ALL YOU NEED TO ABOUT CATARACTS AND CATARACT SURGERY

Inside our eyes, we have a natural lens. With age,this lens becomes cloudy and vision starts to decline. Things look blurry, hazy or less colourful with a cataract.

The only way to remove a cataract currently is with surgery. Your ophthalmologist will recommend removing a cataract when it keeps you from doing things you want or need to do. 

During cataract surgery, your cloudy natural lens is removed and replaced with a clear artificial lens called an intraocular lens. Once a cataract is removed, it will never grow or come back again. The artificial lens remains in your eye for the rest of your life. 

Cataract surgery is performed at the hospital in the operating room and takes anywhere from 10 to 20 minutes.  You will NOT be asleep during the procedure but you may be given a sedative prior to help you relax if you wish. You will have drops or gels dropped on your eye so you do not feel any pain during surgery but you may still occasionally feel some pressure sensation. During cataract surgery, the clouded lens is removed using an ultrasound machine (NOT a laser), and a clear artificial lens is implanted.  There are small incisions made in your eye that will take a week to heal but NO stitches. 

The most complication after cataract surgery is dry eye symptoms that can last up to 6 months post surgery. Symptoms may include burning,soreness, light sensitivity and foreign body sensations. Please use artificial tears 3-4 times daily to decrease symptoms.

Fortunately, the risks associated with cataract surgery are less than 1% but they do exist and can be associated with vision loss. They are: 

· Inflammation

· Infection

· Bleeding

· Swelling of the cornea or retina

· Drooping eyelid

· Dislocation of artificial lens

· Retinal detachment

· Glaucoma

· 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 severe dry eye, retinal disease, glaucoma or macular degeneration. 

Special measurements of your eye need to be taken to determine the correct power of the lens implant required for your eye. This will be arranged at the office and can be done with either laser or ultrasound.

What is ocular biometry?

Ocular biometry involves anatomical measurements of the eye. These  measurements are crucial for the selection of the correct IOL power in order to achieve the desired refractive outcome after cataract surgery. Therefore, ocular biometry is an essential step before cataract surgery. There are currently two procedures available: 

1. Ultrasound: Covered by OHIP 

-Invasive Procedure that requires direct contact with the cornea and the use of anesthetics

-Less accurate than laser

2. Optical (laser) biometry: Not covered by OHIP and costs $500 

-Non invasive and no contact with eye

-More accurate measurements

MEDICAL HISTORY AND PHYSICAL FORMS: Please ensure that your family doctor forwards us your complete Patient Profile to our office. It must be received at the surgical centre by email/fax/drop off 2 weeks prior to your surgery.

MEDICATION EYE DROPS: Start your drops 2 days before your surgery.

FOOD & DRINK

DO NOT EAT after MIDNIGHT the night before surgery: This includes no soup, chewing gum, or hard candies.

ONLY WATER WITH MEDICATIONS before your surgery time .

NO COFFEE, TEA, MILK OR CREAM. No soup or broth.

TRANSPORTATION

You MUST HAVE AN ESCORT/DRIVER to accompany you home. Your escort is expected to stay at the surgery centre the entire time you are there in case of an emergency, which may take 1-3 hours. Drop-offs are NOT ALLOWED.

FAILURE TO COMPLY MAY RESULT IN CANCELLED OR DELAYED SURGERY; CANCELLATION FEES WILL BE CHARGED 

MEDICATION

You SHOULD take your morning pills as usual (you must take blood pressure and heart pills) BUT DO NOT TAKE DIABETES PILLS OR ANY MEDICATION THAT NEEDS TO BE TAKEN WITH FOOD. Take your pills with sips of clear fluids three hours before your surgery.

You MUST take blood pressure and heart pills

Do NOT take diabetes pills and/or insulin

OTHER INSTRUCTIONS

BRING ALL of your eye drops and a list of your medications

WEAR loose-fitting clothes so that monitoring equipment can be applied easily

DO NOT WEAR jewelry, and do not bring any other valuables

DO NOT WEAR contact lenses, face cream, makeup, perfume, or aftershave

BRING a valid form of payment (VISA, Mastercard, debit, or cash)

WHAT TO EXPECT

-It is normal for the operated eye to feel blurry, light-sensitive, tender, sandy, or itchy for hours to several days

-You may take regular or extra-strength Tylenol or Advil.

-Often the vision clears up slowly, but it can also be sharp within a day. -Everyone heals differently and your two eyes will often heal differently from each other.

-You will see one of our doctors within 1 week for a follow-up visit.

FOOD & DRINK

-You may EAT whatever you like after surgery, but DO NOT drink alcohol for 24 hours as this may interact with the anesthesia medications you had during the surgery.

MEDICATION

-About an hour after the surgery, START USING MEDICATION EYE DROPS. Consult the drop instructions chart.

-Use your glaucoma drops as usual

WOUND CARE

-A PLASTIC SHIELD (given to you on the day of surgery) is to be worn when you are sleeping or lying down for the first 3 days/nights after surgery.

-If your eyes burn, feel scratchy or itchy, USE LUBRICATING DROPS as often as you need.

-DO NOT put any pressure or rub your eye for 2 weeks.

-GENTLY CLEAN any eye drop residue from your lashes or the corner of your eye with a clean tissue.

-AVOID wearing makeup for 1 week. You can use face cream after surgery, but avoid around the eye.

ACTIVITIES

-Take a BATH at any time, or SHOWER from the neck down for the first 3 days. Afterward, you can wash your hair, but avoid getting soap or water in the operated eye for 1 week.

-You may resume LIGHT ACTIVITIES (e.g. walking, reading, cooking, watching TV).

-You may bend, look down, tie your shoelaces, and sleep on any side you wish.

-AVOID STRENUOUS ACTIVITIES for 1 week, such as heavy lifting or intense exercises. RULE OF THUMB: if you need to strain to lift something or breathe heavily after an activity, wait 1 week before doing it.

-AVOID DIRTY/DUSTY ACTIVITIES for 2 weeks, such as gardening & home renovation.

-You can play golf or tennis after 1 week with protective eyewear.

-No underwater swimming or diving for 2 weeks.

-TRAVELING by car is permitted anytime, but wait 2 weeks before travelling by airplane.

-You should avoid DRIVING for 1-2 days or longer if your vision is still blurry, as you may not meet the legal driving standards. At your 1 week visit, your doctor will let you know if you can drive.

WORK

-For office or desk jobs, resume work within 3 days. For jobs that require heavy lifting or working in dusty environments, we suggest 1 week off from work.

GLASSES

-WEAR sunglasses whenever you are outdoors for at least 1 week for protection and because your eyes may be sensitive to bright lights.

-You may choose to wear your glasses if you feel more comfortable with them on, but often the prescription will change after surgery and you may see better without them.

-You may wear over the counter readers in the meantime before you see your optometrist.

-Book an appointment to see your OPTOMETRIST 1 month after your last surgery to check your new glasses prescription.