Your Cataract Surgery Procedure
& Operation

Reviewed by:

Jason Jacobs, MD & Paul Koch, MD

Cataract Surgery is a relatively “patient friendly” type of surgery whereby the Cataract Surgeon removes the clouded Crystalline lens and replaces it with a permanent artificial Intraocular Lens Implant called an IOL.

Generally, your Cataract Surgery operation can be performed on an outpatient basis and very often within a comfortable and convenient outpatient eye surgery center.

When you arrive at the eye surgery center, a staff member will greet you and review and update any paperwork that might require clarification or additional information. You will be asked to cover your street clothes with a gown or change into a patient gown. When you have changed and are ready, a staff member will seat you in a comfortable waiting area. They will then begin by placing eye drops in your eyes to dilate your pupil and numb and anesthetize the surface of your eye. Several sets of eye drops may administered for Cataract Surgery. The use of eye drop anesthesia is sufficient for most Cataract patients so that they feel just about nothing and experience little if any discomfort at all. In general it is not necessary for the Cataract Surgeon to use injections or needles to anesthetize your eye. In addition, either a staff member or your surgeon may give you an oral tablet of a small dose of anti-anxiety and/or a sedative medication to help you relax.

In preparation for your surgery a sterile drape will be placed around the eye to be operated on. To begin your surgery, the surgeon will place a very small incision-about 1/8 inch or less- at the outermost edge of the Cornea.

small incision cataract surgery, tiny incision cataract surgery, clear cornea cataract surgery

Because of the size and the position of this incision it is “self sealing” and rarely requires stitches or sutures to heal properly. The incision is just large enough to allow a precise microsurgical instrument about the size of a pen tip to pass through it. This instrument is actually a sophisticated surgical instrument that generates high frequency sound waves-or Ultrasound. 

By inserting the instrument through the tiny incision, the surgeon can use Ultrasound to break apart your cataract so that it can be washed away and suctioned out of your eye. This surgical technique is called “Phacoemulsification”.  Phacoemulsification is the preferred technique to remove the vast majority of Cataracts in the United States today.

Phaco, Phacoemulsification, modern cataract surgery, advanced cataract surgery

After the Cataract has been removed, your eye surgeon will insert a new clear permanent artificial intraocular lens implant or IOL through the same tiny incision at the edge of the Cornea. Your surgeon will insert the Lens Implant so that it is folded up at first and will then allow it to unfold so that it can be set in the correct position.

lens implant, IOL

During your Cataract Surgery you will be aware of the surgeon, the staff and the operating room surroundings but you will not be able to see images or the surgery being performed. Expect to see team members in scrub uniforms and surgical gowns wearing masks to protect the sterile area. Your surgery will typically take less than 15 minutes per eye during which you should not experience pain and minimal if any discomfort. If you do experience pain during the surgery it is important to tell the eye surgeon. Your surgeon will complete the surgery by placing some antibiotic drops and possibly some anti-inflammatory drops in your eye to prevent infection and prevent swelling.

Upon completion of your Cataract and Lens Implant Surgery, one of the surgery center staff members will take you to a comfortable place where you will be able to rest and relax prior to going home. After resting for a short while, a surgery staff member will discharge you and have a caregiver, family member or friend drive you home. If you have not already received them, you will be given instructions regarding medications and eye drops to use to help you heal and protect against infection and you will be instructed on where you need to go and at what time for your follow-up examination the day after your surgery.

An Important Note About Cataract Surgery

A significant number of men in their 50’s and 60’s and beyond experience an enlarged prostate as part of the aging process. Today, many of men are taking the prescription medication Flomax or other similar medications that are members of the class of drugs called “alpha-antagonists”.

IT IS VERY IMPORTANT THAT YOU NOTIFY YOUR SURGEON BEFORE YOU HAVE CATARACT SURGERY IF YOU ARE TAKING ANY MEDICATION FOR AN ENLARGED PROSTATE

In August 2006, a joint advisory letter was issued by the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and the American Urological Association that identified that drugs such as Flomax, commonly used to treat an enlarged prostate, and other alpha-blockers can cause abnormal movement of muscles controlling the opening and closing of the iris. During cataract surgery, the pupil must stay enlarged or dilated to allow the Cataract Surgeon to easily view the Crystalline Lens. Flomax and certain other alpha-blockers including Hytrin, Cardura, and Uroxatral can interfere with pupil dilation, creating a condition known as Intraoperative Floppy Iris Syndrome (IFIS). If you are taking one of these medications and notify your eye surgeon or the staff, they will be able to take extra care to make sure the pupil stays dilated to prevent unexpected complications during your Cataract Surgery. 

The information that has been provided here is intended to give patients an overview of Cataract Surgery. It is possible that your individual experience might be different. None of the information provided here is meant to be a substitute or replace your physician’s consultation nor does it replace the need for you to consult with your surgeon about specific details of Cataract Surgery.

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