Cataract Surgery

The eye is composed of many different structures and the main components are: Muscles for external movement of the eye; Cornea; Iris; Crystalline Lens and Muscles for internal movement of the Crystalline Lens; Retina and Optic Nerve. When an Ophthalmologist examines your eyes and determines you have Cataracts, the Crystalline Lens of the eye has begun to cloud and is interfering with sharp, clear vision.

Procedure Details

The physician will determine when you should have surgery to remove the cloudy lens based on their internal examination, visual acuity and how you, the patient, feel the cataract is affecting your day to day lifestyle.

Once there is agreement on when the surgery should be performed, you will have a pre-operative appointment with one of the clinic staff. Measurements of the eye will be taken and you will have a choice of implant type you would like. The clinician will have a discussion on what your visual needs are and together you will decide if the standard single vision lens, astigmatism-correcting or multifocal lens is the most appropriate for you. Depending on which type of lens is chosen you may have an additional choice of monovision (one eye for distance and one eye for near or intermediate). The patient will have informed consents to sign and you will be given prescriptions for eye drops to help to prevent infection and inflammation. It is extremely important to follow the drop instructions exactly, as to timing and when to begin using the drops.

On the day of surgery, you will come to our surgical center with a driver as post surgery you will not be allowed to drive home. There will be more informed consents to sign which allow the surgery center to perform the operation and to administer anesthesia. A nurse will call you back to the admitting area where a mini physical is performed by the nurse to include blood pressure, temperature and questions about your health. You will be asked several times which eye is the surgical eye during your visit. It is vitally necessary for each person you encounter to reaffirm that the eye being operated on is the correct eye. This prevents a mistake from happening. If you have any allergies this will be noted and appropriate precautions will be taken, as allergies could be dangerous to the procedure. The eye that is being operated on will be marked with an arrow large enough for all to see. The nurse will then bring you to one of our surgical chairs and place a blood pressure cuff and heart monitor on you. The anesthesiologist will then come and ask you more questions about your health, family history and what type of operation you will be having as well as the surgical eye. If all is satisfactory, he will anesthetize the surgical eye according to the orders of the surgeon. Then, dilating drops will be in the eye to enlarge the pupil for the operation. The anesthesiologist will give you an IV sedative to relax you and put you in a “twilight” sleep.

When the operating room is ready for you, another nurse team will come to take you back to the operating room for your procedure. Even though you are sedated, you will be able to respond to commands and after your procedure you will have some memory of the operation. In the operating room, you will be placed fairly flat and positioned so the surgeon can operate on your eye. A solution is placed on the skin around the eye and a sterile drape is placed over the eye in order to keep the area clean and sterile. A mechanical device will be placed between your eyelids to keep them open and your lashes out of the surgical area. The surgeon will enter the room and put on a new sterile, disposable gown, gloves and a “time out” is conducted. The time out is performed to orally describe the patient, type of surgery, type of implant and the eye being operated on. At any time, during the reading, if anyone in the room hears something incorrect; they must immediately stop the reading and determine the correct term or agree that something was not heard correctly. Once everyone is in agreement the surgery begins.

The surgeon orients themselves to the operative eye and begins by making a small incision at the juncture of the cornea and sclera. Some fluid is injected into the eye via the incision to make sure there is enough room for the surgeons’ micro-tools. The surgeon inserts an instrument into the eye through the incision and a small round portion of the front capsule (bag like structure that holds the lens in place) is removed to expose the lens. The surgeon then uses an instrument called a Phaco-emulsifier to break up and aspirate the lens from the eye. Once all the material is removed, the surgeon inserts the chosen lens implant into the empty capsular bag, adjusts fluid levels and exits the eye. Depending on the surgeon they may close the incision with a stitch but most leave the incision to heal over as it is just a few millimeters in length. You will then be brought from the operating room to the recovery area. Your vitals will be taken and you will rest for a set period dependent on the last dose of anesthetic.

When it is determined that the anesthesia is sufficiently out of your system, you will be taken from the operating chair and brought to a seat where you will be offered a light snack of juice and crackers. When you are oriented enough to stand and walk, the last of the IV equipment will be removed. The person responsible for taking you home will be notified to bring the car around to the discharge area. You will be reminded of your post operative instructions, and post operative visit at your surgeon’s office and escorted to the vehicle for your ride home. It is important to rest and relax for the remainder of the day. If at any time you feel discomfort or something seems amiss please call the surgeon who performed the operation to discuss your situation so you can continue recovery with peace of mind.

This description of cataract surgery is an overview only and may not represent what will actually happen during your surgery. Each surgery is individual and the process and results will vary. This representation is to help you understand the basic process. Individual questions should be directed to your surgical team.

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