Cataract Surgery

Cataract surgery is done to remove the lens of the eye and, most often, to replace it with an artificial lens. Our Doctors at Orbit Eye Centre can assess your situation and make any necessary recommendations. This common and safe procedure is done for patients when their normally clear lens has become cloudy and reduces their vision.

How Cataracts Affect Your Vision

Cataracts are common. Roughly one person in five has cataracts by age 65 to 74. Half of all people over the age of 74 have them. This cloudiness of the lens eventually makes your vision blurry and commonly increases the glare from lights at night. When they progress far enough to affect your normal activities it is time for cataract surgery.

However, you may have another eye problem that requires examination of the back the eye, such as macular degeneration or diabetic disease of the retina. In such a case you may need to have the procedure done sooner than usual to make it easier and safer to follow and treat your other eye disease.

In general, you will have time to consider if you want this surgery as cataracts progress slowly.

Symptoms may include:

  • Do your cataracts affect your safety in driving and doing your work?
  • Are you able to read and watch TV without significant problems?
  • Has it become difficult to take medications, go up or downstairs, do your shopping or handle chores around your home?
  • Are your cataracts a threat to your degree of independence?
  • Does the glare from bright lights make it difficult to see (especially when driving at night)?
  • Needing more light to do common day to day activities such as reading
  • Gradual changes to color perception

Is Cataract Surgery Safe?

Although there are always risks to having cataract surgery, they are uncommon, short term, and easily dealt with. These are the common ones.

  • Swelling
  • Bleeding
  • Inflammation
  • Infection
  • Drooping of the eyelid
  • Dislocation of your new artificial lens
  • Detachment of the Retina
  • A Secondary Cataract
  • Glaucoma
  • Loss of vision

The risk of complications with your cataract surgery is higher if you have another disease of the eye or have a serious medical condition. Cataract surgery will cure the problem of impaired vision caused by a cloudy lens but will not help visual problems caused by other eye diseases. Our surgeons will always evaluate you for other eye conditions before recommending cataract surgery.

Why Do People Get Cataracts?

Cataracts become more frequent as we get older due to chemical changes in the lens. However, some medications like steroids can make them more likely. To a degree, your likelihood of getting cataracts is higher if they “run in the family.” Eye injuries can make cataracts more likely, andcataracts are more common with some diseases such as diabetes and high blood pressure as well as with obesity and smoking. When cataracts occur in a baby they may have been caused by an infection before birth and are called congenital cataracts.

Artificial Lenses with Cataract Surgery

Most commonly, your cloudy lens is replaced with an intraocular lens (IOL) during your cataract surgery. The use of these lenses dates back to the middle of the 20th century and is now a standard part of the surgery. With an IOL you will not need the heavy “cataract glasses” that once were needed when a person’s natural lens was removed. The artificial lens will remain clear forever. You will be asked to fill out a “vision questionnaire” to help determine which type of IOL is best for your lifestyle.

How Is Cataract Surgery Performed?

Surgery for cataracts is most commonly an outpatient procedure. You will only need a topical or local anesthetic to prevent any pain. The surgery takes place under an operating microscope using very delicate instruments to precisely break up and remove your old lens. The clear capsule that surrounds your natural lens is left in place and the new artificial lens is placed inside of it.

In rare cases, the capsule breaks and parts of the cataract can fall back into the eye. If this occurs, you may need a second procedure simply to remove the debris.

Virtually all patients who have cataract surgery have improved vision (>95%). However, when a person has other eye conditions, these may limit the extent of their improvement and, as with all surgeries, rare complications can occur and limit the improvement you experience.

Pre-Operative Testing

Once it is determined that you will benefit from cataract surgery, further pre-operative testing is done in our office. Many measurements are taken multiple times to help ensure the best possible result, and surgery cannot be completed without these measurements.

Do not wear contact lenses before this testing as they will alter the measurements.  Remove soft contact lenses at least 48 hours beforehand and remove hard contact lenses at least 14 days before testing.

Use artificial tears at least six times a day for at least two days before your visit as they will improve the accuracy of your testing. If your eyes are too dry, you may be asked to return for a follow-up appointment after using the drops!

Bring a translator with you if you have difficulty reading or writing English.

You will not have your eye dilated for this testing and when it is done you will receive the paperwork for your surgery and the surgery date.

Please give our office 24 notice hours in advance if you need to change your appointment time.

Intra-Ocular Lenses

The type of intra-ocular lens that is implanted in your eye will depend on whether you have a greater need to good vision in the distance as with driving, up close as with reading, or intermediate distance as with computer work. You may need to use glasses for seeing well at distances that are not ideal for the lens that you have of if you have residual problems like astigmatism.

A lens that works well for distance vision is almost always used, and you will then require reading glasses for up close and arm’s length work. There are multifocal lenses as well to help correct for a greater depth of field, and these options will be discussed with you.

The most commonly used IOLs today are made from a soft and foldable acrylic material. They last indefinitely and, because they are foldable, they can be inserted into the eye through a much smaller incision than would be needed with a hard lens.

The small incision usually does not need sutures. And, aside from the fact that vision is better, you never know that they are there!

Common Questions about Cataract Surgery

The medications and drops that are used will provide relief of all pain and virtually all discomfort.

You will be awake during the surgery but the medication you get will relax you and you may well sleep once you get home from the surgery. Be sure to have someone come with you to drive you home.

Your surgeries will be at least two to three weeks apart. Your vision may be blurry after surgery and having only one eye done will allow you to still function normally at home.

Expect to spend at least half a day in the surgery centre for your cataract surgery and a few hours thereafter.

You can expect to resume things like watching TV and reading the day after your surgery but avoid any strenuous activity for at least two weeks. Please plan on not driving until two weeks after your surgery.

No, your artificial lens will never get another cataract, but it is common for patients develop scar tissue behind the lens implant.  This can happen quickly or many years after your cataract is removed.  If this does occur and it is affecting your vision, an in-office laser treatment is used clear it away.

You will be given specific written instructions for what to do and what to avoid after your surgery. These instructions may vary from patient to patient.

Nighttime driving will be a lot easier after your cataract surgery. However, patients vary in terms of how quickly issues such as halos and glare from bright lights will get better and can take months to resolve. Other eye diseases can also make driving at night difficult and may limit your visual outcome.

Yes. However, your ability to see up close computer distance will depend on the type of lens you choose. If your implanted lens is made for good long-distance vision, you may need glasses for computer work and reading.