This booklet has been designed to give you all the information you need to undergo cataract surgery.

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1 Eye Unit Cataract Surgery: This booklet has been designed to give you all the information you need to undergo cataract surgery. University Hospitals Coventry and Warwickshire is a teaching hospital and as such has a responsibility to train surgeons of the future. We cannot guarantee that your surgery will be performed by a particular surgeon. Cataract surgery is carried out by consultants and other suitably skilled surgeons. Surgery is also carried out by surgeons in training, under the supervision of an experienced consultant. Having a cataract removed should not disrupt your life greatly, but some extra care is required for up to 4 weeks after surgery. During this time your eye is still healing and could be vulnerable to the smallest knock. If you normally cope independently at home, you should not need anyone to stay with you following discharge. If you have any concerns about this, discuss this at your pre-op assessment. What is a cataract? The natural lens of the eye is a transparent flexible structure suspended in the middle of the eye; a muscle in the eye pulls on the lens, changing its shape slightly, and this allows the eye to change focus. 1

2 In many older people, and in a few younger people, the lens becomes cloudy and discoloured, preventing clear vision. This tends to become worse, usually over a few years. Often both eyes are affected, and the patient will become more visually impaired. In the early stages, a change of glasses may help, but eventually a cataract operation is needed. How is cataract surgery done? These days, a keyhole operation is almost always used. The surgeon makes a very small wound (2.5 millimetres wide) at the join between the white of eye and the cornea (the clear front window of the eye). The cataract is broken up into small pieces by ultrasound and gradually removed. Then a clear plastic artificial lens is put inside the eye, and left permanently supported in the same place as the cataract used to be. The plastic lens implant lets the light through into the eye again. Usually the keyhole wound is selfsealing, and stitches are not needed. The operation usually takes minutes, and is done under local anaesthesia (with the patient remaining awake throughout). Where possible, cataract surgery takes place on a day-care basis and the patient is usually able to go home about half an hour after surgery. Pre-operative assessment When you are listed for surgery you will have a pre-operative (preop) assessment. This is to assess your fitness for surgery and to assess any special factors that may affect the way the operation is done. Your eye will be measured so that the power of the plastic lens implant can be calculated. You should bring a list of all your medications so that they can be documented. Ideally someone should come with you. The practical arrangements for your hospital admission, transport details, and plans for your post operative care will be discussed. You will have the opportunity to ask questions. 2

3 Please note that ambulance transport is only available for admission if there is a medical need. Take all your medications as normal on the day of surgery, including aspirin. If you take warfarin you will be given specific instructions from the pre-op nurse. Post operative assessment and recovery At the end of your operation you will be taken back to the Day unit/ ward. Tea and biscuits are offered prior to going home. Eye drops and a dressing pack and saline will be supplied to you on discharge along with a plastic eye shield. A discharge leaflet explaining cleaning of the eye on the following morning and when the drops need to be administered will also be given to you. When you remove your eye shield the next morning, you may notice an improvement in brightness and colour. At first, the vision may be misty or out of focus, the eye may feel bruised and the white of the eye may be red. A gritty feeling under the eyelid is common in the first few days. Take paracetamol or your normal pain relief, if required. Some important things to remember following cataract surgery 1. Do not touch or rub the eye 2. If you suffer from any of the following: more than mild pain have a loss or change of vision increasing redness of the eye have a sticky discharge Contact Eye Casualty straight away on Monday day- Friday 9.00am pm, Saturday 9.00am.00am-12 noon. 3

4 General Accident and Emergency should be contacted outside these hours and offers a 24hr service Wear the plastic eye shield at night to prevent you rubbing the eye in your sleep (please purchase your own tape from a chemist to secure the eye shield) Further Instructions Take care when washing your face and hair to avoid getting any soap or shampoo into the eye. Most activities (moderate bending and light lifting) can be resumed straight away but avoid swimming and strenuous exercise or heavy lifting. Do not drive until you are able to read a new style car number plate at 20 metres. Remember until you have your new glasses, judgement of depth and distance may be poor. It is advisable not to travel abroad before your first follow up appointment. Eye make-up must not be worn for 3 weeks. When can I return to work? This really depends on the work you do. Office work is safe as soon as you feel comfortable. Discuss this at your pre-operative assessment clinic visit. Your sight will not be at its best until you have your new glasses. What are the risks? All operations carry some element of risk; with cataract surgery we find about 97% get an improvement in sight, 2% end up with the same level of sight as before, and 1% are sadly worse off because of complications. One in a thousand may actually lose all of the sight in the eye (usually through infection). Other complications 4

5 include: detachment, haemorrhage and water-logging of the retina, and corneal problems. If you have any other pre-existing eye disease as well as the cataract, this could have some affect on the final visual result. How to apply your eye drops Wash your hands before applying eye drops. 1. Gently pull the lower eyelid down until there is a small pocket 2. Squeeze the upturned dropper bottle to release a drop into your eye. Avoid touching the tip of the bottle against your eye. Do not rub your eyes after applying the drops If you are concerned that you won t be able to instil your eye drops, discuss this with the nurse at your pre-op assessment appointment. 5

6 Information on eye drops 1. Store eye drops and ointments in a cool place, out of children s reach. 2. Only store drops in the fridge if requested to do so. 3. Dispose of all opened eye drops and ointments after one month. 4. Never share your eye drops with anyone else. 5. Eye drops need to be put in 4 times a day up until your post operative appointment (approx 4 weeks later) 6. If you run out of drops contact your GP We hope you will gain lasting benefit from your cataract operation, and we will try to make it as stress free as we can. Contact telephone numbers Pre-Op Service: (Answering Machine messages can be left Monday-Friday 9.00am-4.00pm) or , Weekends: The Trust has access to interpreting and translation services. If you need this information in another language or format please contact and we will do our best to meet your needs. The Trust operates a smoke free policy Document History Author Linzi Randle/Linda Nicholson Department Eye Unit Contact Tel No Published June 2009 Review June 2010 Version 2 Reference No HIC/LFT/266/06 6