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Patient information – Cataract removal and lens replacement

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Before surgery

  • Get someone to take you to hospital and home again – you will not be able to drive yourself.
  • Dress casually.
  • Wear slip-on shoes and a top that buttons down the front – you will be given a dressing gown to wear.
  • Do not wear jewellery other than a wedding ring.
  • Thoroughly wash your face.
  • Don’t wear make-up.
  • No contact lenses.
  • Discuss your oral medications with Mr Malhotra – they can usually be taken with a sip of water.
  • A nurse will help you prepare for your operation. This will include giving you some eyedrops that dilate the pupil. These drops temporarily affect your vision.
  • You will move from your room to the anaesthetic room either on foot or in a wheelchair.

If your operation is scheduled for the morning:

  • You may have an early, light breakfast – do not eat or drink anything after 7.30am.

If your operation is scheduled for the afternoon:

  • You may have an early, light lunch – do not eat or drink anything after 12.30pm.

During surgery

  • You will lie down for up to half an hour in the anaesthetic room before being taken to the operating theatre.
  • Lie flat, keep still and do not talk during the operation.
  • Your other eye will be covered and you will see bright lights.
  • You may hear some noises from the machine that powers the ultrasound probe – this is normal.
  • You may see many different colours – this is normal and can be enjoyable.
  • You may feel water on your skin and hair – this is linked to the procedure.
  • Mr Malhotra may explain what is happening as the operation goes along.
  • The procedure involves a tiny key-hole cut (incision) at the top of the eye.
  • This incision is self-sealing and is usually so small that no stitch (suture) is required.
  • Mr Malhotra works with very fine instruments while looking at the eye through a microscope.
  • A hole is made in the lens capsule covering the front surface of the cataract.
  • The cataract is broken up into very small pieces and sucked up through the ultrasound probe, out of the eye.
  • Once the cataract is removed, a small folded plastic lens implant is inserted into the eye through the incision and unfolded inside the lens capsule to replace the original lens.
  • The procedure usually takes 15 to 20 minutes.

After surgery

  • After your surgery, your eye will be covered with an eye pad and shield which may be removed the same day, as appropriate.
  • You may be prescribed a tablet to stop the pressure in your eye rising in the first day following surgery. This drug – Diamox or Acetazolamide – can make you feel tired or give you pins and needles. The sensation should only last a day or two.
  • Remember that it is easier to prevent complications than deal with them – don’t take risks and don’t overdo it.
  • You should not drive until after your sight has been tested and you have been given the go-ahead by your surgeon, so arrange for someone to collect your from the hospital.
  • Ensure that someone is with you for the next 24 hours.
  • Wash your hair leaning backwards rather than forwards for the first few weeks to avoid getting shampoo in the eyes – you may need help.
  • Do not use hairspray, perms, tints or hood hair dryers for one week.
  • Be cautious if it’s windy – something could blow into your eye and injure it.
  • You will be given antibiotic or steroid eye drops to use after the operation – if you are given ointment, ask for drops instead.
  • Use the drops four times daily, reducing by one session every week for a month. In the last week, you’ll be using the drops once a day. Complete the course.
  • If your eyelid becomes sticky, clean it with cotton wool soaked in sterile salt water solution or cooled boiled water.
  • Your eye may look bloodshot for a few days.
  • Your eye may feel gritty for a few weeks as the wound heals.
  • Some people experience slightly blurred vision. This will clear in the coming weeks.
  • Your vision in the treated eye might quiver occasionally for the first few weeks – this is normal. It is the new lens settling itself.
  • If you experience floaters in your eye or persistent flashing lights, telephone the hospital for advice.
  • Use the plastic eye-shield you are given every night when you go to sleep for two weeks. Use sticking plaster to keep it in place. Use your glasses or sunglasses during the day if they are comfortable.
  • If you notice any increase in redness, sensitivity, visual disturbance or pain, contact the hospital at once.
  • Avoid swimming, gardening, lifting heavy weights, getting soapy water into the eye or touching and rubbing the eye for at least six weeks or until after your outpatient’s consultation but otherwise go about your life normally.
  • If you want to resume driving, check with Mr Malhotra first.
  • Wait at least a month before taking an eye test to confirm whether you need glasses and what your prescription should be – it takes time for the eye to settle.

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