Replacing a clouded lens inside the eye (a cataract) with an artificial lens is a routine procedure with a low risk for complications. That doesn't mean you can be complacent about recovery; you need to follow exactly the postsurgical plan your doctor prescribes. Here are some extra tips.
Cataract surgery basics
Cataract surgery is an outpatient procedure to replace a clouded lens inside the eye (a cataract) with a clear artificial lens. During surgery, the surgeon makes a makes a tiny incision in the eye, then breaks up and removes the cataract. After that, the new artificial lens is slipped into place.
Some surgeons use a scalpel for the incision. Increasingly, surgeons are using an ultra-short-pulse (femtosecond) laser, which is integrated with three-dimensional imaging. Some doctors report that this tool offers more precision for certain steps of the surgery and ensures better lens placement.
Review post-procedure instructions
The day of your procedure isn't the time to become familiar with complicated postsurgical instructions. For example, you'll need to use several types of prescription eye drops. "There's an antibiotic eye drop you'll use for a week to prevent infection. And for four weeks, you'll use a steroid drop to reduce inflammation, and a nonsteroidal anti-inflammatory [NSAID] drop to help with pain and prevent swelling. Some of the drops will have to be tapered off, according to a precise schedule," says Dr. Nandini Venkateswaran, a cataract surgeon at Harvard-affiliated Massachusetts Eye and Ear.
Ask about post-procedure instructions well in advance. If possible, pick up medications before the procedure, or arrange for someone to get them afterward and help you use them if necessary.
Ask about a simpler drug regimen
If a complex eye drop regimen sounds challenging, ask your doctor well before the procedure if you can get a compounded eye drop.
"It must be made at a special pharmacy that can combine all three eye medications into one. It might cost more money, and your insurance might not cover everything. So you need time to do some legwork," Dr. Venkateswaran says.
Learn the right way to use eye drops
Some people have a hard time using eye drops: when they squeeze the little plastic container, the drops don't get into their eyes. "Learn how to use eye drops before the procedure. Practice with artificial tears in front of a mirror," Dr. Venkateswaran says. "Pull down the lower eyelid, look up, and place the drop in the little pocket that's created when you pull down the eyelid. Don't touch the eye or eyelid with the tip of the dropper; the tip should be just above the eye. If you have trouble doing it, teach a loved one to do it for you. Also, store the drops in a clean environment to reduce infection risk."
Adjust your eyeglasses
If you wear eyeglasses, removing cataracts will change your prescription in the affected eye. That eye might not even need a prescription lens anymore (you'll know once your eye heals). If the other eye still needs correction, you can get a clear lens installed on the side of the glasses where the cataract was removed. Ask your doctor whether and when this should be done.
Protect your eye
After the procedure, you'll wear a clear plastic shield over the eye for 24 hours (and then at a night only, for a week), to protect it from things that can poke into it (like your pillow). When the shield comes off, avoid exposing your eye to elements that can cause infection, such as pool or ocean water, or outdoor environments with dust and debris in the air. Don't hike, bike, or swim for a week.
Pause certain activities
To keep your eye incision from reopening, avoid putting pressure on your eye in the days after surgery. Dr. Venkateswaran says that means no bending over, lifting objects that are 10 pounds or heavier, cleaning, vacuuming, or doing laundry. "It's okay to do gentle walking, but don't jump around and get sweat in your eye, which could cause infection. Wait at least a week before resuming normal activities."
Put your eyes to work
Dr. Venkateswaran finds that some people are scared to strain their eyes after the procedure. That's not a problem; for example, it's fine to read or work on a computer as long as you choose. Your depth perception might be off initially, so don't drive unless you're sure your vision is at least as good as before the procedure.
Don't stress over differences
If you get a cataract removed from each eye, a few weeks apart, don't worry if you have vision differences. "You had natural differences in your eyes before surgery, and you may have some afterward," Dr. Venkateswaran says. "Give your eyes time to work together and adjust, and enjoy your new vision."
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