After Cataract Surgery: What to Expect

I perform a lot of cataract surgery in Traverse City. I also pride myself on spending a lot of time with patients. When I see a patient with a cataract most of our discussion focuses on whether or not we should proceed with cataract surgery and if so, what to expect on the day of cataract surgery. However, an equally important discussion relates to what to expect after cataract surgery.

Immediately After Cataract Surgery

Let’s start with right after surgery. Most cataract surgery in the United States is performed using topical anesthesia, this means that the only thing used to numb the eye are drops and gel placed on the eye surface and fluid put in the eye at the beginning of surgery. This is often combined with “twilight” anesthesia where relaxing medications are given orally or through an IV (similar to the sedation used for a colonoscopy). The use of topical anesthesia allows the eye to remain open and see immediately after cataract surgery; however, the vision may be a little blurry. It will also feel like there is something in your eye for the rest of the day as the surface heals. To protect the eye, the cataract surgeon places a clear plastic shield over the eye right at the end of surgery. This shield is held in place with tape adherent to the cheek and forehead. I instruct my cataract surgery patients to leave the shield in place until the following morning, at which point they can remove the shield. However, they are instructed to wear the shield while sleeping for 1 week following surgery. This is to prevent inadvertent touching and rubbing of the eye that just had cataract surgery.

Restrictions After Cataract Surgery

Besides not touching or rubbing the eye, the most important activities to avoid following cataract surgery are bending over, lifting heavy objects, and swimming for one week after surgery by your eye doctor. Specifically, you want to avoid bending over at the waist and placing your head below the level of your heart because this can increase the pressure in your eye and theoretically cause the incision to re-open. The same goes for straining or bearing down (Valsalva maneuver), such as with lifting something heavy, straining at a bowel movement, or forcefully blowing your nose. Regarding a specific weight restriction, I usually say nothing more than 15 or 20 pounds for the first week. Use common sense, and understand that each day is a bit less than important than the previous day because the eye is more and more healed throughout the first week. So it’s most important to really take it easy for the day or two immediately after eye surgery.

Do I Need Drops After Cataract Surgery?

No. Well at least not usually in my practice. Cataract surgeons across the world are transitioning more and more to “dropless” cataract surgery. This means that patients don’t need to take eyedrops following cataract surgery. This is accomplished by placing a small amount of antibiotic inside the eye at the end of surgery and a small amount of steroid either inside the eye or on the surface of the eye at the end of surgery. I place the steroid under the clear tissue overlying the white part of the eye (on the nose side) at the conclusion of surgery. This steroid slowly dissolves into the eye over the next few months to help the eye heal; it can often be seen as a bright white “deposit” behind the lower eyelid. Dropless cataract surgery is much easier on the patient, and also saves the patient money because of the recent ridiculous increases in the price of eyedrops.