By Dr S.S. Gill
Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about what happens on the day of cataract surgery.
On the day of the cataract surgery at the hospital, do ensure that you do not have any facial makeup, eyeliners, cosmetics or powders of any kind. Have a thorough hair-wash and shower on the morning of surgery. The face especially should be washed well with a mild soap. Similar proper hygiene will have to be practised even during the healing phase after the surgery.
The first thing that will be done when you enter the hospital is instillation of eye drops to dilate the pupil. In the operation theatre, the area around your eye will be cleansed with a mild antiseptic followed by draping of the area surrounding the eye to be operated. In Malaysia, just as in the United States and the UK, the majority of cataract surgeries are performed by the phacoemulsification technique. The entire operation usually takes about 15 to 20 minutes and is relatively painless although a mild discomfort may sometimes be felt. You may choose to stay awake during surgery (local anaesthesia), while some others may request not to be awake during surgery (general anaesthesia). Either way, the surgical technique is the same. You will not have to worry about holding your eyelids open during the eye surgery because an instrument (eyelid speculum) will keep your eyelids open. Patients undergoing eye surgery under local anaesthesia will be able to see a bright light from the operating microscope that is used and movement of instruments during surgery.
Cataract removal and IOL implantation
The cataract surgery procedure is called phacoemulsification. It was introduced in 1967 by Charles D. Kelman, an American ophthalmologist (1930-2004).
During the surgery, a very tiny incision of 2.2mm to 2.75mm (depending upon surgeon’s preference) is made on the surface of the eye between the cornea (clear transparent part) and the sclera (white part of the eye). A thin phaco probe is inserted into the eye to break up the clouded cataract lens (photo on left). The tiny cataract pieces are then sucked out through the probe.
An artificial lens (intraocular lens or IOL) is then implanted into the eye. The IOL is a soft lens and will unfold in the eye as shown in the (photo on the right). After the operation, an eye pad and or eye shield will be placed over your eye and you will rest for a while before proceeding home.
Since you will not be able to drive, make sure you make arrangements for someone else to drive you home. The eye pad will be removed the following day. Remember not to wet the eye. If you are put on an eye shield instead of an eye pad, you may be asked to instil eye drops regularly on the same day after cataract operation. Remember to follow all instructions given to you after the operation.