Surgery & Recovery
When the cataract is removed, a new artificial lens called an intraocular lens (IOL) made of plastic is implanted. Before the surgery, Columbia surgeons will discuss which type of IOL is recommended since cataracts do not grow back, this lens will stay with you for the rest of your life.
Columbia ophthalmologists offer a few different types of IOLs to our patients:
- Standard monofocal IOL gives either distance or near vision. Glasses would be needed to correct reading vision if left distance-sighted or correct distance vision if left near-sighted.
- Toric monofocal IOL gives either distance or near vision with astigmatism correction.
- Multifocal IOL (comes in Toric Multifocal as well) gives a range of vision from distance to near with or without astigmatism correction. There must not be other conditions in the eye like severe dry eye, corneal scarring, glaucoma, and/or retinal diseases.
- Extended depth of focus (EDOF) IOLs also provide a range of vision like multifocal IOLs but by creating a single elongated focal point to enhance a “depth of focus.”
Recovery After Cataract Surgery
Visual recovery from cataract surgery can occur as soon as a week or longer. Eyedrops will be needed for about a month, and new eyeglass prescriptions are provided at the one-month postoperative visit. It would help if you avoid heavy lifting, exercise, and putting your head below your waist (bending all the way down) for at least one week following surgery. You will wear a clear plastic shield at night for one week when you sleep to protect the eye. Your postoperative care will be with our surgeons and optometry service. Our team of Columbia optometrists will also check for your eyeglass prescription (refraction) after your eyes have healed.
On the Day of Surgery
The surgical team will put drops into your eye to dilate the pupil. Many people choose to stay awake during surgery. Others might need to be put to sleep for a short time. If you decide to stay awake, you will have an anesthetic to numb the nerves in and around your eye. This anesthetic will be given either with an injection near the eye or topical anesthesia. Then, a Columbia doctor will perform the surgery. The surgery usually lasts about half an hour and is almost painless. After the operation, a patch and/or shield will be placed over your eye. Some people need to use eyedrops right after their surgery. Your Columbia team will watch for any problems you might have, such as bleeding. Most people who have cataract surgery can go home the same day but cannot drive themselves. You must arrange for a person to pick you up after surgery.
After Surgery
It is normal to have itching and mild discomfort. It is also normal to have some fluid discharge. Your eye might be sensitive to light and touch and can see halos. If you have discomfort, your doctor can suggest treatment. Moderate discomfort should go away on its own in one or two days. Your doctor will ask you to use eye drops to help heal and lower infection risk. Avoid rubbing or pressing on your eye. As you continue to heal, try not to bend from the waist repetitively to pick up objects on the floor. Your doctor will schedule exams to check on your progress.
Problems after surgery are rare, but they can happen. Problems can include:
- Infection
- Bleeding
- Inflammation (pain, redness, swelling)
- Loss of vision
- Double vision
- High or low eye pressure
With prompt medical attention, these problems can usually be treated successfully. Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract or posterior capsular opacification (PCO). A PCO can develop months or years after cataract surgery. A PCO is treated with a procedure called a YAG laser capsulotomy. For this procedure, the doctor uses the laser to make a tiny hole in the opacified film behind the lens to let light pass through. It is painless and rarely causes eye problems such as increased eye pressure. As a precaution, your doctor might give you eyedrops to lower your eye pressure before or after the procedure.