Understanding your Cataract Surgery

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1 Understanding your Cataract Surgery If you have problems reading this leaflet please ask us to send you a copy in a larger print size. If your first language is not English we can arrange for an interpreter to be available. Please let us know in advance if you require this service. Your doctor has advised you to have a cataract operation. Many people, generally over the age of 65, will develop a cataract. Most of these cataracts can be treated successfully with surgery. This leaflet tells you, your family and friends about this procedure. It explains what is involved and what the possible risks are. You should have plenty of time to discuss your operation with your consultant and perhaps even your own General Practitioner (GP). Please bring this leaflet with you when you attend the pre-assessment clinic and the ward. You will be required to attend a pre-assessment clinic appointment prior to surgery. This may take place on the same day you attend the Outpatients Clinic and agree surgery or you may receive a letter to attend for an appointment at a later date. The pre-assessment is to ensure you are fit and prepared for the operation and the appointment can take up to two hours. It is essential that you attend as we cannot perform your operation unless you have had this assessment. For patients who are attending Eastbourne for surgery you may receive a letter giving you the option to undertake your pre-assessment over the telephone. What is a Cataract? Your eye is like a camera with a lens which focuses light rays on the retina (the receptor layer at the back of the eye, the film in the camera). Normally this lens is transparent but when there is a cataract it becomes cloudy. The light rays can no longer pass evenly through the lens to reach the retina making it difficult for you to see. East Sussex Healthcare NHS Trust Page 1 of 8

2 What is a cataract operation? Your cloudy lens will be removed and a replacement lens (intraocular implant) is positioned in the eye. Why do I need a cataract operation? What are the benefits of having a cataract operation? The only effective treatment for a cataract is an operation to remove the cloudy lens. Assuming your eye is otherwise healthy, your vision should improve. You may need glasses before you have full benefit from the operation. What are the alternatives? A cataract cannot be cured by taking drugs or by the use of laser. At present there are no treatments for this eye condition except surgery. The doctor in charge of your case has advised that you need an operation. However, you will have the opportunity to have your opinion taken into account. After discussion with the doctor, if you do not want the operation done, you can decide against it. East Sussex Healthcare NHS Trust Page 2 of 8

3 What are the potential risks and side effects? As with all procedures there are possible complications which may delay your discharge or require further treatment. Rarely, the operation can make the vision worse. 1. A small risk of haemorrhage in the back of the eye (approx 1:1000) at the time of surgery. 2. The posterior lens capsule can tear and result in the lens dropping into the vitreous gel (a semi-fluid, transparent substance behind the lens of the eye). This may require a further operation at another hospital. 3. The pressure inside the eye can rise resulting in pain but can be treated effectively with medication. 4. A small risk of serious infection (approx 1:1000) after surgery. 5. A slight risk of intraocular implant moving in the eye. 6. A small number of patients develop a problem with the retina e.g. a retinal tear which requires further treatment (less than 1 in 1000). 7. The vision may become cloudy again. If the capsule on which the intraocular implant sits becomes hazy this can usually be successfully cleared with outpatient laser treatment. 8. In some cases the vision may not be improved after surgery if a pre-existing condition is present e.g. age changes on the retina (macular degeneration) and diabetes. Although you will sign a consent form for this procedure, you may change your mind and decide not to proceed with the operation. Please discuss this with your medical team. Will I need an anaesthetic? Your doctor will discuss the most suitable type of anaesthetic for you. This is usually a local anaesthetic; more rarely a general anaesthetic is required. General, topical and local anaesthetics are available. Please refer to the anaesthetic leaflet (Anaesthesia Explained) given to you separately. How long will I be in hospital? If you are having a local anaesthetic you should only need to stay in hospital for the morning or afternoon of surgery (unless your surgeon or anaesthetist thinks you should stay in longer due to a medical condition). What should I do before I come into hospital for my pre-assessment clinic appointment? At your pre-assessment appointment you will be given the opportunity to discuss the operation and anaesthetic with the ophthalmic team. East Sussex Healthcare NHS Trust Page 3 of 8

4 Please arrive on time for your appointment. If you are unable to attend please let us know. Your appointment letter will tell you who to contact. Do I need to bring anything with me to the pre-assessment clinic? Yes, we would like you to bring: A relative or friend who will help you with your post operative eye drops as well as transporting you to and from the hospital for your operation and follow up visits. A list of all medications you are currently taking. Details of any present or past medical history. All spectacles that you are using or your most recent optometrist s prescription. Your phone number. The name, address and phone number of your next of kin Please remove any contact lenses one week prior to attending the preassessment clinic. What should I do before I come into hospital for the operation? Do have a bath and wash your hair if you are able to do so. Wear loose comfortable clothing. Follow the advice given on whether you should eat or drink (on your appointment letter for surgery). Do bring all your medication with you. Please remove any make-up, especially eye make-up and nail varnish before you arrive. Please remove all jewellery apart from your wedding ring. Arrange for someone to bring you to hospital and stay with you until you can go home. Occasionally it may be necessary to keep you in hospital overnight so please come prepared and arrange for someone to look after children, pets etc. Please do not bring any valuables with you. What will happen when I arrive at the hospital for my operation? When you arrive on the ward / unit you will be welcomed by a nurse. You will have several eye drops administered prior to surgery to enlarge the pupil (they may sting a little). What happens in the anaesthetic room and theatre? Please read the Anaesthesia Explained leaflet. East Sussex Healthcare NHS Trust Page 4 of 8

5 What happens after the operation? At the end of your operation we will place a pad and or shield over your eye which will remain on until the following day or can be removed sooner as per your surgeon s instructions. How will I feel afterwards? Generally patients experience very little pain after this operation. Once you get home, if the eye is uncomfortable or feels gritty, take either paracetamol tablets or any tablet you would normally take for a headache. This should be sufficient to relieve any mild discomfort. If your symptoms are more severe or persist, please contact the hospital. Your vision may not clear immediately after the operation. The surface of your eye needs to heal and until this occurs your sight may be blurred. You could also experience some transient double vision. When can I go home? The majority of patients go home approximately thirty minutes to one hour after their operation, but this depends on the type of anaesthesia used. The Consultant may ask you to return the following day. Will I need someone to take me home? It is very important that someone takes you home. You must not drive yourself home after eye surgery. What should I do when I get home? You may go home with the eye pad and or shield dressing in place. Your nurse will tell you before you leave hospital when you can remove it. Some patients are required to return to the hospital the following day or be seen at a dedicated post operative appointment and details will be provided before you are discharged home following surgery. (Conquest Hospital only) You need to start your post operative eye drops as soon as you remove the eye shield. You will need to put your eye drops in four times a day for three weeks. You may need a friend or a relative to help you do this. It is important that anyone touching your eyes, (you included) wash their hands beforehand. East Sussex Healthcare NHS Trust Page 5 of 8

6 If your eyelids are sticky they can be gently cleaned with fresh, cooled, boiled water. Do Instil your eye drops regularly as prescribed. Place your thumbs over the ends of spectacle frames (if you wear them) when putting them on to avoid any chance of poking yourself in the eye. Remove the eye shield after your first night at home and throw away. Wear sunglasses in bright sunlight for comfort for two weeks. Prevent soap and water getting in the eye for two weeks. Avoid smoky and dusty areas for two weeks. Wipe your cheek with a clean tissue if your eye waters. Resume most normal activities including stooping, bending over, washing etc. Enjoy reading, television and other recreations and hobbies as usual. Discuss with your doctor when you can work, drive and fly again. Don t Rub or touch the operated eye for two weeks And avoid straining or heavy lifting for one week after surgery. Will I have to come back into hospital? You will usually have to come back at least four weeks after your operation to check your eye. You will either be given your appointment before you leave hospital or it will be sent in the post. Some patients may have the post operative check organised with their local accredited optometrist. Please do not drive to your outpatients appointment as you may need to have drops instilled. Will I need new glasses? On the doctor s advice, new glasses can be prescribed for you anytime after about a month following your surgery. The hospital optician (Conquest) or your local optician can do this for you. When can I return to work? You will need to discuss this with your doctor as it depends on the exact nature of your work. You can discuss this at your pre-operative assessment or at your first post operative examination. If you need to refrain from work we can give you a sick certificate for one week. You will need to visit your GP if you need additional notes. East Sussex Healthcare NHS Trust Page 6 of 8

7 Sources of information Conquest Hospital Ophthalmic Day Unit - Tel: (01424) Ext: 7515 (between 8.00am and 5.00 pm, Monday to Friday) Eye Clinic - Tel: (01424) Ext: 8714 (between 8.00am and 5.00pm, Monday to Friday). Outside of these hours in an emergency please phone the telephone number below and ask switchboard to page the ophthalmic doctor on call. Eastbourne District General Hospital Tel: (01323) between the hours of 7.00am and 7.00pm, Monday to Friday Tel: (01323) outside of the above hours in an emergency; ask the switchboard to page the eye nurse or ophthalmic doctor on call. RNIB Helpline: Royal College of Ophthalmologists - Royal College of Anaesthetists (RCOA) - RCOA Patient Information leaflets: 'Anaesthesia explained' and 'Local anaesthesia for your eye operation' NHS Direct Telephone: Your GP Important information The information in this leaflet is for guidance purposes only and is not provided to replace professional clinical advice from a qualified practitioner. Your comments We are always interested to hear your views about our leaflets. If you have any comments please contact our Patient Advice and Liaison Service (PALS) details below. Hand hygiene The trust is committed to maintaining a clean, safe environment. Hand hygiene is very important in controlling infection. Alcohol gel is widely available at the patient bedside for staff use and at the entrance of each clinical area for visitors to clean their hands before and after entering. East Sussex Healthcare NHS Trust Page 7 of 8

8 Other formats This information is available in alternative formats such as large print or electronically on request. Interpreters can also be booked. Please contact the Patient Advice and Liaison Service (PALS) offices, found in the main reception areas: Conquest Hospital - Telephone: Eastbourne District General Hospital - Telephone: After reading this information are there any questions you would like to ask? Please list below and ask your nurse or doctor. Reference The following clinicians have been consulted and agreed this patient information: Ophthalmic Sister: Xanthe Knowles Ophthalmic Theatre Sister: Lesley Carter Pre-assessment Staff Nurses: Tracey Reading, Ingrid Benge Consultant Ophthalmologists: Mr Saldana, Mr Kashani. Date agreed: February 2011 Mr P Gregory, Mr I Wearne, Mr C Merrick Mr J Hickman-Casey, Mr P Gouws, Mr Plumb, Review date: February 2013 Responsible clinician: Xanthe Knowles Senior Sister East Sussex Healthcare NHS Trust Page 8 of 8

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