Following your Operation

Immediately after you cataract surgery
The day after your cataract surgery
How quickly will your vision improve?
When can you resume normal activities?
Driving and travel
When will you need to change your spectacles?
What can you do to help make your operation a success?
What are the risks and complications?

 

Immediately after your cataract surgery

After the operation you will return to the ward with a protective shield covering the operated eye. This remains in place overnight. You will be given a combination antibiotic and anti-inflammatory eye drop to take home, with written instructions on how to instil this and the frequency with which it should be used. We will make sure you know how to care for your eye when you get home.

Whilst resting after the operation you will be offered refreshments. You may leave the hospital when you feel ready.

During the first few hours after your operation the eye may water and feel sore. This is nothing to worry about and your normal headache tablets should settle any discomfort.

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The day after your cataract surgery

 

The plastic shield can be removed on the morning after your surgery. Usually you do not need to use it thereafter, although some patients prefer to wear the shield for the first few nights for peace of mind.

You may find the eye a little sticky and there might have been a slight discharge overnight. This is quite normal and you should cleanse the eye only if necessary, by wiping gently across your closed eyelids with cotton wool dampened with clean water.

You will then need to start your eye drops, noting the detailed written instructions given to you before you left hospital.

If you are running out of drops before your appointment at the clinic, you can request a repeat prescription from your GP.

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How quickly will your vision improve?

Your vision will certainly be blurred on the first post-operative day until your pupil returns to its normal size. Thereafter the operated eye can take time to settle but you should start to notice an improvement in your vision within a couple of days.

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When can you resume normal activities?

You may return to your normal daily activities as soon as you feel ready to do so, but specific written instructions will be given to you on discharge from hospital. As a guide however, for the first two weeks you should refrain from swimming, strenuous activities, high impact sports, heavy lifting and wearing eye make-up.

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Driving and travel

It is not advisable to drive until you feel confident to do so. Your ability to drive may be dependent upon a number of factors including the vision in your other eye and the quality of your vision when using both eyes together. This will be discussed with you prior to discharge from hospital.

If you are in any doubt regarding your visual status you should refrain from driving until you have been seen for review in the clinic.

It is acceptable to travel (including by air) following cataract surgery. However, please remember that you will need to continue putting drops in the eye for approximately three to four weeks. If you are unsure about making travel arrangements, please contact us for advice.

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When will you need to change your spectacles?

If you were wearing glasses prior to cataract surgery it is unlikely that the prescription lens will still be suitable for your operated eye. You will be advised at your follow-up appointment when to return to your local optometrist.

We always recommend that you wait at least a month from the date of surgery before getting new glasses, as your eye needs time to settle and the prescription can change.

In the interim, many people find they need to have the spectacle lens removed from the operated side if they are reliant upon the prescription lens for the non-operated eye. Other patients find they manage better without glasses for distance, using simple reading glasses for near.

A follow-up appointment in the outpatient clinic is usually arranged within a month of cataract surgery.

Some patients with cataract in both eyes choose to proceed to second eye surgery without being seen again in the outpatient clinic. There may be a feeling of imbalance between the two eyes before the second procedure is carried out and we can offer advice to help you deal with this.

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What can you do to help make your operation a success?

Following your cataract surgery it is very important that you instil the eye drops as instructed, as this will help prevent any complications such as infection or inflammation in the eye.

You should avoid knocking or rubbing your eye, but you may touch the surrounding area. Although it is safe to have a shower or bath, take care when washing your hair to avoid getting soapy water in your eye.

The eye can seem more sensitive to bright light for the first few days and you may find dark glasses helpful, especially in strong sunlight.

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What are the risks and complications?

The aim and potential outcome of cataract surgery will be discussed with you in clinic and again prior to your operation. If cataract is not the only condition affecting your eyesight, for example if you have age-related macular degeneration or diabetic eye disease, the potential for visual improvement may be limited.

Cataract extraction is one of the most successful surgical procedures in modern medicine with over ninety-eight per cent of patients experiencing an improvement in vision. Our team operates from modern private hospitals where the equipment and products used in the operating theatre are of the highest standard. Every effort is made to minimise risk and ensure your operation is safe. Serious problems during or after cataract surgery are rare, however every surgical procedure has risks and potential complications.

Complications at the time of surgery:

  • Tearing of the lens capsule. Capsular rupture makes it difficult to place the new lens within the capsular bag. If we are unable to position the lens implant safely, this part of the operation will be deferred to a later date.

  • Loss of cataract material into the eye. Dislocation of all or part of the cataract into the back of the eye during surgery necessitates a more complex procedure (vitrectomy) to remove the lens fragments.

Complications early in your recovery:

  • Endophthalmitis. Infection in the eye, affecting approximately one in a thousand cases, is a rare but potentially devastating complication. All aspects of comfort and vision should improve over the first few days following surgery, but if there is any deterioration you should contact us immediately or attend the Eye Casualty Department. Prompt treatment improves the chance of avoiding permanent visual loss.

  • Bruising of the eye or eyelids. If local anaesthetic is used it may cause some bruising around the eye, particularly on the lower lid. The sclera may be red where the tiny incisions are made into the eye. This usually resolves completely within the first month.

  • Double vision. If a local anaesthetic injection is used to numb your eye it takes some time to wear off and this may leave one or more of the muscles around the eye weak for the first few hours. This causes double vision, which resolves spontaneously.

  • A temporary increase in the intra-ocular pressure in the eye. This necessitates an additional course of eye drops or tablets. Patients with advanced cataract or known glaucoma may be asked to take oral medication to prevent this.

  • Cystoid macular oedema. Swelling of the central macular area of the retina causes blurred vision. This usually resolves within a few weeks of using additional eye drops.

  • Corneal oedema. Clouding of the cornea is rare and usually clears within a couple of weeks.

  • Allergy to eye drops. Ocular allergy typically causes lid swelling, itching or redness. If this happens please let us know and we can prescribe an alternative drop. Some patients are allergic to the preservative used in eye drops. If you have previously had a reaction, please inform us prior to surgery so that we can prescribe a preservative-free option.

Complications late in your recovery:

  • Thickening of the posterior part of the capsular bag. This can occur at any time after cataract surgery. The new lens implanted in your eye cannot develop cataract like your natural lens, but some patients develop similar symptoms of mistiness over time. This is easily corrected with a simple and painless laser procedure known as YAG capsulotomy, which allows light once again to pass without interruption to the retina.

  • Retinal detachment. This is a sight-threatening condition in which the retina becomes separated from the inner wall of the eye. In most cases the retina can be re-attached and vision restored, but action should be taken promptly. If you notice floaters, flashing lights or a shadow blocking out part of your field of vision, you should contact us immediately or attend the Eye Casualty Department.

  • Instability of the implant lens. Movement of the implant lens within the capsular bag is most unusual. If this occurs however, it can be repositioned surgically.

  • Desired focusing not achieved. In spite of modern assessment techniques and implant lens technology, very occasionally patients do not achieve the focusing outcome they desire. If wearing a spectacle correction is unacceptable we can consider either adjustment of the implant lens or corneal refractive procedures, for example laser eye surgery.

  • Glaucoma. Any ocular surgery can increase the risk of glaucoma in later years. Glaucoma is damage to the main optic nerve of the eye, caused by an unsuitably high pressure. It is more common in short-sighted eyes and in individuals who have a family history of glaucoma. It can nearly always be controlled with eye drops, although prolonged or even indefinite use may be required.

  • Dry eyes. This is a common symptom with increasing age, for which many sufferers use simple lubricating drops. Interfering with the conjunctiva on the surface of the eye can upset the production of mucus, which is an important constituent of the tear film. In most cases this is temporary, responding to simple measures such as ocular lubricants and warm compress bathing. We will advise you on a treatment regime if required.

Information explaining how to care for your eye together with contact telephone numbers will be given to you on discharge from hospital.

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