All your questions answered

How do I know when my cataract is ready to be operated?

A mature cataract has to be operated as it blocks nearly all the light from entering the eye, resulting in poor vision. At other times the decision has to be taken by you depending on your visual needs (i.e. vision less than 6/6, glare, persistent haze, double vision while driving).

I am a diabetic. Will I face any extra risk during or after the surgery?

Diabetics are evaluated by the physician before clearance for surgery is given. Poorly controlled diabetes is a risk factor for postoperative infection. Mild to moderate inflammation (reaction in the eye), & worsening of diabetic retinopathy (affection of the retina in diabetics) can occur after cataract surgery. It is mandatory to have a detailed retinal evaluation before and after cataract surgery.

Will the surgery be painful? What anaesthesia will you use?

Cataract surgery is not painful. The type of anaesthesia to be employed, whether local or topical, is decided by the surgeon.

What is microsurgery?

Cataract surgeries are performed under the operating microscope which provides a magnified view of the operating field, thus allowing fine, meticulous surgery to be performed. This is sometimes called “microsurgery”.

One of my eyes was operated earlier without an IOL implantation (aphakia). I am keen to have an IOL implanted in my other eye. Will there be any problems?

An IOL can be implanted in the fellow eye. However the patient may have a problem of double vision with his glasses later since the eye with the IOL requires little power (thin glasses), while the aphakic eye requires a high power (thick glasses). One way around this problem is to use a contact lens on the aphakic eye so that the patient can wear thin glasses over both eyes. The other option is to implant an IOL in the aphakic eye so that both eyes eventually have IOLs. However this implies a second surgery to the aphakic eye and consequently additional risks.

Is the IOL lifelong or will it have to be replaced?

IOLs are for life. Only in very rare instances the IOL is removed. These situations include infection inside the eye, vitreous surgery for complicated retinal detachments, or if the power of the implanted IOL is not optimum, etc. These situations are very rare.

Do I need to wear glasses after surgery even if an IOL is implanted?

Yes. Most patients will require some additional power in the form of glasses either for distance or near vision or both. The power to be worn is usually small and many patients can see quite well without glasses.

Although an IOL implantation was planned, it was not inserted. Why?

Implanting a PC IOL requires an intact posterior capsule. In case the capsular support is weak or deficient (as in approximately 1 in 100 patients) a PC IOL cannot be implanted. Sometimes the surgeon may decide to implant an AC IOL. This decision can only be taken during surgery.

Can I lose my vision following cataract surgery?

Cataract surgery is one of the safest and most successful of all surgeries in the eye. However infection or uncontrollable bleeding during surgery can rarely occur and cause loss of vision or even loss of the eye itself. Fortunately these complications are very rare. (See Section 11)

Do stitches have to be removed after surgery?

Usually no. Occasionally sutures are removed if they cause excess postoperative astigmatism (power), or produce irritation. Phacoemulsification does not require any stitches at all.

My doctor says that my cataract surgery is fine but I have not regained any useful vision. Why?

There are many reasons for this. Most commonly it is due to other diseases within the eye especially those affecting the retina and optic nerve. It is difficult to evaluate the appearance of the retina and optic nerve in a patient with cataract since the cataract prevents a good view of these structures. In these cases an ultrasound test tells us whether all structures are in the right position or not. The functional status can only be gauged by indirect testing such as ability to recognize colors, the pupillary light reflex, visual evoked potential test etc.

Can cataract recur?

No. However after-cataract occurs in 30% of adults within 5 years following an uncomplicated extracapsular cataract surgery. This is easily treated by YAG laser (See Section 11). Phacoemulsification with foldable lens has the least chance of after- cataract.

My 3 year old child has cataract which apparently has been present since birth. Can my child have cataract surgery? Will there be complete recovery of vision?

Yes, cataract surgery should be performed if there is visual potential in the eye. An IOL can even be implanted in the child if older than 24 months. Further medical treatment will be required after surgery to improve vision in that eye

Can both eyes be operated at the same time?

Theoretically both eyes can be operated at the same sitting but practically for various reasons surgeons prefer to operate only one eye at a time. An interval of at least 1 day is recommended between the two surgeries if the patient wants both eyes operated early.

Can cataract surgery be combined with other ocular surgeries?

Yes. Cataract surgery can be combined with other procedures such as glaucoma filtration surgeries, squint correction procedures, corneal transplants and complex vitreous and retina surgeries.

Can I lead a normal life after cataract surgery?

YES! We recommend 2 weeks of precautions after a PKE surgery, or 6 weeks in the case of ECCE.