Surgical treatment of cataracts has been practiced in ophthalmosurgery for quite a long time, but until recently, patients were reluctant to agree to surgery, putting it off until “later”. What was the reason for reluctance to go to the operating table? The main obstacle was the long rehabilitation period after cataract surgery. The patient would be hospitalized for at least two weeks, and then would face a long list of restrictions for several months with slow recovery.
The modern treatment of cataract is based on a fundamentally new approach using minimally invasive techniques. The surgeon no longer has to make long incisions, which increase the risk of complications and impose many prohibitions in the postoperative period. Phacoemulsification cataract surgery does not require admission to a hospital, is performed within 10-15 minutes without anesthesia, and is characterized by quick rehabilitation with minimal restrictions. Within the first hour after the surgery, the patient can leave the clinic without feeling any discomfort from the manipulations, which is especially important for elderly people and patients with various concomitant pathologies.
What is the recovery period after surgery?
If the surgery is successful, the patient will be able to see within 2-3 hours after the operation. If we talk about the limiting period, the first two weeks after surgery are the most important. Full recovery of the eye is noted 4-6 weeks after surgery.
Early recovery period
On the day of surgery, the patient receives recommendations about his behavior and leaves the clinic with a note that lists all the restrictions.
The eye must be covered with a protective bandage to prevent dust and dirt particles from getting into the operated area. When you come home the bandage is removed and drops are put into the eye, according to the memo every 2 hours. The next day the number of drops is reduced to 4 times a day. A bandage is not put on the eye. It is not necessary, you can safely use your new eyesight. However, it is recommended to wear dark sunglasses outdoors for barrier protection.
On the day of surgery, you may experience pain in the upper face (eye area, temples, forehead). In case of a pronounced pain syndrome, you can take an analgesic (Ketorol, Naise, etc.). The drug should be used according to the dosage given in the enclosed instructions.
It is extremely important to attend the follow-up appointments prescribed by the attending physician after surgery!
Recommendations for the rehabilitation period
Rules for post-operative period of cataract extraction received from your doctor should be treated with utmost responsibility. Though seemingly simple, they are very important in order to preserve the achieved result and prevent the development of complications.
Basic rules for rehabilitation after cataract:
Regimen. After replacement of the lens the postoperative period is sparing for the body, but it is not obligatory to be in bed. Home work should be manageable, without long bends and physical overstrain. Cleaning and other household tasks that require significant effort should be postponed for later.
Hygiene. In the first 3 days, do not wash your hair. Then you can wash your hair with your head thrown back to keep water and shampoo out of your eyes. You can not wash your face with running water, hygienic measures may include only wiping the skin with an antiseptic solution. If water accidentally gets into the operated eye, eye drops must be immediately applied without putting pressure on the eyeball.
Eye drops. Eye drops prescribed by the doctor can speed up recovery and prevent infection. These drops can be preparations with disinfectant, anti-inflammatory or combined action. The most popular agents are Tobradex, Ciprofloxacin, Maxitrol, Naclof. These recommendations may be supplemented by the attending physician at any of the routine examinations, taking into account the progress of recovery.
Rules for Drops
Rehabilitation after cataract requires paying attention to the smallest details of eye care. It is easy to make mistakes even when performing simple manipulations – thus, the injection of eye drops should follow certain rules:
- Wash your hands thoroughly with antibacterial soap;
- Open the bottle with the medicine prescribed to you;
- Hold your hands horizontally, or with your head slightly tilted back;
- Bring the bottle of drops to your eyes, without the tip making contact with your eyelashes;
- Using a finger of your other hand, gently pull the lower eyelid downward;
- Look up and gently squeeze the bottle so that a drop of solution is between the pulled back eyelid and the eyeball;
- Close your eyes and squeeze the inside corner of your eye with your finger to prevent the solution from leaking out of the conjunctival cavity;
- If more than one dose is prescribed, the interval between doses should be 5-10 minutes.
After the injection procedure, close the bottle immediately and place it out of the reach of children. Store the eye drops according to the instructions for use.
Patient’s visual acuity and glasses selection
Adaptation of the visual system to the new conditions occurs during the whole rehabilitation period after cataract surgery. The final results of the intervention can be assessed 4-6 weeks after the removal of the crystalline lens and IOL implantation. Before that time, the visual acuity is unequal in both eyes, so patients are often prescribed glasses until the visual function stabilizes. If glasses are necessary (for distance vision or short-distance work), they are prescribed after the recovery period is over. Contact lenses may also be worn, but careful attention must be paid to their cleaning and disinfection.
Additional recommendations
Some limitations apply to the entire rehabilitation period after lens replacement:
- It is necessary to protect the eyes from external mechanical influence and friction;
- Makeup should not be used, eyelashes should not be painted, eyelids should not be shadowed;
- Sleep on the opposite side of the operated eye for the first three days;
- Must wear sunglasses to protect against ultraviolet light;
- You should not bend, shake your head, put things over your head with a narrow neck;
- Should postpone for a while all manipulations with the hair (cutting, dyeing, perming);
- It is necessary to take care of the prevention of constipation in order to avoid pressure;
- Television and computer work are not prohibited, but the eyes should not get tired.
Visiting saunas, swimming pools, baths is contraindicated during the first month after the surgery.
During the first month you should avoid physical activity. Excluded are sports training, fitness, yoga, jumping, visiting the pool and sauna. Lifting heavy weights is forbidden: maximum weight allowed is 7-9 lbs (3-4 kg.) Physical overexertion increases the intraocular pressure, which could lead to hemorrhages and complications.
Important! Several weeks, months or years after the surgery, vision may deteriorate due to clouding of the crystalline lens capsule. This condition is called secondary cataract and is not related to the condition of the installed IOL. The defect can be easily corrected by laser correction directly on the capsular bag, and the vision returns to normal after the procedure.
Eye lens replacement is a surgical procedure that requires a rehabilitation period in order to achieve the effects of the treatment. After the surgery, it is necessary to strictly follow the doctor’s advice and prescriptions. If the prescribed conditions are followed, the patient will have clear vision and a shorter recovery period.
What is allowed after cataract surgery
- Wear an eye patch at home for a day, outdoors for 3-5 days;
- Walking is allowed in calm, clear weather one week after discharge;
- Wear sunglasses when leaving home for a walk;
- Cook meals, do light household chores;
- Getting a full night’s sleep for up to 9 hours;
- Using drops according to a plan made by an ophthalmologist;
- Watching television programs or working on a laptop no more than 30 minutes a day.
In the postoperative period it is necessary to visit an ophthalmologist periodically for diagnosis and examination.
What is forbidden to do?
- Limit visual stress – no more than half an hour a day is allowed to watch TV programs or work on a laptop;
- Exclude bad habits: refuse to drink alcohol, smoke, including passive smoking;
- For 3 days after discharge from the clinic, do not wash your hair;
- During the entire recovery period, do not use decorative cosmetics;
- Limit fluid intake during the first seven days;
- Avoid direct sunlight – wear sunglasses when walking outside;
- Refrain from driving for 30 days;
- Do not take hot baths;
- In the first few days, avoid getting tap water in your eyes, do not use cosmetic gels and foams to wash your face;
- Men are advised to give up the use of electric razors that create vibrations;
- Do not sleep on your stomach or on the side of the operated eye;
- In the diet, limit the amount of spices, animal fats, and verified salt consumed;
- Do not remove the fixation bandage for two days;
- Do not visit baths, swimming pools, or saunas;
- Avoid dusty and smoky places;
- It is forbidden to lift weights over 7lbs (3 kg);
- Restrict physical activity for one month.
When should you visit your doctor?
You should visit your doctor urgently if the following symptoms occur in the postoperative period:
- Fever, chills, and significant deterioration of well-being;
- Sharp pain in the operated eye;
- Purulent masses discharge from under the dressing;
- Tearing, reddening of the eye;
- Deterioration of vision, edema of the eyeball.
If you follow all the recommendations given by the doctor for the period of rehabilitation after cataract surgery, the risk of complications is minimal. Our clinic pays close attention to each step on the way of gaining excellent vision – diagnosis, treatment plan, surgery, information support of the patient during the recovery period.
Q&A
Does cataract affect both eyes at once or one of them?
Usually, cataracts develop individually in each eye. In the classic variant of the disease, as a result of aging processes, cataracts may develop symmetrically in both eyes, with cataracts usually being more severe in one eye.
Is it possible to avoid surgical intervention for cataract?
At the moment, the only possibility of correcting this pathology is a micro-surgical procedure, which consists in removing the clouded crystalline lens and replacing it with an artificial lens, or in medical terms, an intraocular lens. The intraocular lens is similar to the natural crystalline lens in its optical characteristics. It is very reliable and can last a lifetime in the eye.
The changes in the crystalline lens are irreversible, and no drops, special glasses, diet, or exercises can “make” it become transparent again. There is a widespread belief that vitamin drops help to inhibit further cataract development. However, this claim is not supported by any serious research. So it is impossible to say with certainty that this is true.
There are different artificial lens models on the market today. Which one is better to choose – European or American-made? How do they differ from each other?
There are many different models of intraocular lens. Some modern models allow the correction of additional pathologies such as corneal astigmatism. In 90 per cent of all cases the standard artificial lenses made in different countries of the world are used in clinical practice: USA, Germany, Switzerland, Belgium, Russia and other countries. Switzerland, Belgium, Russia and others. Bear in mind that no artificial lens enters the market without a thorough examination: a certain number of surgeries must be performed and certification procedure must be completed, which includes the certification of the material, model and so on. This is to ensure that the product has all the necessary characteristics, is standardized, and is safe to use. In other words, if it has hit the market, it is already a guarantee of its quality.
But what type of lens is more suitable for the eye – the surgeon decides. The optical power of the artificial lens is determined individually for each patient and depends on the anatomical and optical characteristics of the eye. In very rare cases with severe accompanying pathology the doctor may even decide that an intraocular lens implantation is not advisable.
Are there any contraindications to cataract surgery?
The only contraindication to surgery, taking into account versatility of today’s technology and skill of surgeons, is reluctance of the patient.
What is the duration of the surgery?
If cataract surgery is uncomplicated it takes an average of 10 minutes. It is nevertheless worth mentioning that there are so many factors that could make the technical execution of the operation more difficult and in complicated cases the operation might take up to 2.5 hours.
How does the surgery go?
In preparation for surgery, about two weeks before the operation, the patient must undergo blood (total, coagulation, sugar) and urine tests (total, sugar), an electrocardiogram and chest X-ray, examinations by a dentist, otorhinolaryngologist and internist. Patients treated for diabetes mellitus, in addition requires consultation with an endocrinologist.
The operation is usually performed the day after admission to the hospital. On the morning of the operation the eye is dosed with drops to dilate the pupil. The patient may also be given a mild sedative to help relax and not to worry.
Cataracts are removed under an operating microscope. The surgery is performed under local anesthesia. The patient does not fall asleep, he is conscious and hears what the doctor tells him. Moreover, sometimes during the operation, the doctor asks the patient to look to one side or the other, up or down.
First, the surgeon makes several micro punctures, then the front capsule (shell) of the lens is opened and the cloudy lens is removed. The sac, in which the crystalline lens was located, is cleaned of all cellular elements. Then, through a special delivery system, a coiled elastic artificial crystalline lens is introduced, which spreads out inside the eye. It should be noted that it is not liquid, as many believe. It is made of special biocompatible polymers – flexible memory materials that, even after repeated folding, quickly regain their shape and take the place of the natural lens. After the surgery is completed, the eye is flushed with a special solution, and the patient is transported to the recovery room. On average, the patient stays in the hospital after surgery for 1-2 days. If the operation was performed on an outpatient basis, the patient can go home after a few hours.
Is the lens rejected or is there an allergy to the material used to make it?
Such cases are described in the literature, but they are very rare and the percentage is negligible.
How should a patient behave after surgery?
After surgery, the patient definitely needs to self-treat, on which the positive result depends to a large extent. In particular, within 4-6 weeks special drops that will help fight the inflammatory process and prevent the infection from getting into the eye should be dropped. In addition, for the postoperative period to pass without complications and in the shortest possible time, the patient must follow the general recommendations of the doctor. In particular, do not make any sudden movements, do not lift heavy weights, do not rub the operated eye or apply pressure to it. In the first 1-2 months after cataract surgery it is necessary to avoid baths, swimming pools, steam rooms and limit sport activities. As we pointed out earlier, full recovery after surgery takes 4-6 weeks.
