I have been diagnosed with
cataract. My daughter is getting married next month. Can the surgery wait?
Cataracts usually mature slowly.
The patient, in consultation with his ophthalmologist, should decide when his
eye should be operated.
Unless it is a Hypermature
cataract, there is generally no emergency about cataract surgery. If
you get the surgery done before the wedding, may be you can admire the
newly-wed couple better!
Today, cataract surgery is performed when the cataract is interfering with
the subject's daily life and duties - it may be done even when the cataract is
Spectacles - The cataract increases the refractive power of the lens, making
the person myopic. This can be corrected wholly or partly with appropriate
|Protection from ultraviolet light (UV B)
and strong sunlight, by using Sunglasses.|
Diet and Healthy habits. Role of Antioxidants
like Zn, Se, Lutein, Zeaxanthin, Vit A, B, C, E, Calcium etc is not proven.|
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Why should I get my cataract removed?
A Cataract can become Hypermature. This means, the
material inside the lens becomes liquid, milky white. It starts leaking
proteins into the aqueous. This causes inflammation of the
eye, pain, severe headache and glaucoma. This requires an Emergency
hospital admission and surgery.
Anaesthesia- Local injection for the eye or topical anaesthesia with drops.
| Antibiotic drops prior to surgery may be given.|
|Dilating drops every 10 min, 2 hours before surgery.|
|Other medications like those of diabetes, hypertension are to be continued as
The patient lies down on the operating table.
- The eye to be operated is cleaned with Betadiene or and other antiseptic
solution. An eye drape is placed, other eye is covered.
- The surgeon sits at the head-end. He views the eye through the operating
- The lids are kept open. A small incision is taken in the upper
- The anterior capsule of the lens is cut open.
- The cataract is extracted
either by manually delivering out the nucleus or by cutting the nucleus into
very small parts, using Phaco-emulsification. These small
bits are then sucked out.
- All the cortical matter is removed.
- An artificial lens is placed over the posterior capsule.
- Sutures may or may not be
applied, depending on the size of incision and the surgeon's technique. This
type of surgery is called as ECCE, Extracapsular cataract
In olden days, Intracapsular cataract surgery (ICCE) was done, when the whole
lens with the anterior and posterior capsule was removed. In those days, IOL was
not used and thick aphakic glasses had to be used postop. These were heavy,
cosmetically disfiguring and had a lot of problems, vision was never
satisfactory, since everything got highly magnified with them.
Cataract surgery is NEVER done by LASER.
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The eye is kept closed, with an eye-pad for about 6-8 hours after surgery.
Painkillers are given. Other medications for diabetes, hypertension are to
be continued as before.
Dark glasses are worn for 2-3 weeks post surgery. These keep the eye
protected from dust or any mechanical injury.
Eyedrops are to be instilled as advised. They consist of
|Steroid eye drops to keep the inflammation under check.|
|Antibiotic drops to prevent infection|
|Cycloplegics to relax the eye.|
Each ophthalmologist has his own regime, but the general scheme remains the
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Post Operative Visit Schedule
A Follow-Up on -
2 nd Week
3 rd - 4th Week
6 th Week
By sixth week, the eye has healed and any corrective glasses, that are required
may be given. Glasses for near vision are usually required after cataract
surgery, inspite of the IOL. This is because the IOL cannot change its
refractive power like the natural lens.
|The eye needs to be cleaned 3-4 times a day with clean cotton, to remove the
discharge. The cotton is boiled in water, cooled and then used, for better
sterility. Water for cleaning is better if boiled and cooled.|
|A head bath is avoided for 3-4 weeks, post-op.|
|Swimming is avoided for 6 weeks.|
|Avoid lifting heavy weights 3-4 weeks post-op.|
|Persons doing table-jobs can return to work in one week.|
|An eye- shield should be placed on the eye while sleeping, for about 4 weeks.|
Any complaints or sudden redness should be treated as emergency and
ophthalmologist seen immediately.
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Every surgery is a risk, but every precaution is taken to avoid the untoward.
Infection- This can be mild or may be severe. Usually presents as increased
redness, pain and watering. Infection involving, the whole eye called
endophthalmitis. For this, antibiotics are given, in form of drops, tablets or
injections into the eye. It is vision threatening.
Inflammation - Mild inflammation is okay, but it can be severe especially in
diabetics, and requires treatment and follow-up.
Increase in intra-ocular pressure can occur, and is controlled by drops.
Infections are rare.
The posterior capsule
gets opacified. Sometimes, few lens
behind inspite of through cleaning and these can grow and opacify later, thus
reducing vision at a later date. These are remedied by cutting the posterior
capsule with Laser. Posterior capsule opacification occurs to at least a minute
extent in 60% cases.
CME - Cystoid macular edema. This means swelling of the center of the retina
at the macula. This is not very common, except in diabetics and uveitis.
IOLs are very commonly in use now and they rarely cause any complications.
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