Cataract surgery is generally performed with a combination of intravenous twilight sedation and local (topical) anaesthetic in the form of numbing eye drops. The drops are very effective in blocking pain signals from the eye to the brain.
These include midazolam, clonidine, propofol, fentanyl, dexmedetomidine, remifentanil, and oral diazepam. Intravenous (IV) clonidine has a half-life of 9-13 h and increased risk of postoperative hypotension. Propofol causes disinhibition and it has to be titrated during surgery to prevent oversedation.
Most cataract surgeries are performed under a local anesthetic. This means that most patients are awake during their cataract surgery. This eliminates risks associated with general anesthesia (where you are “put to sleep”) and enables Our Doctors to communicate with you during your procedure.
Along with the anesthetic to the eye, in most cataract surgeries an anesthetist will also give you some mild sedative medication through an IV. This relaxes you but does not put you “out,” although some people do fall asleep during the procedure from the effects of the sedation.
At the beginning of surgery, your ophthalmic surgeon will clean the skin around the eye and place a plastic cover on the eyelid so that partially covers your face and if your surgery is under local anaesthetic you have some oxygen to breathe and space around your mouth to feel comfortable and non-claustrophobic.
Cataract surgery patients often worry about what may happen if they blink during the procedure. Although this is an understandable concern, there is no need to worry. You will be given an oral medication prior to the procedure to help you relax during your surgery.
To save time and ease the stress of surgery, we don't ask cataract patients to remove their clothing before surgery. Instead, we instruct them to wear a loose-fitting top so that we can easily attach monitor leads and place a hospital gown on top of their clothes.
During cataract surgery
You'll be awake during surgery, but you won't be able to see what's happening in your eye. Our ophthalmologists at Beverly Hills Institute of Ophthalmology perform cataract surgery using a state-of-the-art femtosecond laser.
Cataract surgery is not painful. While patients are awake during surgery, there is little or no discomfort involved. A mild sedative may be administered before the surgery, which calms the nerves, and eye drops are used to numb the eye.
How long does cataract surgery take? Cataract surgery takes 10 to 20 minutes to complete, depending on the severity of the condition. You should also plan to spend up to 30 minutes following the surgery to recover from the effects of the sedative.
In the preoperative area, the nursing staff will prepare your eye for surgery with a combination of dilating, antiseptic, and anesthetic eye drops. You will usually be offered a Valium pill to take by mouth to reduce your anxiety in the pre-op area.
Here are some things that you may want to avoid before and after cataract surgery to ensure that you heal properly. Avoiding eating and drinking before your surgery. Don't wear makeup to the surgery appointment, and avoid wearing makeup until your ophthalmologist allows it so that you can better prevent infection.
Anesthesia typically wears off after an hour or two, and you can go back home soon afterward. However, the drugs can stay in your system for up to 48 hours.
As soon as you detect the sneeze or cough happening, pull out of the eye. You want your instruments out of the eye because they can do serious harm with the sudden, jerky movement from the cough or sneeze. Pull straight out immediately and then take your time examining the eye to determine if any damage has occurred.
In surgery, patients feel only minimal discomfort; most patients describe it as pressure on the eye. In addition to pain, patients also fear that they will be able to “see” the surgery through the operative eye.
A long-term consequence of cataract surgery is posterior capsular opacification (PCO). PCO is the most common complication of cataract surgery.
The patient sits upright or semi-recumbent, and the surgeon sits or stands, facing the patient. The microscope is rotated forward, and surgery is done via an incision in the lower half of the cornea, using topical intracameral anesthesia.
Plan on taking one to three days off of work to be sure you have enough time to rest, but it is normal to resume most normal activities within a couple of days. Simple diversions like reading, watching TV, writing, and walking are okay to resume as soon as you feel up for it after your eye surgery.
While home, you may be allowed to remove your eye shield, but you should wear it when sleeping for at least a week to prevent eye injury. Full recovery from cataract surgery should be complete in about a month, although it can take up to three months for your eye to be completely healed.
You can read or watch TV right away, but things may look blurry. Most people are able to return to work or their normal routine in 1 to 3 days. After your eye heals, you may still need to wear glasses, especially for reading.
After the procedure, you will most likely wait in a recovery room until the anesthesia begins to wear off. While you may feel well enough to drive yourself home, we strongly encourage all patients to have a family member or friend drive them home after cataract surgery.
The requirement for fasting before surgery was recommended by the American Society of Anesthesiologists (ASA), which published updated guidelines in 2011 for patients undergoing general anesthesia to reduce the risk of aspiration pneumonia.
To ensure optimal recovery and results, our Chicago eye care specialists usually wait to operate on the second eye. We want to give the first eye enough time to heal and for vision to stabilize before performing another surgery. It's a simple, common-sense precaution to ensure good vision and eye health.