Cataract Operation Information

HOSPITAL: ......................................................................

DATE OF OPERATION: ......................................................................

ARRIVAL TIME AT HOSPITAL: ......................................................................

OPERATION ON RIGHT/LEFT EYE

SPECIAL FEATURES:- Small incision / no suture / topical anaesthetic.

- Insertion of intraocular lens.

- Attempted reduction of astigmatism.

- Combined with glaucoma drainage surgery.

Dear ................................................

Now that your cataract has progressed to the stage that an operation is required I would like you to spend a few minutes reading some notes I have prepared for you about the procedure.

As discussed with you, a cataract is clouding of the lens inside your eye. As the lens has become more opaque, your vision has gradually reduced. The only way to improve your sight is to remove the opaque lens. Once the lens (cataract) has been removed you will need something to focus your sight. Several possibilities exist but the best of these is to insert an artificial lens into your eye at the time of the operation.

This intraocular lens, or lens implant, is made of plastic or silicone and can remain in your eye without any discomfort forever. It never needs cleaning or replacing. There are a variety of different lens types and I have selected the one I feel best suited to your eye. The measurements I have taken from your eye are used to calculate the strength of the implant needed. This may reduce your need for glasses after the operation, however, you may still require glasses for detailed work or night driving.

On the day of your operation you can eat light meals until 2 hours prior to admission. Please do not drive yourself to hospital, you will also need to arrange for someone to take you home. Please arrive at the hospital at the arranged time and present yourself to patient reception. You will need to fast (no food) after your admission, but you may drink small amounts of water up to the time of your operation. The staff will look after you and change you into a theatre gown (wear light comfortable clothing to the hospital). They will put drops into your eye at regular intervals. These drops are similar to the drops put into your eye at my examination and enlarge the pupil to let me see the cataract. One of the drops is an antibiotic to prevent infection.

As discussed, the operation will be under local anaesthetic using eye drops. The anaesthetic drops will be put in your eye a few minutes before the operation begins, they may sting slightly for a few seconds before the eye goes numb. At this time you can still see but the bright light from the microscope will dazzle you so that you will see only vague movements or beautiful colours during the operation.

Your anaesthetist will monitor your blood pressure, pulse and blood oxygen content during the operation. He will also insert a small needle into a vein in your arm and if required will administer medication to relax you. Oxygen will be blown over your face to ensure that it does not get too stuffy under the drapes.

To begin with, I will wash your eyelids with antiseptic then cover you with a special stick-on plastic drape to keep the area clean and hopefully prevent any of the solutions used from running into your ear and feeling uncomfortable. During the operation your eyelids will be kept open by a speculum, an instrument which will prevent you from blinking. This may feel a little strange but will not be uncomfortable. I may ask you to look in a specific direction to make the operation easier for me. If at any time there is any discomfort please let me know as I can add more drops to numb your eye further. You will also hear some buzzing noises from the machinery, this is quite normal and should not concern you, but if at any time you have any queries please interrupt me and ask. Because of the small incision it is possible to interrupt the operation at any time (If for example you need to cough, but please try to warn me first.)

After the operation (which takes about 15 minutes) a clear protective shield is put over the eye. You may see vague outlines with the newly operated eye immediately. You will be taken to the recovery area for a while to rest and have light refreshment. Sight may improve quite dramatically as the eye starts to recover from the bright operating light.

During the first night you should be reasonably quiet but using the other eye will do no harm. Reading or watching television is OK. There should be little if any pain after the operation, however, you may notice a slight irritation like sand in the eye or a dull ache around the eye. You may also notice a drop or two or dry blood on the eyelids through the clear shield, this is quite normal and there is no cause for concern. If needed, a mild analgesic such as aspirin or panadol can be taken to ease the dull ache. If there is marked surface pain (burning & stinging) then use both eyedrops as they will sooth and lubricate the eye then replace the protective shield. The drops may be applied as often as required. Please use them last thing at night then replace the protective shield.If there is any problem during the night feel free to ring me at home. It is very common for the eyelids to be a little stuck up in the morning - remove and discard the shield then apply the eyedrops (this will usually free them up).

The next day I will review you. You may see quite a lot at this stage, although it will take about 3 weeks for the eye to fully heal. Your eye can now stay uncovered and I will usually ask you to put drops into your eye four times a day. The two drops can be put in together in any order. As the eye heals the drops will gradually be reduced to cease in a few weeks.

After the first day, you can resume normal activities, but I would ask you to refrain from very strenuous activity, or any activity during which the eye might be bumped or jarred. You can wash your hair at any time (shampoo may sting a bit, but will do no harm). Swimming is probably best avoided for three days. If you currently drive it may be possible to drive within a couple of days, however, I will discuss this with you after the operation. During the healing phase I will be reviewing you regularly. The intervals will be tailored to your eye, but are usually daily for two days then at 3 weeks. At the final review glasses are prescribed (temporary glasses can be fitted after a few days if needed).

After the first night there should be little discomfort. For a few days the eye may be a little irritable and watery. There will be no stitches in the eye because the small wound is self sealing. The eye will be sensitive to light as the cataract has been acting like a filter and blocking out light for a long time. The implant I insert has an ultraviolet filter to block out any harmful rays, however, you will probably feel more comfortable in sun glasses for a while. If you like, you can wear your old glasses until new ones are prescribed.

I hope these notes have answered your questions and helped reduced any anxieties you may have. Please remember, if you have any questions just ask me, or my staff.

Regards,
IAN ANDERSON.