Both cataract surgery and lens implant surgery have a very good safety record. It is however, an operation, and no operation is without some risk. Fortunately, significant problems or complications are very rare. An important part of the consultation is the discussion of risk with the person considering surgery. Further detailed discussion of risk can be found in our cataract booklet or the lens implant surgery booklet.
Do I need to stay in hospital overnight?
No – the surgery is carried out as a daycase. You will probably be in the day care unit for approximately 2-3 hours in total
Does the lens implant wear out?
No – the lens is made from a high-tech acrylic polymer that is completely inert. There are no moving parts, so the lens can’t wear out.
When can I have my cataract treated?
You may wish to have your cataract treated as soon as your vision interferes with your daily life and your ability to work, read, or do the things that you enjoy. If you have a driving licence you must reach the drivers and vehicle licensing authority (DVLA) standard. You can download their leaflet here and more details are available from the DVLA website.
Do you treat both eyes at the same time?
There are some surgeons who do both eyes at the same time, and it is probably safe to do so. However, common practice is to treat one eye at a time. The main advantage is to see what the outcome is like for the first eye – this sometimes allows slight modifications to the lens power for the second eye to better suit the requirements of the patient.
Why can’t I have laser treatment?
The main reasons for being suitable for lens implant surgery and not for laser are:
– Having too great a spectacle error
– The laser works by removing tissue from cornea, the clear structure at the front of the eye. This re-shapes the cornea, altering its focus. The more short-sighted you are, the more tissue has to be removed. Above a certain amount, there may be not enough tissue remaining to maintain the strength of the eyeball, and the cornea may “buckle” and cause visual problems. This is known as ectasia. Additionally, the predictability of the treatment falls off significantly the more short-sighted you are.
– Significantly long-sighted or hyperopic people are unsuitable because of the predictability of the treatment is poor. The shape that the laser has to create on the cornea to steepen it is complex, and under-correction, over-correction and irregularity are more common the higher the attempted correction.
– Having some cataract: it’s quite common for people to develop a degree of cataract even though they don’t notice an effect on their vision. The cataract is likely to develop, albeit slowly in some cases, but this change in the lens is often accompanied by a change in spectacle requirement. This means that an initially good result from laser treatment doesn’t last, and patients find that their spectacle requirement increase again with time.
– Being too old: patients over the age of 40 would, if their distance vision were completely corrected, need readers afterwards, sometimes straightaway. There are some ways round this, for example you can have what is called ‘monovision’ where one eye is deliberately made slightly short-sighted so that you effectively see distance with one eye and close with the other. Some people can’t cope with the imbalance, although most find it acceptable.
What if I cough / move / blink during the operation?
Before the procedure starts, you will be made comfortable on a bed, and there is a specially shaped pillow to rest you head in. This minimises any movement, although keeping still is important. A gentle metal spring device is used to hold the eyelids apart. An anaesthetic, in the form of drops or delivered via a blunt tube, freezes the eye so you won’t feel any pain that might cause you to move. A nurse or orderly will hold your hand if you wish during the procedure, and you can indicate if you feel the need to cough or sneeze, and the procedure can be paused.
Will it hurt?
Significant discomfort is unusual, but a sensation of intermittent pressure can be noticed.
Will I see anything during the surgery?
Right at the start there may be some vision, but very quickly this gets very blurry. Vague shapes and movements may be seen, and some notice coloured lights.
How long does the surgery take?
The procedure usually takes between 10 and 15 minutes to complete, but sometimes takes longer.
I’m quite nervous – can I be sedated?
It’s quite normal to be apprehensive before surgery. Usually, once patients realise that there is no significant pain or discomfort involved, they relax. If the patient is very anxious, then we will organise either having a light sedative tablet beforehand, or even in some cases, having a general anaesthetic.
Will I need to use eye drops afterwards?
Yes – these are normally used to up to four weeks after the procedure. Full instructions are given on the day of surgery.
Will I need glasses afterwards?
Most cataract and lens implant surgery patients will have clear distance vision but require reading glasses, unless a multifocal lens has been implanted or there is monovision. Some people, even if they have had a multifocal lens implanted, will glasses for some tasks.
What do I do between my procedures as far as glasses are concerned?
We will provide specific advice tailored to the individual. This may be to wear just one contact lens, or go without glasses.
Can I bend down to pick things up?
Yes, but don’t lift any heavy weights (something that would cause you to hold your breath). We advise patient s to avoid heavy gardening duties for a week or so.
How soon can I exercise after surgery?
Gentle low-impact exercise can be resumed after a few days. High impact activities such as running ought to be avoided for at least a fortnight. You should avoid swimming for a fortnight.
When can I start to use eye make-up?
Avoid mascara for at least two weeks. Other products such as eye shadow may be used after a week.
When can I drive?
Driving can be resumed can drive as soon as you feel comfortable and confident, and as long as you can read a standard car number plate in daylight from 20 metres away (about three car lengths).
Can the cataract come back or regrow?
No. The membrane behind the lens can become a little cloudy in the months or years after surgery, and if that is significant, some will require an outpatient laser treatment with a special laser, the yag laser.
When can I return to work?
This depends on your job. If you are office-based, then usually within a few days you should be comfortable enough to return to work. If you work in a dirty or dusty environment, then it may be longer before you can safely return.
When can I fly?
Flying as a passenger is possible the day after surgery. If you are a pilot, then the civil aviation authority will need to clear you before you can fly.
Will my vision change as I get older?
Changes in the natural lens are usually the reason why peoples vision changes as they get older. After a lens implant, the vision should be much more stable. Small changes in the requirement for glasses are however possible in the future.