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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Illustration
Illustration
Cataract Extraction with Intraocular Lens Implantation
What is a cataract extraction with intraocular lens
implantation?
A cataract extraction with intraocular lens implantation is
a procedure in which an eye surgeon removes a clouded lens
(cataract) from the eye and replaces it with an artificial
lens (lens implant).
When is it used?
Cataracts can cause vision problems by preventing clear
images from reaching the retina (the light-sensitive tissue
at the back of the eye). You may choose to have cataract
surgery because you need to have better vision to continue
your normal activities. In the early stages of cataracts,
an alternative to surgery may be to change your glasses.
Alternatives to having an intraocular lens implanted in your
eye after removal of a cataract are:
- wearing contact lenses
- wearing cataract glasses.
You should ask your eye doctor about these choices.
How do I prepare for the procedure?
Plan for your care and recovery after the operation,
especially if you are to have general anesthesia. Allow for
time to rest and try to find people to help you with your
day-to-day duties.
Follow instructions provided by your doctor. No particular
preparation is needed for local anesthesia. If you are to
have general anesthesia, eat a light meal, such as soup or
salad, the night before the procedure. Do not eat or drink
anything after midnight or the morning before the procedure.
Do not even drink coffee, tea, or water.
Do not wear eye makeup on the day of the surgery. Also, tell
your doctor about any kind of medications you are taking. Ask
your doctor if it is okay for you to take your medications the
day of surgery.
What happens during the procedure?
You will be given a local or general anesthetic to prevent
pain during the operation. A local anesthetic numbs your
eye while you remain awake. A general anesthetic relaxes
your muscles and puts you to sleep. Most surgery is done
with local anesthesia only. Sometimes the doctor will give
you a sedative to help you relax.
The surgeon will make a small cut in your eye and remove the
cloudy lens. The surgeon will remove the lens by either:
- Nuclear expression: A procedure in which the lens is
removed in one piece.
- Phacoemulsification: A procedure in which sound waves
(ultrasound) are used to break the lens into small pieces.
The small pieces are then removed through a narrow
hollow tube.
After the lens is removed, the surgeon will put a plastic
lens in your eye. The surgeon may put one or more stitches
in your eye and then put a patch over the eye.
What happens after the procedure?
You will be in the recovery area for about an hour after
surgery or until you are ready to go home. Have someone
take you home.
It's normal to feel itching, sticky eyelids, and mild
discomfort for a while after cataract surgery. Some fluid
discharge is also common. If you have discomfort, your
doctor may suggest a nonaspirin pain reliever every 4 to 6
hours (aspirin can cause bleeding). After 1 to 2 days, the
discomfort should stop.
You will have few limits on your activities after surgery.
You can read and watch TV almost right away, but your vision
may be blurry at first. You can do simple tasks such as
ride in a car, stoop over to put on shoes, resume normal
work, and visit friends. Do not rub your eye or allow water
or other substances to get into your eye. Avoid being
struck in the eye.
Your eye doctor will schedule exams to remove the patch and
to check on your progress. You may need to use eyedrops to
help healing or to prevent infection or inflammation. For a
few days after surgery, you may also use eyedrops or take
pills to control the pressure in your eye. Ask your doctor
how and when to use the drops or pills and what effects they
can have.
In most cases, it takes about 6 weeks for the eye to heal.
You will be ready for new glasses in about 1 month. It may
take a few more weeks for the sharpest vision to return.
What are the benefits of this procedure?
You can regain nearly normal vision if the rest of your eye
is normal.
What are the risks of this procedure?
The risks of this procedure include:
- infection
- bleeding
- inflammation (pain, redness, swelling)
- glaucoma (higher pressure inside your eye)
- retinal detachment
- need for additional surgery
- loss of vision (rare).
There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
A local anesthetic may not numb the area quite enough and
you may feel some minor discomfort. Also, in rare cases you
may have an allergic reaction to the drug used in this type
of anesthesia. Local anesthesia is considered safer than
general anesthesia and is used for most cataract surgeries.
You may develop an after-cataract. When this happens, the
back part of the capsule that enclosed your lens becomes
cloudy and blurs the image reaching the retina at the back of
your eye. The after-cataract can be treated with a laser. In
a procedure called YAG capsulotomy, your doctor uses a laser
beam to make a tiny hole in the clouded capsule so a clear
image can reach the back of the eye. This is a painless
outpatient procedure with low risk.
Ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You have unusual pain.
- You have a sudden loss of vision.
- You have a lot of drainage from your eye.
- You develop a fever.
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