Cataract surgery: starting from preparation, procedures, and side effects

Cataracts are one of the main causes of blindness, both in Indonesia and the world. As is known, the most common cause of cataracts is aging. Therefore, the number of cases of this disease will continue to increase in line with the increasing elderly population. The only way to completely cure this disease is to perform cataract surgery. However, not many know what happens during cataract surgery. Here it is the stages and the process.

What is cataract surgery?

Cataract surgery is a procedure to remove the lens of your eye and — in most cases — replace it with an artificial lens. This cataract treatment is usually an outpatient procedure that takes about 15 minutes to 1 hour.

Before the operation, the doctor will give eye drops to dilate the patient's pupil. The patient will also receive local anesthesia to relieve pain in the eye area to be operated on. During the operation, the patient will be conscious, but numb in the eye.

After the operation is complete, the doctor will ask the patient to rest for about 30-60 minutes. If there are no complaints, the doctor will let the patient go home.

There are three reasons a person is advised to undergo cataract surgery:

• Want to improve visual acuity, especially if the cataract symptoms that appear affect daily activities.
• If there are other medical conditions that are dangerous due to cataracts, such as glaucoma.
• Aesthetic reasons. Cataract patients will have a pupil (the center of the eye which is usually black) which is grayish in color. They can undergo cataract surgery even though the improvement in visual acuity is not very significant.

What are the types of cataract surgery?

There are several types of methods in carrying out cataract surgery procedures, the doctor will determine the best type taking into account your health. The following are various surgical methods that can be used to remove cataracts:

1. Phacoemulsification

This method is most commonly performed by making a small incision into the lens substance where the cataract is forming. The doctor will then insert a small instrument using ultrasound waves to break up the cataract and pull it out. The rear lens is left intact to accommodate the artificial lens.

2. Laser

Another option for cataract surgery is to use state-of-the-art laser techniques. This is a type of laser used in the LASIK surgery procedure. The ophthalmologist uses a laser to make all of the incisions and break the cataract to make it easier to destroy and remove.

3. Extracapsular cataract surgery

Unlike the previous method, this operation is performed with a larger incision in the eye. The doctor will remove the foggy front of the capsule and lens completely. This procedure is generally reserved for those whose cataracts have covered most of the lens of the eye and are experiencing certain complications.

4. Intracapsular cataract surgery

This one method involves removing the cataract lens, the capsule intact, through a large incision. This type of cataract surgery is relatively rare.

What are the side effects of cataract surgery?

Cataract eye surgery rarely causes serious side effects or complications. Even so, you may need to wear glasses or contact lenses for a while after surgery.

The most common side effects of cataract surgery after taking place include:

• Blurry vision
• The eyes become more sensitive to light
• Itching occurs in the eyes

Some patients may be completely cured after two months of surgery. Even so, this healing process will be different for each person. Apart from side effects, there are several possible complications from cataract surgery, namely:

• Inflammation
• Bleeding
• Infection
• Swelling
• Drooping eyelids
• Artificial lens dislocation
• Retinal detachment
• Glaucoma
• Secondary cataracts
• Loss of sight

Tell your doctor right away if after surgery you experience reddened eyes, persistent pain in the eye, nausea and vomiting, and loss of vision.

What needs to be prepared before cataract surgery?

After you and your eye doctor agree to do cataract surgery, you need to prepare a few things before doing it.

The following are some of the things you need to know before doing cataract surgery:

• A week or so before surgery, your doctor will perform a number of tests on you. These tests include general health checks, visual function checks, external eye examinations, examinations slit-lamp, examination of the inside of the eye, and biometric and topographic measurements of the cornea.
• You may also be asked to stop taking some medications that can increase your risk of bleeding during the surgical procedure.
• Use eye drops to reduce your risk of infection as directed by your doctor for one to two days before surgery.
• You will also be asked to fast for 12 hours before the surgery.
• Wear comfortable clothes and bring sunglasses when you go to the hospital for surgery.
• Do not use perfume, cream aftershave, or some other fragrance. It doesn't matter if you want to use face moisturizer, but avoid it make-up and false lashes.
• Get ready for the healing phase.

Everyone who has cataract surgery will be given an artificial lens called an intraocular lens. These lenses can improve your vision by focusing light on the back of your eye. The following are some of the types of lenses available for cataract patients:

• Fixed-focus monofocal: This lens has a single focus power for distance vision. When reading, you will probably still need reading glasses.
• Accommodating-focus monofocal: although the power of focus is also single, this lens can respond to eye muscle movements, and alternately focus on objects far or near.
• Multifocal: This type of lens has a function similar to that of a bifocal or progressive lens. Different points on the lens have different focus strengths, some for near, far, and medium distances.
• Astigmatism correction (toric): This lens is usually intended for those of you who have cylinder eyes. Using these lenses can help your vision.

What happens during cataract surgery?

At first, the doctor will give you an injection of anesthesia to relieve pain during the surgical procedure. Eye drops will also be given so that the pupil will be wider. Not to forget, the skin around the eyes and eyelids is also cleaned to make it more sterile during the operation process.

Next, the operation begins by making a small incision in the cornea of ​​the eye so that the lens in the eye that is blurry due to cataracts will open. The doctor then inserts an ultrasound probe into the eye, with the aim of removing the cataract lens.

The probe that delivers ultrasound waves will destroy the cataract lens as well as remove any remaining parts. A new lens implant is then inserted into the eye through the small incision.

In most cases, the incision is able to close on its own so there is no need for sutures to the cornea. Finally, your eyes will be closed using a bandage to mark the operation is over.

In fact, you will be given an anesthetic injection during the operation process. Most people do not feel very painful during and after this surgery. However, some others may feel pain. This may be because everyone's ability to endure pain is different.

What happens after the procedure?

Your doctor may ask you to wear a patch or eye protection on the day of the operation until a few days later. The eye patch or shield is also used to protect your eyes while sleeping during the recovery period. The goal is to avoid accidentally rubbing your eyes.

You may feel itchy eyes for one to two days after having the cataract surgery procedure. In fact, the vision usually appears blurry due to the adjustment during the healing process.

All of these conditions are normal and normal. You can submit all complaints related to postoperative problems at the doctor's visit which is usually scheduled a few days after surgery. The doctor will also monitor the condition of your eyes and the quality of your vision.

In addition, you will be prescribed eye drops to prevent infection, reduce inflammation, and control eye pressure. Avoid touching or rubbing your eyes for a while.

Has my vision returned to normal after cataract surgery?

Quoted from the Mayo Clinic, the cataract removal procedure is successful in restoring vision in the majority of people who undergo this procedure. The National Eye Institute says that about 9 in 10 people who have cataract surgery see better afterward, but your vision may be blurry early in your recovery.

Some people experience the ability to see colors that appear brighter after the cataran removal procedure. This is because the artificial lens that is still clear replaces the original lens that has become cloudy due to cataracts.

After your eye is completely healed, you may need a new eyeglass prescription or contact lens to be able to see clearly according to the sharpness of your eye.