Old Cataract Surgery

About Cataract:
In a healthy eye, light enters the eye and passes through a clear lens. In cataract, the lens becomes cloudy and blocks light from passing through. This causes blurred vision.

Causes & Risk Factors:
Cataracts are caused by changes in the lens of the eye. A few things can increase your risk of cataract. These include:

  • Increased Age
  • Eye diseases like glaucoma, diabetes, and eye tumors
  • Prolonged Use of steroid drugs
  • Eye injuries
  • Direct exposure to sunlight

As you get older, your eyes start to age and may form cataracts. This is very common. While people above the age of 45 are at a greater risk, cataract can sometimes occur in children. Luckily, both adult and childhood cataracts can be treated.

Key Points to Remember:

  • Cataract is not contagious.
  • It is very common in older adults.
  • Surgery is the only effective cure and is very safe.

Blurry vision

Glare or double vision

Cloudy pupil

Colors look faded

Cataracts are treated through a safe, effective surgery. Your doctor will remove your cloudy opaque lens and replace it with an artificial lens. This lens is called an “Intraocular Lens”, or an IOL. Since light can pass through this new lens, clear vision is restored. Unlike contact lenses, the IOL stays in your eye forever. There are many types of IOLs. Doctors and counsellors can help you choose the best lens for you.

In adults, surgery is done under local anesthesia. You will be awake, but you will not feel any pain. Depending on your condition, your doctor may do the surgery with a machine or manually. The machine surgery is called phacoemulsification or “PHACO” and the other one is called Manual Small Incision Cataract Surgery (MSICS). Both surgeries are common. Your doctor will choose the safest option for your eyes.

Questions
Phaco & Femto
MSICS
How is surgery performed?
High energy (ultrasonic) waves are passed through a tiny incision. This destroys the clouded, cataract lens. The PHACO machine immediately eats up the cataract lens and a foldable intraocular lens (IOL) is implanted in its place.

FEMTO laser-assisted surgery is also available. It is an advanced technology. The procedure uses a laser instead of a blade. The laser makes a tiny incision and breaks the cataract into pieces.

Surgery is performed manually. The incision is slightly larger than in PHACO/FEMTO and a rigid IOL is placed in the eye.
Depending on the type and stage of cataract, you may need sutures to seal the incision.
When can I return to my normal routine?
Your eye will take 1 week to heal. An eye doctor or counsellor will tell you how many days you need to wait before resuming certain activities. After that, you can return to your normal routine based on your comfort. With FEMTO laser-assisted surgery, healing is faster. The eye will take at least 15 days to heal.

Advantages to PHACO/FEMTO:

  • Faster healing because the incision is so small
  • Less likely to need stitches or sutures
  • Fewer follow-up visits
  • Stable vision within 1 month of surgery
  • Patients can read or watch TV after 1 week

Risks and Associated Complications

Complications are very rare and most can be treated. They usually occur when a patient has another eye disease that interferes with vision. If you have another eye condition, your consulting doctor may want to treat it before the cataract surgery.

Risks include:

  • Inflammation
  • Infection
  • Bleeding
  • Swelling
  • Secondary cataract
  • Vision loss

Preparing for Routine Cataract Surgery: Before, During and After

You will likely need to take eye drops on the day before surgery, the day of surgery, and just after surgery. An eye doctor or counsellor will provide you with specific instructions as to when to apply the drops. Please inform the doctor if you are allergic to any medications.

Do not use any other medicines on your eyes. Follow the doctor or counsellor’s instructions carefully. For quick healing without any complications, you must take your medicines as advised.

Recovery:

After the surgery, your vision should slowly get better. At first, your vision may be blurred. Your eyes may be itchy, watery, or slightly red for a few days. This is a normal part of healing. With proper care, your eyes should heal completely within 8 weeks.

Once you return home, you will need to take the following precautions:

  • Remove the eye bandage and wear dark glasses
  • Wash hands with soap before applying eye drops
  • Clean the eyes once a day with a sterile cotton ball. To sterilize the cotton, dip it in boiling water and wait until it cools to room temperature.
  • Wear dark glasses when traveling
  • Follow the medication chart closely

For the first month, you will also need to:

  • Avoid sunlight, smoke, and dust
  • Avoid tobacco, smoking, and alcohol
  • Patients with glaucoma will need to take their glaucoma medicines regularly
  • Patients with diabetes or hypertension should monitor their blood sugar, blood pressure, and cholesterol levels

Precautions to be followed after cataract surgery:

  • Avoid using the TV, computer, or smart phone. If you feel any eye pain, stop using electronics entirely.
  • Do NOT remove the eye shield, bandage, or patch for 1 day.
  • Do NOT go to sleep while wearing your glasses for 3 days.
  • Do NOT sleep on the side of the face with the operated eye for 3 days.
  • Do NOT shave for 1 week.
  • Avoid playing with children or pets for 1 week.
  • Do NOT get water on face, shower, wash hair, or use facial cosmetics for 1 week.
  • Do NOT wipe near the eye with anything other than a sterile tissue/cotton ball for 1 week.
  • Do NOT go outside without wearing the dark sunglasses for 10 days.
  • Avoid cooking foods that create smoke or steam for 10 days.
  • Do NOT do anything that creates “pressure” on the body, such as lifting heavy weights or strenuous exercise for 15 days.
  • Do NOT ride a two-wheeler without protective glasses for 15 days.
  • Do NOT let dust or smoke get into the eye for 15 days.
  • Resume all normal daily activities after 15 days.

If you have severe eye pain, redness, or vision loss, please visit an eye hospital immediately.

Can cataract be treated with medications or glasses?

In the early stages, glasses may be used. You may need to change them often. For the best vision, surgery is advised. There are no medications to treat cataract.

What will happen if I don’t remove my cataract?

If the cataract reaches an advanced stage, vision will deteriorate. At this stage, cataract can also increase the pressure in the eye. This increases the risk of glaucoma.

Why do I need Cataract Surgery?

If you have cataracts, your eye’s natural lens is cloudy. This blocks light from passing through the eye and results in blurred vision. Cataract surgery replaces this cloudy lens with a transparent Intra Ocular Lens (IOL) that doesn’t block light.

For most people, surgery is a quick, safe way to restore clear vision. It is the only way to treat cataract. The surgery can significantly improve your quality of life.

How long can I wait?

  • Some people with early stage cataracts can delay the surgery and wear glasses instead. Keep in mind that you may have to change your glasses frequently. Also, they are not a permanent solution.
  • You will need surgery once the cataracts disturb your daily activities.
  • Surgery will clear your vision, so you can drive, read, cook, etc.
  • The progression of cataract will vary from person to person

Do I have to stay in the hospital after cataract surgery?

You do not have to stay. Surgery can be done as a day care procedure and the patients can go home a few hours after surgery.

How many types of cataract surgery are offered at Shivam Eye Hospital?

The two type of surgery are Manual Small Incision Cataract Surgery (SICS) and Phacoemulsification (PHACO). Some newer PHACO surgeries may be FEMTO laser assisted. Manual surgery uses rigid lenses, while PHACO uses foldable lenses. We offer many types of IOLs.

What is the difference between manual and PHACO surgery?

PHACO generally has a smaller opening, earlier recovery, less induced astigmatism, and better IOLs. However, it may not be possible for everyone. Your doctor will choose the best option for you.

If cataract is very advanced, is PHACO surgery possible?

PHACO should be possible in most cases, except the most advanced ones. Your doctor will decide if you are eligible.

Can you do the cataract surgery without eye injections?

Yes. Depending on your eye condition, it can be done without injection.

After surgery, will I have good vision?

If you have no other eye problems, yes. For healthy eyes, the risk of complication is very low.

After surgery, do I need to wear glasses?

You will need to wear near-vision glasses after the surgery. Some people may need to use distant-vision glasses for the best results.

I don’t want to wear near-vision glasses after surgery. What can I do?

If you don’t want to wear the near-vision glasses, you should tell your doctor to consider implanting a multi-focal lens.

How many days will I need to wear the dark glasses?

For your safety, you will need to wear the dark sunglasses for 1 month after surgery at least outdoors.

After the surgery, can cataract develop again?

No. Some people may get Posterior Capsule Opacity (PCO). This is when a layer behind the lens becomes cloudy or opaque. PCO is a possible side effect of surgery, but it is easily treated with a laser.

After surgery, can I change the lens again?

Unless it is an emergency, you cannot change the lens. The lens you choose will be in your eye for the rest of your life.

How many years will this lens be useful?

The new lens should provide clear vision for the rest of your life.

I had cataract surgery without IOL many years ago. Can I get an IOL implanted?

Yes – a doctor’s opinion will be needed, but it should be possible.

I have systemic problems (like heart problems, asthma). Can I still get cataract surgery?

Yes. You will need to get fitness from physician or the specialist who treats your systemic condition.

Can I get cataract surgery if I am diabetic?

Yes, as long as your blood sugar levels are under control.

Can I take my regular medicines on the day of the surgery?

Yes, you can take all regular medicines, except diabetes tablets.

When would I need to come back for a follow-up?

You will need to get your eye checked after 1 month.

How many days should I rest?

For PHACO surgery, 10 days is usually enough.

Can I eat all types of food?

Yes. Both vegetarian and non-vegetarian are fine.

When can I go back to work?

With PHACO surgery, you can go back to work after 10 days. With manual surgery, you can return after 1 month.

Can I take a head bath after the surgery?

You can only take a head bath after 15 days. Before that, you can take a body bath. Keep water away from the face.

Can I do yoga after the surgery?

Not right away. You will need to wait at least 15 days before you can do yoga. For yoga that increases the pressure on the eye (such as kapalbhati),  you may need to wait 3 weeks.

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