To determine if your cataract should be removed, your ophthalmologist at Physicians Eye Care and Laser Center will perform a thorough eye examination. If you and your doctor feel that the cataract should be removed, your surgery will be scheduled. Prior to your surgery you will need to see your primary care physician for a routine pre-operative physical exam. We will also make an appointment at Physicians Eye Care and Laser center to measure your eye to determine the proper power of the intraocular lens that will be placed in your eye. Your ophthalmologist will also talk to you about the possible use of special lenses or procedures to decrease astigmatism, and about the new multifocal lens implants. Talk to your ophthalmologist about use of your usual medications before surgery.

You must make arrangements to have someone drive you home after surgery.

The Day of Surgery

Surgery is done on an outpatient basis, either at the Snowden River Surgical Center, St. Agnes Hospital outpatient surgery center, or the ambulatory care center at Howard County General Hospital. You will be asked to skip breakfast, but generally should take any medications you normally take in the morning, especially blood pressure medications. These may be taken with a small amount of water.

When you arrive for surgery, you will be given eye drops and a mild intravenous sedative to help you relax. A local anesthetic will numb your eye. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed over your eye and around your head. Your eye will be kept open by an eyelid speculum. You may see light and movement, but you will not be able to see the surgery while it is happening.

Under an operating microscope, a small incision is made in the eye. In most cataract surgeries, tiny surgical instruments are used to break apart and remove the cloudy lens from the eye using a combination of suction and ultrasound. The technique is called phacoemulsification. The back membrane of the lens (called the posterior capsule) is left in place to help support the lens implant for the first few weeks while the eye is healing. The lens implant becomes a permanent part of your eye; you will not see or feel it, and it will last for your lifetime.

After surgery is completed, your doctor may place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home.

Following Surgery
You will need to:

• Use the eye drops as prescribed
• Be careful not to rub or press on your eye
• Avoid strenuous activities until your ophthalmologist tells you to resume them
• Ask your doctor when you can begin driving
• Wear eyeglasses or an eye shield, as advised by your doctor

You can continue most normal daily activities. Over-the-counter pain medicine may be used, if necessary. You will receive full instructions in writing after the surgery. You will need to be seen at one of the Physicians Eye Care and Laser Center offices the day after surgery, then again one or two weeks later. By two to four weeks after the surgery, the eye is usually stable enough to give a prescription for glasses, if needed. Surgery can be scheduled for your second eye as soon as two weeks after the first surgery.

After Cataract

In some eyes, over the course of time after cataract surgery, the lens capsule (the part of the eye that holds the lens in place) sometimes becomes cloudy This can occur several months or years after the original cataract operation. If the cloudy capsule blurs your vision, your ophthalmologist can perform a second surgery using a laser. During the second procedure, called a posterior capsulotomy, a laser is used to make an opening in the cloudy lens capsule, restoring normal vision. Unlike the original cataract surgery, there are no external openings made in the eye, so there is no restriction on your activity and no special eye drops needed after this office procedure.

Complications After Cataract Surgery
Though they rarely occur, serious complications of cataract surgery are:

• Infection
• Bleeding
• Swelling
• Detachment of the retina

• Pain not relieved by nonprescription pain medication
• Loss of vision
• Nausea, vomiting, or excessive coughing
• Injury to the eye

Even if cataract surgery is successful, some patients may not see as well as they would like to. Other eye problems such as macular degeneration (aging of the retina), glaucoma or diabetic retinopathy may limit vision after surgery. Even with these problems, cataract surgery may still be worthwhile.