Cataract surgery
Cataract surgery, called phacoemulsification, is performed under local anesthesia. The clouded lens ( cataract ) is removed and replaced with an artificial lens called an intraocular lens (IOL). This is essential for correcting vision. The procedure does not require stitches and is permanent. Your ophthalmologist will discuss the implants and how they work during your pre-operative consultation. Post-operative recovery is generally straightforward, and visual recovery is very satisfactory.
What is cataract surgery?
Cataract surgery involves aspirating the cataract using a micro-aspirator that emits ultrasound, before replacing it with a vision-correcting implant.
The procedure is painless and performed under local anesthesia. It lasts approximately 10 minutes and does not require stitches.
Before the operation
During the pre-operative consultation, your surgeon will measure your eye (biometrics) to determine the appropriate focusing power for your implant. They will also ask you about your medical history, habits, and visual needs.
Before the surgery, you will also be asked to meet with the anesthesiologist to determine the type of anesthesia that will be used. For this surgery, local anesthesia is most often recommended.
For this consultation, remember to gather your medical records and documents available: list of treatments, medical history, medical examinations, medical reports which will help the anesthesiologist to draw up a complete medical assessment.
The day of the operation
You will be required to arrive on an empty stomach, having started at 6 a.m., at the time indicated on your summons. Please note: do not consume coffee, tea, food, liquids, or cigarettes!
The procedure takes approximately 10 minutes. Afterwards, if the surgery was performed on an outpatient basis (the most common case), you will be able to return home accompanied by your companion.
The phacoemulsification operation
The standard surgical technique is phacoemulsification. Contrary to popular belief, the operation does not use a laser but ultrasound.
Here is how it unfolds:
Your eye will be numbed with eye drops. The anesthesiologist will inject you with medication if necessary to help you relax.
You will be partially awake during the operation. You will be able to see light and movement during the procedure, but you will not see what the doctor is doing to your eye.
Your surgeon is looking through a special microscope.
The steps of the operation
It creates tiny incisions (using a blade or laser) near the edge of your cornea.
The surgeon uses these incisions to reach the lens of your eye.
Using fine instruments, he will fragment the diseased lens (cataract) and aspirate it.
He then places the implant (artificial lens) in place of the cataract in order to properly correct your vision.
In general, your surgeon will not need to suture the incisions. These "self-sealing" incisions will close on their own over time.
A transparent protective shell will be placed over your eye to protect it.
You will rest in a recovery room for approximately 15 to 30 minutes. Then you will be ready to go home.
The cataract implant
Cataract surgery literally involves replacing a clouded lens (the cataract) with a clear lens that corrects vision: the implant. These implants, depending on their characteristics, can correct myopia, hyperopia, astigmatism, and presbyopia.
Therefore, depending on the characteristics of your eyes and your visual habits, the surgeon will suggest the following possible visual outcomes:
Emmetropia – Clear distance vision without glasses, wearing reading glasses for close-up vision.
Residual myopia – Clear reading vision without glasses, but glasses are needed for distance vision.
The switch – Dominant eye at a distance, dominated eye at close range for 70-80% independence from glasses, with a small loss of 3D vision.
Multifocality – Multifocal implants correcting distance and near vision but generating loss of contrast and light halos.
Post-operative care and convalescence
The postoperative course following this procedure is generally excellent, allowing for very rapid visual recovery. Eye drops will be prescribed and instructions given to you on the day of the operation.
Among them, the following should be noted:
You will need to use antibiotic eye drops after the operation. Be sure to follow your doctor's instructions for using these drops.
Avoid putting soap or water directly into the eye.
Do not rub or press on your eye. Your ophthalmologist may ask you to wear glasses or a protective shield.
You will need to wear eye protection while sleeping for 1 week.
Your ophthalmologist will explain to what extent you can be active soon after the operation. They will tell you when you can safely resume exercising, driving, or other activities.
Sick leave following cataract surgery
A one-week sick leave is usually prescribed.
However, in the case of sedentary work on a computer, it is possible to start work the next day.
Conversely, in the case of work in unsanitary conditions or driving heavy vehicles, a minimum of 15 days of leave is required.
What are the risks of cataract surgery?
Like any surgery, cataract surgery carries risks of adverse events or complications. Here are some of these risks:
Endophthalmitis – A serious infection of the eye.
Vitreous hemorrhage – Bleeding from the eye.
Corneal edema – The cornea is unable to recover from the ultrasound used to fragment the lens, resulting in edema.
Retinal edema – says Irvin Gass. The center of the retina is subject to persistent inflammation leading to edema.
Retinal detachment – The periphery of the retina tears and lifts up.
Iris thinning – Cataract removal has resulted in some tissue tearing in the iris and pupil.
Dryness and chronic pain – Most often linked to disinfection with Betadine.
Blurred vision.
A vision of halos, glare, and dark shadows.
Loss of vision.
Implant dislocation – The intraocular implant can dislocate and move.
Warning! Cataract surgery cannot restore vision lost due to other eye conditions, such as macular degeneration, glaucoma, or diabetic retinopathy.
Frequently Asked Questions
How is cataract surgery performed?
Cataract surgery is performed on an outpatient basis, under local anesthesia with eye drops. The cataract is aspirated through a 2.2 mm incision and replaced with an artificial lens that corrects vision: the implant.
How long does cataract surgery take?
Cataract surgery takes approximately 10 minutes. In cases of fragility, additional time may sometimes be required.
How long does it take to see results?
Visual recovery is rapid. Colors will be more vivid the next day, and full recovery is usually present after 7 days.
Is it possible to watch TV after cataract surgery?
Yes! And as soon as you get home. Television won't interfere with your healing process at all. On the contrary, stay calm and enjoy this newfound visual clarity.
How long should I refrain from driving after cataract surgery?
If your vision recovers quickly, you will be able to drive the day after the operation. To help you, you can ask your optician to put a clear lens on your old glasses.
How long should I keep the protective shell on after cataract surgery?
The case should be left overnight for 1 week. Wash it with clean water and mild soap every morning and let it dry.
How to avoid cataract surgery?
Avoiding surgery requires early management of the factors that contribute to the aging of the lens:
Contrary to popular belief, having blue eyes or looking at a computer does not increase the risk of developing cataracts.
NO SMOKING.
Maintain a healthy and varied diet.
Protect your eyes from the sun.
Take corticosteroids in drops or orally only if necessary and for a short course of treatment.
Is it possible to have sex after cataract surgery?
Yes! And starting the day after the operation, avoiding face-down positions for the first week.