, takes an hour or less to perform.

First, your doctor will place eyedrops in your eye to dilate your pupil. You'll receive local anesthetics to numb the area, and you may be given a sedative to help you relax. If you're given a sedative, you may remain awake, but groggy, during surgery.

During cataract surgery, the clouded lens is removed, and a clear artificial lens is usually implanted. In some cases, however, a cataract may be removed without implanting an artificial lens.

Surgical methods used to remove cataracts include:

Using an ultrasound probe to break up the lens for removal. During a procedure called phacoemulsification (fak-o-e-mul-sih-fih-KAY-shun), your surgeon makes a tiny incision in the front of your eye (cornea) and inserts a needle-thin probe into the lens substance where the cataract has formed.
Your surgeon then uses the probe, which transmits ultrasound waves, to break up (emulsify) the cataract and suction out the fragments. The very back of your lens (the lens capsule) is left intact to serve as a place for the artificial lens to rest. Stitches may be used to close the tiny incision in your cornea at the completion of the procedure.
Making an incision in the eye and removing the lens in one piece. A less frequently used procedure called extracapsular cataract extraction requires a larger incision than that used for phacoemulsification. Through this larger incision your surgeon uses surgical tools to remove the front capsule of the lens and the cloudy lens comprising the cataract. The very back capsule of your lens is left in place to serve as a place for the artificial lens to rest.
This procedure may be performed if you have certain eye complications. With the larger incision, stitches are required.

Once the cataract has been removed by either phacoemulsification or extracapsular extraction, the artificial lens is implanted into the empty lens capsule.

After the procedure

After cataract surgery, expect your vision to begin improving within a few days. Your vision may be blurry at first as your eye heals and adjusts.

Colors may seem brighter after your surgery because you are looking through a new, clear lens. A cataract is usually yellow- or brown-tinted before surgery, muting the look of colors.

You'll usually see your eye doctor a day or two after your surgery, the following week, and then again after about a month to monitor healing.

It's normal to feel itching and mild discomfort for a couple of days after surgery. Avoid rubbing or pushing on your eye.

Your doctor may ask you to wear an eye patch or protective shield the day of surgery. Your doctor may also recommend wearing the eye patch for a few days after your surgery and the protective shield when you sleep during the recovery period.

Your doctor may prescribe eyedrops or other medication to prevent infection, reduce inflammation and control eye pressure. Sometimes, these medications can be injected into the eye at the time of surgery.

After a couple of days, most of the discomfort should disappear. Often, complete healing occurs within eight weeks.

Contact your doctor immediately if you experience any of the following:

Vision loss
Pain that persists despite the use of over-the-counter pain medications
Increased eye redness
Eyelid swelling
Light flashes or multiple new spots (floaters) in front of your eye

Most people need glasses, at least some of the time, after cataract surgery. Your doctor will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses. This is usually between one and three months after surgery.

If you have cataracts in both eyes, your doctor usually schedules the second surgery after the first eye has healed.

Results

Cataract surgery successfully restores vision in the majority of people who have the procedure.

People who've had cataract surgery may develop a secondary cataract. The medical term for this common complication is known as posterior capsule opacification (PCO). This happens when the back of the lens capsule — the part of the lens that wasn't removed during surgery and that now supports the lens implant — becomes cloudy and impairs your vision.

PCO is treated with a painless, five-minute outpatient procedure called yttrium-aluminum-garnet (YAG) laser capsulotomy. In YAG laser capsulotomy, a laser beam is used to make a small opening in the clouded capsule to provide a clear path through which the light can pass.

After the procedure, you usually stay in the doctor's office for about an hour to make sure your eye pressure doesn't rise. Other complications are rare but can include increased eye pressure and retinal detachment.

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What is involved in pre op for cataract surgery?

Preoperative medical testing may include screening electrocardiography, chest radiography, complete blood counts, and serum measurements. For a minor surgery such as cataract surgery, it is unclear which specific laboratory or other tests are necessary.

Do you need a pre op before cataract surgery?

Before the cataract surgery, you will need to undergo a detailed pre-operative examination. This examination si completely painless but you will not be able to drive a car after it, since special eye drops will dilate your pupils.

How long is pre op before cataract surgery?

(The maximum acceptable window for pre-operative Medical Evaluation prior to surgery is 6 months). The anesthesiologist at the ASC will examine the patient immediately prior to the surgery to evaluate the risk of anesthesia and of the procedure for the patient.

What is included in a pre op exam?

Your preoperative exam will: Review your medical, surgical and family history. Include a physical exam. If necessary, complete additional preoperative testing following your exam, including blood tests, urine tests, X-rays or an EKG.