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.

If your biometry measurement was not carried out prior to admission this will be performed soon after your arrival. 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?

Most cataract surgery today is carried out using topical anaesthesia. This involves using eye drops to numb the eye and surrounding area. You will be awake during the operation and aware of some movement, touch and water, but the procedure will be painless.

For some patients we may recommend local anaesthesia which involves gently injecting anaesthetic around the eye. You may be offered sedation if you are particularly anxious, which will help you relax whilst the procedure is carried out.

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 breathe and talk easily.

Your eyelids will be gently held open and you will be asked to look at a central light which positions your eye in preparation for surgery.

You 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 operation usually takes about fifteen to twenty minutes, but in some cases may take longer.

Many people believe laser is used to remove cataracts, but this is not the case. The modern technique of cataract extraction is called phaco-emulsification. It is performed using an operating microscope and involves making a very small incision in the cornea of the eye (the clear part at the front covering the iris and pupil) through which a tiny probe is inserted. The incision is self-sealing so stitches are not required.

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 cataract material, leaving a cavity into which the new lens is inserted.

 

The rolled-up implant lens slips into the eye through the tiny corneal incision and once situated within the capsular bag, unrolls and is adjusted into position. You will not be able to feel this new implant lens.

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

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