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An expert answers common questions about cataract surgery

two women friendsIn the past, if you had cataract, you had to wait till your cataract was 'ripe and mature' before having it removed. Today, you can take it off as soon as a cataract interferes with normal activities like driving, watching television, climbing stairs, playing games, cooking and reading.

Since today's approach to cataract is nothing like it was before, it's natural to have doubts surrounding it. Here, we clear some common ones:

Can a cataract be prevented or dissolved by taking medicines and eye drops?

There are no eye drops scientifically proven to dissolve cataracts. As per today's scientific knowledge, age-related cataracts cannot be prevented by any drugs and surgery is the only method of removing them

Is cataract surgery done with lasers?

Lasers were tried some years ago, but were found to be inefficient. The surgeries now are stitch-less, quick, enable speedy recovery but don't involve lasers. Advanced cataract surgery can even reduce or eliminate your dependence on glasses.

My doctor has offered me different type of lenses. Which would be best for me?

Cataract surgery needs an artificial lens implant [IOL] to refocus the eye. The standard implant for years was a 'monofocal implant', designed to focus the eye for distance vision, which means that reading glasses were necessary [to enable viewing objects that are near].

Multifocal implants and accommodating implants are now available. These are considered premium lenses and designed to help with near, intermediate and far vision. They also reduce or eliminate the need for reading glasses.

However, the suitability of implants also depends on the condition of an individual's eye. The advantages or disadvantages of these options must be discussed with your surgeon.

What can I expect after surgery?

Cataract surgery can now be done under eye-drop anaesthesia in less than 15 minutes. Hence, recovery is quick. Most patients do not even require pain medication. At the most, they feel as if there's a foreign body in the eye. However, this feeling usually passes in a few hours.

The next day, the vision could either be excellent or cloudy, depending on the amount of swelling [oedema] in the cornea. While patients with mild cataracts have little swelling, those with dense cataracts have more, as they require more energy to remove the cataract. Typically, the swelling subsides in a few days and most patients are able to see quite well.

For how long is the eye sensitive to light?

It is not unusual to be extra-sensitive to light for a few days. This is temporary and settles down soon. Light sensitivity could be because of several possibilities—dilated pupils or inflammation from prolonged healing.

It could also be because the person's lens, which was opaque due to the cataract, is now clear, allowing more light in. If you experience this, a follow-up consultation with your surgeon will determine the cause.

Will I be able to see colours properly after surgery?

Cataracts significantly reduce a person's 'blue light' perception. Hence, after surgery, some patients see 'blue' with the eye, as compared to the other non-operated eye. This is normal. The ability to perceive colours returns to normalcy within a few days of recovery.

Is it normal to see floating spots in the eye post surgery?

The spots that you see in your vision when you look around are called floaters, and are not unusual. They can appear as curved or straight lines, strings, spots, or O or C shaped blobs. You could see a single floater or hundreds of them. These usually settle down without any treatment. However, if you develop more floaters, flashing lights or a shadow in the peripheral vision, get yourself checked again.

How frequently do I need to change my spectacles after surgery?

The prescription for your glasses is usually tested by the end of one month post surgery. Variation in it is expected. Nevertheless, you needn't change your glasses if you don't face a difficulty in seeing distant objects, reading or doing any activity.

I had surgery some years ago and the eye is getting cloudy again. What to do?

You may have developed a cloudy membrane behind the lens implant, called posterior capsular opacification [PCO]. PCO can develop months or even years after cataract surgery. In many patients, opaque cells slowly migrate over the capsule in which the implanted lens is fixed. This layer of cells blocks light and blurs your vision.

Treatment for PCO is simple and quick with a painless, laser procedure that just takes a few minutes. This restores your vision to how it was just after the cataract surgery.

I've heard that steroids in the eye drops can be harmful. Is it true?

Yes. If used for long duration, steroids do affect the eyes adversely. But steroids are the only way to treat and cure the inflammation in the eye after surgery. Hence, it is recommended you only use eye drops prescribed by an expert surgeon. If you sense any discomfort in the eye, report it immediately.

My eyes started hurting after I stopped using the drops. Why?

Many experience pain, redness, watering and intolerance to light in the operated eye after discontinuing eye drops. This could be a withdrawal symptom by your body, which is now used to the eye drops. Or it could be an indication of inflammation elsewhere in the body. Consult your surgeon at the earliest. This can be treated completely and does not damage the eye.

Try this to avoid cataracts

  • Get a baseline routine eye examination [at least every six months] if you're over 40 years of age.
  • Reduce your risks: Use certified UV-blocking sunglasses when outdoors, avoid smoking keep your blood sugar under control.
  • Include plenty of fruits and vegetables in your daily diet.

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Anand Shroff
Anand Shroff MS (Ophth), F.I.C.S., consultant Ophthalmic Surgeon, specialist in – Cataract surgery, Glaucoma, Squint, keratoconus and Laser eye procedures - ReLEx SMILE, LASIK, Bladeless LASIK, EpiLASIK, C3R. He practices in Mumbai at Shroff Eye Hospital- Bandra & Marine Drive.

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