We offer cataract surgery as a day procedure across our day surgeries in New South Wales, Victoria, Queensland and South Australia. If you’re considering cataract surgery, we’ve put together a list of the common questions our Vision Hospital Group cataract surgeons get asked.
1. Do I need to stay overnight after cataract surgery?
Cataract surgeries are performed as day procedures at one of our dedicated day surgery facilities. This means you can return home after your surgery and do not need to stay overnight.
Typically, a cataract day procedure takes less than 30 minutes. Allowing for admission, preparation and recovery time, you’ll be in the day surgery for around 3 hours.
2. When should I have my cataract operated on?
Previously, cataract day surgery had been performed only when the patient starts to experience vision loss due to their cataracts. Nowadays, cataract surgery may be recommended when the changes to your vision might be subtle – such as loss of contrast sensitivity and loss of colour perception – but still affect your ability to perform daily tasks and hobbies.
If you notice that colours appear faded or dull, or that you have trouble seeing in low-contrast situations (e.g. at night), then you may have early signs of a cataract.
3. Does my cataract need to be mature to have it removed?
This was the case in the past when cataracts had to be removed in one piece. Now, with the latest ultrasound and laser technology, the cataract can be broken into smaller pieces for removal – this means it is better if the lens is softer (i.e. immature) to aid the fragmentation process. In fact, the length of the patient’s day surgery and recovery are both shorter if the cataract is immature when operated on.
4. Is the cataract operation painful?
Cataract day surgery is not painful. The majority of patients do not find the operation particularly painful or distressing. Most patients describe a mild sensation of pressure around the eye. In some cases, you may be offered additional local anaesthesia (administered via eye drops) or a small anaesthetic block around the eye.
Across our Vision Hospital Group day hospitals, your anaesthetist may also offer a general anaesthetic if you prefer to be asleep during the day procedure or if there are other medical issues that need to be taken into account (e.g. patients with tremors who cannot lie flat for ten minutes).
5. Will I have stitches in my eye following the operation?
The modern cataract procedure we offer at our day surgeries does not routinely require stitches. It is a keyhole surgery, and the main incision is about 2 mm in length. The intraocular lens that replaces the cataract-affected lens is inserted via a thin cartridge and is designed to unfold into position once it has been placed inside the eye.
However, some cases of complicated cataract day surgery may require one or two small stitches. These are removed a few weeks post-operatively when the tissue has healed.
6. How long after cataract day surgery do I have to wait before driving?
Most patients can drive within 48 hours of the day procedure – the general advice is that you can start driving when you feel comfortable doing so. However, it is advisable to avoid driving long distances in the first week, as the eye will feel strained after the day surgery. It is also best to wear sunglasses where possible post-surgery to minimise any sensitivity to bright lights and sunlight.
7. When can I resume my regular activities, like cooking or gardening?
Most patients can resume general housework such as cooking and gardening within a day or so after a cataract day procedure – it is really up to the individual. However, avoid heavy lifting and vigorous household duties for the first week after your cataract day surgery. Additionally, take care to avoid irritating your eye after it has been operated on (e.g. with dirt or dust, in windy conditions).
8. When can I go swimming or resume going to the gym?
As a general rule, it is best to avoid swimming for the first month after surgery to reduce the risk of infection. The concern is that pools and other bodies of water are often full of viruses and germs that can infect the eye in the immediate post-operative period. Heavy gym workouts are also generally not recommended for the first week, though there is no issue with gentle treadmill use or walking.
9. My friend had their cataract removed and they do not wear glasses anymore – how is that possible?
The standard replacement lens for cataract surgery is a monofocal intraocular lens (IOL), which has one focal point and is normally used to correct both eyes for distance vision. After the operation, reading glasses are still required for near work.
However, advances in lens technology mean there are now many premium IOL products available to correct the eye’s ability to focus for clear vision. Many patients who have presbyopia (age-related loss of near focus) or other refractive errors may be able to stop wearing glasses after having cataract surgery. However, the lens recommended for you may not necessarily be the same as the one recommended for a spouse, relative or friend. There are many important factors that your ophthalmologist will consider during the planning stage, including the health of your eyes, co-occurring conditions, existing refractive error and visual and lifestyle goals.
Premium IOL options include:
- Bifocal IOLs that can correct distance and near vision, but glasses are likely to be required for intermediate distances (e.g. computer work)
- Trifocal IOLs that can correct vision at far, intermediate and near distances; these are the lens of choice if your goal is to be as independent of glasses as possible. Some patients can get rid of their glasses completely with trifocal IOLs, but they have a higher rate of unwanted side-effects and are not suitable for everyone
- Extended-depth-of-focus (EDOF) IOLs that stretch a single focal point to increase the range of vision. They provide good intermediate and distance vision with functional near vision. Glasses may still be required for some near tasks. EDOF lenses have less issues with unwanted visual side-effects
- Toric IOLs that correct astigmatism.
Monofocal IOLs can also be used to perform a procedure called monovision or blended vision, where one eye is set for distance vision and the other for near. Your brain combines the information from both eyes to form a clear image. A contact lens trial that simulates monovision is recommended before proceeding with surgery. Your surgeon will discuss your options with you before your cataract day procedure, as it’s important that you understand the advantages and disadvantages of each option prior to the surgery taking place.
10. I have astigmatism – can this be cured when I have cataract surgery?
Astigmatism is a refractive error that occurs if the cornea or lens of the eye has an irregular curve. People with astigmatism have blurry vision because light rays do not focus at a single point on the retina at the back of the eye. Astigmatism can also occur with shortsightedness or longsightedness.
At Vision Hospital Group, we offer the technology to correct or reduce astigmatism (and other refractive errors) at the time of cataract day surgery. This generally involves using a special intraocular lens called a toric lens during the cataract removal. Sometimes, the surgeon will make relaxing incisions in the outer edge of the cornea. The severity of pre-operative astigmatism will determine whether a complete correction is possible – your surgeon will discuss this with you.
11. How long will it take for my vision to recover?
The visual results of a cataract day procedure are almost immediate in most cases. However, every patient – and their cataract – is unique, and some patients may take longer than others to notice a change.
Be aware that your vision will tend to fluctuate as the eye heals following the cataract surgery but will generally stabilise within a month for most patients. Occasionally, patients who have chosen a premium intraocular lens may take a little longer to adapt to their post-operative vision. If you have a co-existing medical condition such as diabetes, you may experience delayed healing following a cataract day surgery.
As part of your care across all Vision Hospital Group Australian day surgeries, your post-operative recovery will be monitored by our nursing team together with your surgeon.
12. I have had herpes in my eye – can I still have my cataract removed?
Once a patient has had herpes in their eye, the herpes virus remains in the eye for life and can reactivate following cataract day surgery. This means you will require post-operative antiviral medication to prevent herpes virus reactivation and any virus-related complications. The medication is usually taken for four weeks after the operation.
13. I have glaucoma – is it safe to have my cataracts removed?
There is no issue with this provided the glaucoma is under control prior to the cataract day surgery. At Vision Hospital Group, many of our surgeons offer the insertion of micro-stent technology (e.g. iStent inject) at the time of the cataract day procedure to improve fluid drainage from the eye, reducing eye pressure. The iStent can lower the amount of glaucoma medication required – in many cases, patients can stop their eye drops completely.
14. I have keratoconus – can I have my cataracts safely removed?
Patients with keratoconus generally do very well after cataract day surgery. In fact, many find that they can get rid of their contact lenses altogether. One of the signs of keratoconus is astigmatism, and this can also be addressed at the time of the cataract day surgery (see question 10 above).
15. I have had a corneal transplant in the past – is it safe for me to have cataract surgery?
Patients who have had corneal transplants can have their cataracts removed safely. However, there is a small risk of developing a rejection to their corneal graft following cataract day surgery – this can be treated with steroid drops. There is also a small risk that the corneal graft may be damaged and that a second graft will be required.
16. Do cataracts ever come back after having them removed?
A cataract day procedure is a once-off procedure as cataracts cannot come back. Cataracts do not ‘grow’, and the replacement artificial intraocular lens cannot turn into a cataract.
However, sometimes a thin membrane of scar tissue can develop behind the lens implant after cataract extraction and can affect your vision similar to a cataract. This membrane is called a posterior capsule opacification (or PCO) and can be removed with a quick and painless laser procedure in the clinic (known as a YAG laser capsulotomy).
Cataract surgery is performed at all Vision Hospital Group locations across Australia, including New South Wales, Victoria, Queensland and South Australia.