Quezi

Bronze Head of Augustus from Sudan (photo by Joe Geranio - CC-BY)

Cataract surgery is not normally painful. You may, however, experience some discomfort (pressure or pulling sensations) but for people in good health, there are few risks.

The lens of the eye is normally transparent, producing nice clear and bright images. When cataracts form, the lens becomes cloudy causing a gradual loss of vision. At first you may notice your world isn’t quite as bright as it used to be, but as time goes by, your world becomes flatter and it becomes harder to distinguish any details (imagine seeing a head with no face). Bright lights are also troublesome and it isn’t long before you stop driving at night because of the lights from the oncoming traffic. If left untreated, the loss can be compared to putting tissue paper in front of the eyes (adding another layer of tissue paper every few months) or trying to drive a car in a complete white-out snowstorm.

The principle behind the surgery is simply to remove the clouded lens and replace it with a new intraocular lens implant. This requires making a very small incision in the eyeball, using ultrasound to breakup the old lens into fragments (phacoemulsification) and suctioning out the fragments through a needle. Once done, it’s just a matter of popping the new lens into the posterior capsule (which serves to cradle the lens) and bingo, you’re done.

Prior to surgery, several rounds of topical anaesthetic eye drops are administered which “freeze” the eye to make the procedure pain free,  along with a mild sedative to quiet the nerves. Post operative care consists of applying antibiotic and anti-inflammatory eye drops for several weeks, wearing an eye shield at night, and being careful to avoid causing any extra pressure in the eyeball (no bending over to tie your shoes, no lifting of heavy objects, no strenuous exercise, etc).

In the olden days, the implants were hard and relatively large which required a rather large incision and subsequent stitches. Thankfully today, the implants are small and soft so that they can actually be folded to fit into a tiny incision and then popped open into place. It’s rather fascinating, actually, as one second you can see only the fuzzy bright light of surgery and the next second (when the lens is popped into place) you can actually focus on objects.  It’s a wonderful gift and don’t let your nerves get the better of you, the procedure is well worth the effort. Someone once told me cataract surgery can be compared to a trip to the dentist and I think that procedure-wise, that is probably true. The downside is that everyone you know will suddenly age 5 or 10 years now that you can see all of their wrinkles! I didn’t even recognize my surgeon when I visited him the day after my surgery.