What Is It Like to Have Cataract Surgery?

I have always been more than a little creeped out by the idea of cataract surgery.

When I was about 8 years old, my grandmother had cataract surgery. It didn't go well. Born in the 1890's, my grandmother grew up in an era in which there were certain things you just didn't do around other people, and going to the bathroom was one of them.

My grandmother had to make a relatively long incision around the cornea, take out the old, natural lens, and replace it with a fragile glass lens. After surgery, the patient's head had to be stabilized with sand bags, and absolute bed rest for 2 to 3 days was essential.

My grandmother had the surgery, but she couldn't bring herself to use the toilet aids offered by the hospital. After two days, she finally gathered up her gown and picked up her purse, charged out of her hospital room, hailed a cab, and went home to use the necessary. And she spent the rest of her life blind.

Eager for Cataract Surgery

Fifty years later, I had cataracts myself. I probably have some kind of genes for cataracts, but I never noticed any problem until I had to have maybe 25 CT high-energy CT scans of the head in just a few months. For a long time I had had "eagle eye" 20/8 vision, but over just a few months I started having trouble seeing anything at all.

First I couldn't see the numbers on my cell phone. Then I couldn't see the picture even on a large-screen TV. I couldn't see across the street. I would forget items in my shopping cart at the grocery checkout because I couldn't see them. I didn't realize it, but I couldn't see the color blue. The sky was gray all the time. I thought it was air pollution.

I didn't go to the ophthalmologist, however, until my regularly scheduled appointment. I was told I had cataracts in both eyes, but my insurance wouldn't cover the procedure until I had a policy under the Affordable Care Act. I got the policy last January, but it took until October 2 to get the referral to the surgeon. I was so tired of seeing the world as if it were covered with plastic wrap that I would have had the surgery the same day, but my surgeon didn't have an opening in his schedule for 2 weeks.

An Uncomplicated Surgical Procedure

I have to take not one but two anticoagulants. I have a clotting disorder, and I had to have heart surgery just two months before my eye surgery. Usually eye surgeons want you to wait until it is safe to discontinue the blood thinners, but I had developed glaucoma in one eye, and I was having trouble with lots of daily activities. So my doctor simply told me "We have ways of dealing with bleeding" and I didn't ask what they were. Other than to tell you that they involve needles rather than scalpels, I won't, either--but isn't a needle better than a scalpel?

The anesthesiologist knocked me out so the eye surgeon could inject a numbing agent directly into my eye. I woke up and could see a surgical tool and the most beautiful blue I've ever seen in my life, a shade of sky blue I hadn't seen in a couple of years.

See Also: Cataract surgery

Then I went back to the doctor the next morning for the bandages to come off.

Frequently Asked Questions About Cataract Surgery

When the doctor took off the bandages I could see clearly again. No blur (even though I have a cataract in the other eye that hasn't been operated on yet), all the colors you would expect, in fine detail. I was handed a card for my next appointment. I could read it. I could see the numbers on the buttons in the elevator.

It wasn't until I got outside the office building, however, that I noticed the real difference. I had depth perception again. I didn't even realize I had been seeing the world in 2-D. And I could see leaves on trees and petals on flowers and bricks on the sides of buildings.

I'm convinced cataract surgery was right for me. And here is what I can share about it.

Does cataract surgery hurt?

For me, the procedure itself was completely painless.

The doctor will tell you not to rub your eye. If you start to do that, you probably will quickly stop.

Do you have to wear dark glasses after surgery?

I did, although I didn't have a lot of trouble with bright sunlight. Because I take blood thinners I couldn't stop, my eye is red, and I were the glasses in social situations.

Was it difficult to prepare for the surgery?

No, there was just the standard nil per orum (no eating, no drinking, not even water) order after midnight the night before. Most doctors do a number of cataract procedures the same day. My doctor scheduled them in order of age, children first, then older adults, then younger adults. I was the youngest adult, so my surgery was about two in the afternoon.

Do you need reading glasses now?

No, the doctor implanted a bifocal lens into my eye. I don't need any glasses at all.

But you said you were legally blind before the procedure and you only had one eye operated on.

I'm surprised, myself. Apparently I have enough residual sight in my other eye that my brain gives me depth perception and a clear field of vision. 

Do you have to take eye drops?

I take an anti-inflammatory eye drop and then an anti-fungal eye drop a couple of minutes later. My doctor told me I have to take them for at least two weeks.

What about exercise?

My doctor told me I had no restrictions of any kind (I can pick up whatever I need to, bend from the waist, go to the gym, and so on), but I should not (1) pet an animal or (2) do any kind of yard work. The problem is molds and fungi in dead leaves and grass. No sooner did I step outside his office building than I got blasted by a leaf blower, but I was wearing my protective glasses, and I'm taking my eye drops.

Did you have a black eye after surgery?

Yes. Not everyone does. The doctor injected anesthetic into my eye through the lower ey lid, leaving some bruising.

Do you feel the new lens?

No, although I hasten to say that rubbing your eye is really something you don't want to do after cataract surgery. It would hurt, a lot, and could interfere with healing of the incision.

You said your doctor did something so you could have the procedure despite being on blood thinners. What was that?

My doctor used a process called phacoemulsification. He made a tiny incision on the side of the lens and placed an ultrasound probe into the old lens. The ultrasound broke up the lens, and suctioned out the pieces with a micropipette. Then he inserted a new lens that unfolded once it was inside the eye. The other commonly used procedure is extracapsulation, in which the doctor makes a longer incision and removes the lens in one piece.

See Also: Cholesterol-Lowering Drugs Linked To Increased Risk Of Cataracts: Ten Things You Need To Know

Fortunately, surgical treatment is simple, nearly painless, and highly effective.