Cataract and Lens Implants

How do I know when my cataract is ready to be operated?

A mature cataract has to be operated otherwise it can lead to other complications. Since a mature cataract blocks nearly all the light from entering the eye. Your vision will be very poor. A mature cataract can even be observed by looking at the eye from outside. It produces a white reflex seen in the normally black pupil. At other times the decision has to be taken by you depending on your visual needs.

I am a diabetic. Will I face any extra risk during or after the surgery?

Diabetics are evaluated by the house physician prior to surgery before clearance for surgery is given. Poorly controlled diabetes is a risk factor for postoperative infection. Mild to moderate postoperative inflammation (reaction in the eye) is more common in diabetics. Sometimes there may be a worsening of Diabetic Retinopathy (affection of the retina in diabetics) after cataract surgery. Your doctor will however discuss this with you before surgery if he thinks that this is likely to happen.

Will the surgery be painful? What anaesthesia will you use?

Cataract Surgery is not painful. If you experience any discomfort during surgery, a mild intravenous painkiller or sedative can be given. Anaesthesia may be topical (as eye drops), local (an injection around the eye) or general (producing complete unconsciousness). The type of anaesthesia to be employed is decided by the surgeon and physician.

What is microsurgery?

All surgeries on the eye are done under the operating microscope which provides a magnified view of the operating field. Fine, meticulous surgery on the delicate structures can thus be performed. This is sometimes called “microsurgery”. All surgeries in Rotary Narayana Nethralaya are “microsurgeries”.

One of my eyes was operated earlier without an IOL implantation (this is called aphakia). I am keen to have an IOL implanted in my other eye. Will there be any problems?

An IOL can be implanted in the fellow eye. However the patient may have a problem of double vision with his glasses later since the eye with the IOL requires little power (thin glasses), while the aphakic eye requires a high powered convex lens. This thick convex lens produces a 1/3 increase in image size in that eye. The brain is unable to fuse the images from the two eyes because of their different sizes resulting in double vision.

One way around this problem is to use a contact lens on the aphakic eye so that the patient can wear thin glasses over both eyes. However not many patients like to wear contact lenses because of difficulty in inserting and removing the contact lens daily.

The other option is to implant an IOL in the aphakic eye so that both eyes eventually have IOLs. However this “Secondary IOL implantation” implies a second surgery to the aphakic eye and consequently additional risks. You can discuss this with the surgeon after examination of the eyes.

Is the IOL lifelong or will it have to be replaced?

IOLs are lifelong. Only in very rare instances the IOL is removed. These situations include infection inside the eye vitreous surgery for complicated retinal detachments, if the power of the implanted IOL is not optimum etc. These situation are very rare.

Do I need to wear glasses after surgery even if an IOL is implanted?

Yes. Most patients will require some additional power in the form of glasses either for distance or near vision or both. The power to be worn is usually small and many patients can see quite well without glasses. In certain rare situations higher powered glasses may be required even after an IOL implantation.

Although an IOL implantation was planned, it was not inserted. Why?

Implanting an PC IOL requires an intact posterior capsule. If the capsular support is weak or deficient (in approximately 1 in 100 patients) the PC IOL cannot be implanted. Sometimes the surgeon may decide to implant an AC IOL . This decision can only be taken during surgery.

Can I lose my vision following cataract surgery?

Cataract Surgery is one of the safest and most successful of all surgeries in the eye. However infection or uncontrollable bleeding during surgery can rarely occur and cause loss of vision or even loss of the eye itself. Fortunately these complications are very rare.

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How safe is Cataract Surgery  |  Intraocular Lens  |  Patient Care