Ophthalmologist
1. Sensation:
An incision is made on the cornea and it takes time for your nerves to re-establish their normal growth pattern. During this time, your eye may feel “like sand in the eye”. Some patients may experience mild pressure and heaviness.
These symptoms may last from several days to months. By using the prescribed eye drops, your eye should feel better each day.
2. Vision:
In the first week after cataract surgery, you may have a small pupil and your vision may seem “dark”. A small pupil is due to a medication put into your eye at the time of surgery to reduce the water pressure. This treatment pulls the iris (the colored part of your eye) away from the wound, so that the iris would not prolapse. It will take time up to one week for your pupil to return to normal. Your vision may fluctuate and eventually stabilizes seven weeks after cataract surgery. A new prescription for glasses is not accurate until 7 weeks from the day of surgery.
3. Medication drops:
The specific medication names will be given to you by the surgery coordinator. The surgical team will discuss with you about the use of your post-op eye medication, which will include:
i. A non-steroidal analgesic drop. You should not take this if you are allergic to Aspirin.
ii. A steroidal anti-inflammatory eye drop.
iii. An antibiotic to prevent infection.
iv. An artificial tear supplement to lubricate your tear film.Your tear film can be altered due to the wound on the cornea.
WHAT CAN HAPPEN A FEW DAYS AFTER CATARACT SURGERY
Dry Eye Syndrome
It is common to have dry eyes before and after cataract surgery. If you have a pre-existing dry eye problem or had Lasik/PRK surgery before cataract surgery, your eye may get even more irritated after surgery.
Artificial tears (with or without preservatives) and tear gel are common treatments for dry eyes.
There are also medications that can stimulate your natural tear production (for example Xiidra or Restasis) and it will take time (usually 2 weeks to a few months) to see the soothing effects.
Floaters
After cataract surgery, it is common to notice small moving spots in your field of vision. These are called floaters. They are microscopic collagen fibers within the vitreous jelly. This debris casts tiny shadows onto the retina. They are sometimes visible before the surgery, but more noticeable after the cataract has been removed.
Floaters are usually normal and harmless. However, if you notice MANY floaters, flashing lights, spider web, restricted side vision, or a sudden loss of vision, these may be signs of a retinal detachment. Retinal detachment is an emergency, and you will need to contact our office immediately. If it is outside of regular office hours, please proceed to your nearest hospital immediately. You may visit www.mayoclinic.org for more information.
WHAT CAN HAPPEN A FEW WEEKS OR MONTHS AFTER SURGERY?
What is Posterior Opacification (secondary cataract)?
A few weeks, months, or even years after cataract surgery, some patients may experience blurry and cloudy vision again. The clouding is caused by scar tissue that builds up on the capsular membrane that holds your lens implant. Your eye doctor will confirm if that is the case on the microscope. Secondary cataract occurs in 5% to 20% of patients depending on the lens design. Please visit www.aao.org for further information.
Can this be treated?
Yes, the cloudy membrane can be treated with a laser called YAG capsulotomy in the office. A YAG laser is a treatment covered by MSP. This laser creates a small hole in the membrane to improve your vision.
Your eye doctor will first dilate your pupils and decide if the membrane requires laser treatment. Although the YAG laser takes roughly 10 minutes or less to do, your appointment may take up to two hours. Your doctor will put anesthetic drops to freeze your eye before performing the laser, to eliminate pain and discomfort.
Are there risks to YAG laser?
After YAG laser, it is common for patients to notice an extra-large floater, which is a capsule remnant floating in your vitreous jelly. As the vitreous becomes more liquid with age (i.e. less thick), the capsule remnant will become less prominent and eventually descends out of your line of vision.
Besides that, the laser may cause your intraocular pressure to rise for a day or two after treatment. Therefore, your doctor will prescribe eye drops to keep your pressure controlled.
Some patients have a slightly higher chance of a retinal detachment after YAG laser treatment. Generally, an average eye size is between 23mm and 25mm. Eyes that are longer then 26mm have an increased risk. For that reason some patients may request to see a retinal specialist to see if preventative treatment could be given.
A peripheral retinal examination can sometimes be arranged to discover high risk retinal disorders (especially longer than 26mm) that may preclude retinal detachment occurrence. Evidence of lattice degeneration and retinal holes on a dilated eye exam is important.
A retinal specialist with indirect ophthalmoscopy and possible scleral depression is a good routine if risk factors are identified. These areas can be treated with preventative laser therapy and can be visualized better after cataract surgery.
WILL I HAVE ANY FOLLOW-UP APPOINTMENTS?
Sometime after your surgery you may be scheduled for an office visit with a technician for a specialized test called an OCT. This test photographs your macula and assesses it for any macular edema which is an uncommon swelling following surgery. Dr. Butler will review the tests and our office will contact you only if your results are abnormal.
Once your healing phase of roughly 7 weeks has been completed you may return to your regular eye doctor for continuing care.
The views and opinions expressed here are those of Dr. David Butler. They do not necessarily reflect the opinions of manufacturers or other doctors. Rev Feb 22-21