Cataract Surgery
On the Day of Surgery
You need to arrive at the outpatient surgical suite no later than 45 minutes prior to the procedure. This affords the staff sufficient time to get you prepared for the procedure. You are given drops to dilate the eye and medications for relaxation. Cataract surgery usually takes about 10 minutes, but patients should expect to be at the facility for about one or two hours.
An anesthesiologist will be present during cataract surgery to administer intravenous medication through an arm vein to help you be comfortable. In addition, anesthetic drops are placed in the eye to eliminate pain or discomfort. This is called “topical anesthesia.” The surgeons at EDOW have published scientific articles on the effectiveness of this state-of-the-art technique. In some instances, several local injections are given through the eyelids that numb the area of the eye and prevent movement during surgery.
The Procedure
Cataract surgery is performed with an operating microscope that magnifies the image of the eye, giving the surgeon the ability to remove the cataract with precision.
After adequate anesthesia is administered to calm and relax the patient, a small incision is made in the cornea. A round opening, a capsulorhexis, is made in the outer coating of the lens (the lens capsule). The inner hard central lens nucleus is then fragmented and removed in a finely controlled manner using ultrasound. This is called phacoemulsification. Once all of the inner lens components are removed, there is an empty capsular bag. The intraocular lens, ReSTOR® or ReZoom™, is then loaded into a cartridge and inserted into the capsular bag. Since the incision remains small, there is no need for stitches or a patch at the conclusion of the surgery.
The surgeons at Eye Doctors of Washington have performed thousands of surgical cataract treatments and are nationally and internationally recognized. We are delighted to further assist you with any information about cataract treatments and cataract surgery. Please feel free to contact our Chevy Chase, Maryland and Washington, DC, area offices serving Bethesda, Northern Virginia, and surrounding areas for more information.
Post Operative Care and Recovery
Once the procedure is complete the patient is taken to the recovery area. The staff will then instruct the patient and family members on the recovery process. While healing, the patient will need specially medicated eye drops. This is done with decreasing frequency over the first three weeks after cataract surgery. At that time, the eye is usually stable and glasses will be prescribed (if needed). A small amount of gradual healing may continue over several months, which may necessitate a minor change in spectacle prescription.
Please click here to obtain a copy of the pre- and post-operative instructions.
Complications and Risks
Cataract surgery is a common procedure that is typically very successful. Like all surgery, however, there is a risk of problems or complications either during the operation or afterward. We make every effort to minimize the chance of problems or complications.
Many articles in the press tend to trivialize the risks of having cataract surgery. This is not appropriate. The surgery is not trivial. You should understand that this surgery should be undertaken only because your vision has decreased to the point where you are having difficulty doing things that are important in your daily life.
The serious complications of cataract surgery include bleeding, postoperative infection, severe corneal edema, retinal detachment, and even loss of vision or the eye. Fortunately, these happen very rarely. All of these complications occur at an incidence of far less than 1 percent in patients without a pre-existing condition. Less serious postoperative complications include drooping of the upper eyelid, transient elevation of eye pressure, transient corneal edema, clouding of the capsular bag, permanent irregularity or dilation of the pupil, and, occasionally, development of astigmatism (an irregular curving of the cornea). Most of these complications, with the exception of the shape of the pupil, are treatable.
The vast majority of cataract patients are pleased with the restoration of vision after surgery. Recent advances in cataract surgery have been one of the wonders of modern medicine and have contributed enormously to the quality of life for people.
YAG Capsulotomy
Some patients will develop clouding of the capsular bag in which the lens was inserted. This is called posterior capsular opacification. It occurs in about 20 to 33 percent of patients usually months to years after the original cataract surgery. The usual symptoms are diminished visual acuity or glare.
Posterior capsular opacification is easily remedied with a brief, painless laser treatment. The laser treatment is called a YAG capsulotomy. Dr. Gaasterland holds patents and assisted in the development of YAG laser systems. This procedure is performed in the office and takes about five minutes. There is no convalescence required. Patients can return to full vocational and recreational activities immediately.
Complications from YAG capsulotomy are quite rare. The medical literature does report cases of retinal detachment, movement of the intraocular lens, and bleeding. In 10 years and thousands of cases, no serious side effect has ever occurred to any of the patients at EDOW from this procedure.