What to Expect During Outpatient Cataract Surgery

Cataracts happen when the natural lens of the eye becomes cloudy as a normal part of aging, but can happen faster because of metabolic diseases, smoking, or trauma. The result is cloudy or blurry vision, poor night vision, and increased glare from lights. Cataracts most frequently occur as people age, with the majority of people over 80 experiencing a cataract.

Cataracts usually come on slowly and you may not need surgery right away. Most people choose cataract surgery once cloudy vision interferes with working, driving, or reading.

Outpatient cataract surgery is a safe and routine surgery. Nine out of 10 people see much better after surgery. The odds are even better for those who don’t have another eye condition, like glaucoma or diabetic retinopathy.

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Preparing for Outpatient Cataract Surgery

Your doctor may perform a blood test or recommend a heart function test. These tests can make sure you don’t have any conditions that could make surgery risky.

In addition, the doctor will also take measurements of your eye using ultrasound technology. This is a noninvasive and painless test.

In a pre-surgery appointment, your doctor may prescribe eye drops for before and after surgery. These drops include antibiotics and anti-inflammatories that reduce the risk of complications. You will receive instructions on when and how to put these in your eye.

Your doctor will also ask about your medications. If you are taking certain medications, such as blood thinners, your doctor may ask you to stop these medications for a short period of time before the surgery. Usually, this means not taking the medication on the morning of the surgery.

You will need to avoid eating or drinking a certain number of hours before surgery if your doctor recommends general anesthesia. Outpatient cataract surgery is usually done under local anesthesia with mild sedation, similar to what you might receive for a colonoscopy.

What Happens During Cataract Surgery?

Your doctor will typically only operate on one eye at a time. If you have cataracts in both eyes, your doctor will usually schedule surgery for the other eye a few weeks after the first.

Before the surgery, the nurse or doctor will put eye drops with numbing medication into your eye. Depending on the situation, your doctor may also inject anesthetic (or numbing) medication near the eye. Either way, you should not experience any pain during the surgery.

The nurse will also insert an intravenous catheter into your arm to deliver medication that will help you to relax during the surgery.

When it’s time to begin the procedure, the surgeon will make a small incision in the outer layer of the eye. Then the doctor will remove the natural lens, with the cataract, and replace it with a new artificial lens. Although there is no pain during this part, people commonly describe being aware of a “light show” phenomenon when the cataract is removed.

The actual procedure usually takes less than 30 minutes.

Types of Cataract Surgery

There are three types of cataract surgery. Your doctor will recommend the one that’s best for you. (Laser surgery may not be available in all outpatient cataract surgery clinics.)

Small incision surgery. The surgeon makes a small cut in the outer eye. Then the doctor uses a tool that emits ultrasound waves to break up the lens and remove it in pieces.

Laser assisted surgery. A computer-guided laser makes an incision in the eye. Then the surgery proceeds as with small-incision surgery.

Extracapsular surgery. This involves making a larger incision and taking out the lens in one piece. This type of cataract surgery is rare, and used for mature or dense cataracts that are difficult to break up.

How Long Does It Take to Recover from Cataract Surgery?

You’ll be drowsy from the sedative medication, so you’ll need someone to drive you home. On the first day, you should take it easy and rest. You should take any eye drops or medication recommended by your doctor.

To avoid infection and irritation, you should wash around the eye only with water and use a clean washcloth each time. You need to also avoid rubbing or pressing on the eye the first few weeks after your surgery.

Finally, you should avoid bending over and lifting heavy objects for a few weeks after the cataract surgery. This is to avoid straining the blood vessels in your eye.

While they are very rare, complications like bleeding, swelling, and infection can occur. If you experience any of the following, contact your doctor right away:

  • Increasing pain that doesn’t get better with medication.
  • Floaters or spots in your vision.
  • Vision loss in the eye.
  • A fever.
  • Increasing redness or swelling that doesn’t improve after the first day.
  • Vomiting.
  • Green or yellow discharge from the eye.

You will be able to see after your surgery, but your final vision outcome may take between 3 to 6 weeks, until the eye is fully healed. Your doctor will schedule one or more follow-up appointments to make sure you’re recovering well.

Sources

American Academy of Ophthalmology. Cataract Surgery Patient Information. Link

American Academy of Ophthalmology. Cataract Surgery: Risks, Recovery, Costs. Link

Consumer Reports. Cataract Surgery Dos and Don'ts. Link

National Health Institute. At a Glance: Cataracts. Link

Dr. David Paine. How long does it take to remove a cataract? emedicineHealth. Link

About Eye Center

The UPMC Eye Center is a national leader in the treatment of eye diseases and disorders. We seek to improve and restore your vision to help your quality of life, diagnosing and treating a wide range of conditions in both children and adults. Our treatments include both surgical and nonsurgical options. We also offer routine eye screenings and have full-scale optical shops. Find an eye expert close to you.