Cataract Surgery Can Be a Boon to a Senior

By Waldor Socket

My father turned seventy-five last April. Except for diabetes, which he controls with diet and pills, he is in reasonably good shape for his age. He was diagnosed with cataracts in both eyes about ten years ago. He eventually gave up driving at night, but despite being nearsighted, he could still read and do most of the activities that seniors of his age are able to do. His eye doctor told him that the cataracts hadn’t fully ripened yet and recommended that he wait until he really needed to get them out. Last month he decided to have them removed. He had lost the ability to drive, even in daylight, and was having greater and greater difficulty being able to engage in one of his most favorite activities; reading.

We arrived at the out surgery clinic at about six a.m. on the day of the surgery. After filling out some paperwork, dad was wheeled into a waiting area and given a mild sedative. An injection was given to paralyze his eye and keep it from moving during surgery. After waiting about thirty minutes he was wheeled into the operating room. The actual surgery itself took about another thirty minutes. He came out with a patch over his eye and some medication for pain. He was also given a strong diuretic to keep the pressure from building up in his eye for the first twenty-four hours after the surgery. He had instructions that also required that he wear a clear plastic guard over his eye when he slept for the first week. The very next morning he removed the patch and was amazed at how well he could see. Things were still a little blurry, and would remain so until he got his glasses, but his perception of color and night vision had greatly improved. A few months later he had surgery done on the second eye. There was some clouding of the capsule in that eye which required some laser to clear it, but overall he is very happy that he had the surgery done. Here’s some information for seniors who may be considering having cataracts removed:

Our eyes have two lenses. Both of them are essential for us to be able to see clearly. The outer lens, the cornea, is responsible for about 60% of our vision. There is another lens that sits inside the eye right behind the iris. Sometimes, as we age or develop certain medical conditions such as diabetes, this inner lens becomes cloudy. When this happens it becomes very difficult to read, make out colors and see at night. There are several different classifications of cataracts depending where they begin to develop on the lens. When vision becomes severely affected they must be removed to restore sight.

There was a time when cataract removal surgery required hospitalization, a long recovery period, and the wearing of thick, “coke bottle” glasses for the rest of your life. Then came a procedure called Extracapsular Extraction. A big improvement over the old procedure with the advent of implantable lenses. This procedure still required a 12 mm incision and multiple stitches which had to be tightened carefully to avoid causing astigmatism.

Now, Phacoemulsification is the preferred technique in cataract removal. The incision required for this procedure is much smaller, only about 3mm. A tiny ultrasound needle is inserted into the corner of the eye. The needle vibrates and breaks up the cloudy lens. The lens fragments are then essentially vacuumed out of the eye. The capsule that the natural lens sits in is left in place to anchor the lens implant.

The intraocular lens (IOL) is similar to a tiny foldable contact lens. It is folded into a tiny microsurgical device and placed carefully into the eye. There are a number of these lenses on the market for your doctor to choose from. Most of them filter out harmful ultraviolet rays. The doctor will take careful measurements of your corneas and test your vision to determine the strength of these lenses. You will probably still need glasses, especially for reading, after the surgery, but your visual acuity should be greatly improved. One decision that you will be asked to make is whether or not you want one eye adjusted for distance or closer up vision. This is called monovision. This is recommended for most seniors as your eyes will automatically adjust for the difference between the lenses and most of the time this reduces the dependency on reading glasses.

The entire procedure lasts about 30 minutes and recovery is usually quick. After getting either numbing drops or a retrobulbar injection, ( a small needle is used to inject anesthetic near the eye), you will be wheeled into the operating room. A small device is used to prop open the eye and you will be draped with sterile cloth. The only thing that you will see is the light from the operating microscope. Try to keep the eye still by focusing on this light. Occasionally you will hear the phacoemulsifier and feel a little water run down your face. This is to keep the eye moist.

Complications are rare, the most common one is a clouding of the small amount of lens capsule that was left in to anchor the lens implant. If this happens a YAG laser is used to open the capsule to allow light to get in. In some cases this restores vision immediately, other times the fragments of the capsule take a few weeks to settle to the bottom of the eye.

© Doityourself.com 2006