Coming into Hospital

What to expect on admission to hospital
What happens during surgery?

 

What to expect on admission to hospital

You will be welcomed at the hospital and shown to the ward where you will be settled in. A nurse will carry out routine investigations including checking your pulse and blood pressure. The nurse will also record details of any medications you are taking and ask questions about your general health.

Once this has all been completed the nurse will instil the drops which dilate your pupil in readiness for the operation.

The Ophthalmic Nurse will come to see you to explain what will happen during and after the operation, and to answer any further questions you may have.

You will be asked to sign a consent form to state that you have been provided with, and understand all the information given relating to the operation (including the risks and benefits of surgery) and that you agree to the proposed treatment.

You will be taken to the operating theatre in your own clothes, so it is important to wear something comfortable.

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What happens during surgery?

From the patient’s perspective, surgery with the IOL-VIP is very similar to a standard cataract extraction. The removal of the patient’s natural lens is performed in exactly the same way, but thereafter the procedure differs.

The IOL VIP procedure involves implanting two lenses rather than one, which is the method by which the larger image is produced on the retina and the telescopic benefit is obtained.

Surgery is usually carried out under local anaesthesia, which involves gently injecting anaesthetic around the eye. The anaesthesia will numb the eye and allow it to remain still during the procedure. You may be offered sedation if you are particularly anxious, which will help you relax whilst the procedure is carried out.

You will be awake during the operation and aware of some movement and touch, but the procedure will be painless.

You will be made comfortable on the operating couch, following which the skin around your eye will be thoroughly cleansed and a sterile cover (“drape”) will be placed over your eye and face.
The cover will be lifted off your mouth so you can talk and breathe easily. Your eyelids will be gently held open, although your eye will feel closed.

You will see little of what is happening during surgery but we will explain what we are doing as the operation goes along. The theatre staff will make sure you are comfortable and help you relax. Someone will be there to hold your hand if you wish.

The IOL VIP surgery will take a little longer than standard cataract extraction because of the implantation of a second lens and the need to use sutures. The operation usually takes about thirty minutes, but in some cases may take longer. Surgery begins with lens extraction, as used in standard cataract removal. This is known as phaco-emulsification.

The natural lens of the eye is contained within a “capsular bag”. The aim of surgery is to remove the lens contents whilst leaving the capsular bag intact, apart from a circular hole on the front surface through which we work.

An ultrasonic probe breaks up and then vacuums away the natural lens material, leaving a cavity into which the new lens is inserted.

The first lens is implanted into the capsular bag. The implant lens slips into the eye through an enlarged incision and once situated within the capsular bag is adjusted into position.

An easy way to visualise this process is to think of the natural lens as a smartie, the chocolate being removed to leave an empty case in which the first new implant lens will sit.

The second lens is implanted into the anterior chamber, the space in front of the iris.

It is because the IOL VIP lenses are not flexible, that a larger incision is required compared with standard cataract surgery and sutures are used at the end of the procedure.

You will not be able to feel either of the new implant lenses.

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