Talk to me about Cataract surgery

So, forty two is not only the answer to Life, The Universe and Everything, it is also apparently the life span of the lenses in my eyes.

Postierior Subcapsular Cataracts. Awesome. They are building fast, and the surgeon wants to get them out ASAPly. Looks like Monday the 31st is the day. What can I expect? what is the recovery timeframe? I’ve asked the doctor this, but he keeps telling me “It really depends”.

I’d like some first hand experiences.
Who has had this done? How long before you could read again? That is my biggest question, I guess. Right now I can’t read a regular book, but the font size selector on my Kindle has been a lifesaver.

Thanks!

I was born with mild congenital cataracts in both eyes and had them removed when I was a teenager. After the first one, I had a bandage on my eye for a day and was restricted to no physical activity for a couple months. I had to wear a plastic guard over the eye at night to prevent accidental whacking of the eyeball during sleep.

The second one went much the same way, but was a little weirder because it was under local anesthesia instead of the general I had the first time. I was semi-conscious throughout the procedure, and the best way I can describe it is that I was vaguely aware that people were poking around in my eyeball, but didn’t really give a shit. It kinda creeps me out now, though.

Oh, there is also a regimen of antibiotic eye drops while the eye is healing, those lasted a few weeks.
ETA: And I was able to read with the new lens right away, after the bandage came off.

My elderly mom had her right eye done and is going to get the left eye done in a month.
She will be sedated so they can numb the eye socket. Then the doc will remove the old crappy lens and put in the new one. Takes half an hour or less. She will then wear an eye patch and use a lot of drops for a while. Of course, there will be bruising. But then she will have clarity of vision.

I had it done when I was 30, in both eyes. I was down to reading one word at a time, book held about three inches in front of my face. I had a general both times (because I am claustrophobic) and the change was like MAGIC. My glasses were wildly out of whack and I could “see” the cut in my eye so that all straight lines had a little nick in them, and clocks looked like chestnuts with a pointy bit at the top. That resolved after about two days. The light was so bright, so intense that it was shocking. I sort of squinted about for a few days till that wore off. I could read right away.

Pain was similar to having been rubbing my eye all day, or a bit scratchier - nothing to speak of.

I stared and stared when my husband came to visit me - he’d gotten noticeably greyer and wrinklier since I’d last had a good look. And my two year old son’s hair wasn’t the colour I thought it was. And my hands were older and wrinklier than I remembered!

All in all it was a wonderful thing and I am so happy I had it done. The only slight worry is that they don’t know why mine went so bad so fast (pregnancy - started just after the kid’s birth, severe stress - he was in hospital with pneumonia when it first was noticed - or long term steroid creams for eczema used on my face - or who knows??) So we don’t know if the implants will last for the 60 or so years I’d like to need them, or if I’ll need anything else doing.

To that end, we bought a house that’s in very easy walking distance of train and shops, so that if I ever get stuck unable to drive, I’ll still be independent. So far, 11 years later, so good! No trouble at all!

I work in the OR of a surgery center that specializes in cataract surgery. I can give you a walkthrough of our procedures.

You’ll be asked to come in about an hour or two before your actual operation. You’ll get checked in and taken back to Pre-Op.
In Pre-Op you will sit in a recliner and be asked to put on shoe covers, a gown and a hair covering. We usually don’t ask patients to remove clothing unless it’s in the way of the BP cuff or IV.
An RN will start an IV and administer eye drops to dilate your pupil. A local anesthetic will be placed in your eye as a jelly, or sometimes as a small soaked sponge called a pledgette. Your surgeon will probably come in around this time to make the surgical site with a skin marker over your eye. This is to make sure we work on the correct eye. You’ll probably be asked a hundred times your name, doctor, and which eye your having worked on. It can get repetitive but it’s all to protect you and us! The anesthesiologist make come in and talk to you about now as well.
When it’s about time for your surgery, you’ll be put in a wheelchair and taken to the OR or procedure room. In this room you’ll be asked to lay down on an eye bed, which is a specialized stretcher used for eye cases. Your nurse or an assistant will put a blood pressure cuff on your arm, an oxygen monitor on your finger and attach you to an EKG monitor. The nurse will then prep your eye and part of your face with a Betadine solution.
The anesthesiologist will give you some medicine to make you relaxed ( our facility uses Versed and Fentanyl) but we don’t want you to go to sleep.
The surgical assistant will put a sterile drape over your face and put a special tape on your eyelashes to keep them out of the way and protect against infection.
The surgeon or assistant uses a speculum to hold you eyelids open and the actual surgery begins.
During all this the happy juice has kicked in so you probably won’t mind any of the taping etc.
During the surgery, you’ll see a very bright light that comes from the microscope the surgeon uses, and you’ll hear some chirping or buzzing noises coming from the machine that actually breaks up and removes your cataract. Your surgeon may remind you to keep your head still during the surgery. Any small movements you make are magnified through the microscope. You may see some shadows or colored light as your new lens is inserted.
When the surgery is finished, you’ll be asked to get back in the wheelchair and be taken to Post-Op. You’ll stay there for about 20 mins and then be on your way home.

A few other things:
You won’t be able to eat anything after midnight the night before the surgery. This is honestly the absolute WORST part of cataract surgery. I’m not kidding.

The Versed has an amnesiac effect so you might not remember a lot about your surgery after a few days.

The incision made is so small it’s usually self sealing and only rarely do patients need a stitch.

You’ll have to wear some really stylin’ huge sunglasses the day of surgery, even indoors, because of the pupil dilation.

You should only need to wear an eye shield to bed for about a week, no other dressing or bandage.

Your vision will be blurry the day of surgery (also because of the dilation) but should be fine within the next day or so.

You’ll have to put drops in your eyes several times a day for a week or so.

It’s standard practice to operate on one eye at a time, so if you have bilateral cataracts, you’ll come back in a week or two to have the other eye done.
The most common thing patients say when we tell them the surgery is over is “Really? He did it already??”

I’m really stoked that somebody on the Dope asked about something I’m kind of an expert in so if you have any other questions let
me know!

Oh, I forgot to add, you should be able to read just fine the next day. And you may be surprised at how bright and colorful things are!

I had both eyes done a couple of years ago. In about 6 months my eyes went from normal to so bad it was dangerous for me to walk across the street, and I had to stop driving for about 3 month while I waited for my turn in an OR.

The first surgery and recovery was just textbook. Like others have said, essentially no pain at all, when the bandage came off the next day, I could drive again immediately, that same day. Since I was nearsighted from a very young age, they corrected for that with the lens, and I saw better than I had since grade school. It’s pretty damn rare that you have surgery to fix something broke, and come out better then even before the “break”.

The 2nd surgery, or recovery, didn’t go so well. Apparently I somehow turned my head and my eyes just wrong, and the lens popped out of the little “pocket” it was supposed to settle in to. I knew something was wrong, because my vision blurred for about a minute, and then became normal again. So I called the doc, then came in for him to take a look, and then had surgery on that eye again the same day.

So I’ve had 3 cataract surgeries. The 3rd worked as well as the first, and no problems since.

Awesome, guys!

thank you so much. I have my preop appointment today, so now I feel like I’m gong in a little better educated.
I’m having both eyes done on the same day. there is one doctor in the Denver Kaiser family that will do both. he asked me last week whether I wanted nearsightedness or farsightedness as my issues after the surgery. I guess you have to pick one. I’m leaning toward nearsightedness, because before the cataracts, I never had any eye problems at all, and would like to be able to read without glasses.

Faustina do you have any thoughts or insights on this?

As far as the choice between slightly nearsighted or farsighted, the docs use a variety of computerized programs to caculate the diopter of your implant. It very rarely is an exact match so the doc will pick the closest match. Almost always this is the implant that makes you slightly nearsighted, so if you are offered a choice I would go with that. By “slightly nearsighted” I mean a fraction of a diopter, so you might not even notice.

It’s interesting to me that your doc is going to do both eyes at the same time. I work with about 8 different cataract surgeons on a regular basis and they all do one eye, and then the other a week or so later (if needed). Since I’m on the east coast it may be a regional thing. But I can see the advantage to having just one post surgery recovery time!

sorry I didn’t get back to you sooner, we were up in the Rocky Mountain National Forest camping and getting rained on.

The doc here is the only one in the Kaiser network who does both at the same time. I thought about the cost benefit analysis, and decided the single recovery time was worth the risk.

He seems to think that my age and general good health should get me back on my feet in a couple of days. I really hope so.

Thanks again for your insights. (Ha!)

The surgery is on Monday the 31st, so just a few more days to go.

My grandfather had cataract surgery at 90 years old and he was up and running in just a few days. He was also telling everyone his eyesight was so good he could see two fleas making love on his neighbor’s dog while he sat on his front porch, but I don’t think that kind of hyperbole is a standard part of the recovery period. It’s been a few years now and he still says having the surgery was the best decision he ever made. If I remember correctly, he had a post-op eye drop regimen for about a week and also had to wear an eyepatch for a couple of days after each surgery.

Well, the procedure was a little slice of hell, but I am completely gobsmacked by the array of detail and color I can now see. I know it sounds trite, but it’s like the gauze has been lifted. Like an itch that I couldn’t reach has finally been scratched.

My eyes are still getting a little tired at the end of the day, and I have to get used to carrying reading glasses, but that is a small price to pay for getting rid of those things.

I could see right after the procedure.

Speaking of the operation, man, that was tense. My blood pressure was at 165/99 right before it happened. I was way more tense and worried than I thought I would be. I don’t even like putting in eye drops, and they held my eyes open with a clockwork-orangy contraption and went to town.

Lots of lights kept me from focusing on anything, but the pressure I felt from the sonic probe was freaking me out.

Great job by the surgeon and his crew. Especially the anesthesiologist. She was an awesome bartender. Wouldn’t give me anything to go, though.

Congratulations on the good outcome!

I just had a YAG procedure done a couple of weeks ago after having lens replacement a few years ago. Apparently some cells can grow on the back of the posterior capsule, making things blurry again. A few pulses of laser and I am good to go.

The doctor told me about the cell growth, and the fact that I would need to go in for laser treatment at some point. That is fine and dandy. The difference between my eyes last weekend and now is totally worth any oncoming treatments.

Yay vision!

Glad your surgery went well! How are doing putting your eye drops in? It may freak you out but it’s worth it in the long run to follow the regimen.

And yes, ambulatory surgery anesthesiologists are awesome!

This got bumped by someone who wanted to talk about her own surgery; I split that post off into anew threadand am closing this one.

twickster, MPSIMS moderator