What to know about cataract surgery - 10 questions answered

Cataract surgery is a common procedure that involves removing the patient’s cloudy lens and replacing it with a clear, artificial one, called an intraocular lens. If you're preparing for cataract surgery, it's normal to want to find out more about the procedure and have questions. Here are 10 frequently asked questions to help you learn more about cataract surgery and have a better understanding of what to expect. 

Can I have cataract surgery if i'm on antibiotics?

At your preoperative appointment, it’s important to tell your consultant that you’re on antibiotics. If there’s an active infection or you’ve just started antibiotics, the surgery may be delayed and rescheduled for when the infection is gone. It may be fine to go ahead with cataract surgery if you’re on long-term antibiotics. You’ll be given advice on whether any medication needs to be stopped or adjusted before your procedure.  

Will I be under anaesthesia during cataract surgery?

In the majority of cases, cataract surgeries are performed under a local anaesthetic. This is usually done either by eye drops or anaesthetic around the eye. This means you’ll be awake for the procedure and may be able to see movement around your eye. However, you won’t be able to feel any pain. In rare cases, general anaesthesia may be used, such as for people who have severe anxiety or have other health conditions that mean they may not be suitable for local anaesthetic. 

Does astigmatism get worse after cataract treatment?

Astigmatism is when the cornea at the front of the eye is shaped more like a rugby ball than a football. A toric lens is designed to correct astigmatism and will ensure that all astigmatism is corrected. Astigmatism normally improves after cataract surgery, even if a toric lens isn't improved. Limbal relaxing incisions can also be made during cataract surgery to correct astigmatism, and this involves making incisions in the peripheral cornea. 

Can you develop cataracts twice?

Cataracts cannot recur after treatment because your new artificial lens is unable to cloud over and develop a cataract. However, there is a complication of cataract surgery called posterior capsular opacification (also known as a secondary cataract), which involves similar symptoms to cataracts. During cataract surgery, the cloudy lens is removed and replaced with an artificial lens, and this new lens sits on a membrane called a lens capsule. Months or years after surgery, people can sometimes develop haze in the lens capsule, which can make it feel like their cataract is returning. This is often a sign of posterior capsular opacification, and it can be treated with a quick procedure called YAG laser capsulotomy.

Can you have Cataract Surgery twice?

You can’t have cataract surgery twice, but you can have procedures to fix any complications in case they arise. However, complications aren’t common, and the vast majority of patients won’t experience any. IOL exchange is when the lens that was fitted during cataract surgery is removed and replaced with a different one. This could be for a number of reasons, such as if the intraocular lens slips out of position or if the patient is dissatisfied with it. 

Can both eyes be operated on at the same time?

For those who have cataracts in both eyes, the most common approach is to treat them on separate days, often a few weeks apart once the first eye has settled. This can allow for a smoother recovery and reduce risks. Although not suitable for everyone, it is possible to have both eyes operated on at the same time through immediate sequential bilateral cataract surgery. This can be discussed with your surgeon before you undergo surgery to decide whether this is a suitable option for you. 

What are the signs of complications after cataract surgery?

It’s common to experience side effects after cataract surgery for a few days to a few weeks, including blurred or double vision, red or gritty eyes, mild pain, sensitivity to light, and watery eyes. However, if these symptoms persist or worsen, especially when accompanied by other symptoms, they could be a sign of a complication. Although complications aren’t common, cataract operations can come with complications, and these will be explained to you before you undergo the procedure. Risks include eye infection, swelling, blurry vision, increased eye pressure, and dry eye.

How should I prepare for Cataract Surgery?

Before your cataract surgery, you’ll attend a pre-op assessment that involves a discussion of your medical history. Bring a list of any medications you take and be prepared to share information about your medical history with your consultant. During this appointment, you’ll also be told any specific ways you need to prepare and have any of your questions answered. If you have contact lenses, you may be advised not to wear them for a few days before your surgery.

After surgery, you won’t be able to drive straight away, so it’s important to be prepared with a way home. It’s also a good idea to have someone you can contact for around 24 hours after your surgery in case you need a bit of help when you arrive home.

Will I need glasses after Cataract Surgery?

Many people experience an improvement in their vision after they’ve had cataract surgery. Because of this, cataract surgery gives you the opportunity to correct your glasses prescription. Some people reduce their dependence on glasses, and sometimes don’t need to wear their glasses at all after surgery. This depends on a range of factors, such as which lens type was used and the patient's glasses prescription before surgery. 

How soon can I resume normal activities after Cataract Surgery?

Many patients can resume their normal activities within a few days or a week. Certain activities should be avoided for a longer period, such as swimming, wearing eye makeup, and strenuous activities, like heavy lifting and participating in sports. You should avoid driving until your vision returns to normal and wait until your consultant says it’s okay to do so. You’ll be given advice on aftercare as well as what should be avoided.