An eye surgeon smiles at the camera in the operating room.

Home care instructions after cataract surgery

Careful home care supports healing, helps relieve any temporary discomfort and contributes to the best possible surgical outcome. At Silmäasema, you will receive clear home care instructions, which we will go through with you to make sure you know how to care for your eyes after surgery.

Home care instructions after cataract surgery

Before surgery

  • Any general diseases, such as hypertension, heart disease or diabetes, must be at an acceptable level. Your blood pressure must be less than 180/100 mmHg, measured approximately one week before the surgery. → Contact your physician to reach an acceptable level. 
  • If you are taking Marevan to thin your blood, the INR value should be at your stable medicated level (usually 2–3.5) and controlled during the week before surgery at your health centre. 
  • Surgery will not be performed if you have a fever, cough, gastroenteritis, eye inflammation or an inflammation on your facial skin and/or mouth (such as herpes, blepharitis, acute tooth infection or pain). 
  • If you fall ill before the operation, please contact our customer service, tel. +358 10 190 200 (nationwide appointment and surgery help line, service hours: Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm) 


Other things to note before surgery: 

  • Do not use soft contact lenses for one week or hard contact lenses for three weeks before the surgery. 
  • There should be no eyelash extensions at the time of surgery. They make it more difficult to clean the eyelid and may become detached when the protective tape is removed 
  • Permanent eyelash tinting should not be applied in the two days preceding surgery.  
  • It is a good idea to take a shower and wash your hair on the night before or in the morning of the surgery.  
  • Make sure that you have cotton pads at home. You will need cotton pads to clean your eyelids after surgery.  
  • Also, make sure that eye drops can be applied after cataract surgery, either by yourself or a family member. If necessary, ask the home care services of your municipality for help with the drops. No eye drops need to be applied before the surgery. 

On the day of surgery

Please keep the following in mind on the day of your surgery

  • Only come for surgery if you are healthy! 
  • On the day of surgery, you can eat and take your medication as usual 
  • Apply your usual eye medicine as usual. Take the medicines you need during the day with you. 
  • Do not wear any makeup or perfume when you come for surgery. 
  • Wear clean, loose-fitting and comfortable clothes.  
  • Reserve about 2–3 hours for the operation  
  • A premedicated patient must be accompanied by an escort (discharge home by taxi is permitted) 
  • Driving a car after the operation is not permitted 

Bring the following with you to the surgery 

  • a completed patient information form 
  • an identity card 
  • your current prescription for glasses 
  • the pharmaceuticals you need (e.g., asthma spray, insulin, nitroglycerin) 
  • S-Etukortti card, if you have one

The procedure and possible risks

Procedure

A lens measurement will be carried out prior to the surgery, unless it has been done during a previous visit to an ophthalmologist. The measurement will take a couple of minutes.  


Before the procedure, your pupil will be dilated using eye drops. It is possible to get a relaxant before the operation if needed. In the operating room, your eye will be anaesthetised using eye drops, plastic shields will be placed over your eyelids and a lid speculum will be used to keep your eyelids open.


Lens surgery is performed under eye drop anaesthesia with the phaco technique using ultrasound. An opening of a few millimetres is made at the edge of the cornea. An ultrasound is used to soften ja remove the cataract lens from its capsular bag. Acrylic lens is bent and placed in the capsular bag, where the lens opens and the optics are focused on the pupil opening. The procedure is painless.


The intraocular pressure is checked and a broad-spectrum antibiotic is injected into the eye. The procedure takes approximately 10–20 minutes per eye. Sutures are usually not needed, because the surgical wound closes itself.


After the surgery, we will monitor your condition for about an hour, after which you can go home. Driving is not permitted after the surgery. If you do not have anyone to accompany you home, you can take a taxi. Transportation will be ordered for you by hospital staff if necessary.  


The post-operative symptoms and potential risks are described below.  


Risks of surgery


While the risks associated with cataract surgery are minor, there is no such thing as a risk-free surgical procedure. Ophthalmic surgery involves the following risks:  


Dry eyes 

Your eyes will be more susceptible to dryness after the surgery. After the operation, you will receive instructions on how to use moisturising eye drops, which are useful when applied regularly. 


Posterior capsule rupture 

The eye’s own lens is located inside a capsular bag. In lens surgery, your own lens is replaced by an artificial lens. During the surgery, a rupture may appear in the capsular bag. Intraocular hyaloid (vitreous body) can enter the front of the eye through it. The vitreous body is removed before inserting the artificial lens. Posterior capsule rupture is associated with a slightly increased risk of retinal detachment. With an experienced eye surgeon, the risk is 1–2 promille. A rupture usually does not affect the outcome of the operation.


Retinal detachment 

There is a slightly increased risk of retinal detachment requiring surgical treatment after a cataract or lens replacement surgery even if there were no problems during the surgery. The risk of detachment is affected by the customer’s age, refractive error, the condition of the retina and vitreous membrane, any earlier eye surgeries, and potential injuries. The customer’s individual risk is assessed during the pre-examination. Overall, retinal detachment is rare, with an occurrence of 10–16 per 100,000 people (people with and without surgery in total). 


Intraocular pressure 

There may be a passing increase in intraocular pressure after the procedure. Symptoms may include eye and/or headache and blurred vision. If symptoms occur, contact the operating unit or the surgeon who performed the operation. 


Swelling of the high-acuity vision area 

One to two percent of cataract surgery patients experience swelling in the area responsible for high-acuity vision. This cannot be predicted before surgery. The ophthalmologist will check it during the follow-up examination. If swelling occurs, it can be treated by continuing to use the after-care drops as instructed by your ophthalmologist during the follow-up examination. 


Corneal swelling 

Swelling of the cornea in connection with surgery is possible. As a result, it may take longer for the vision to get clear. The condition is not permanent. 


Infection 

The risk of bacterial infection in cataract surgery is minimal: less than 1 per 1,000 operations. Infections are prevented by means of aseptic surgical technique with sterile surgical equipment and antibiotic eye drops. After-care drops will be used after the surgery to prevent infections. However, if the eye becomes inflamed, it will be treated with an intraocular antibiotic. At worst, the inflammation can reduce visual acuity. 


Posterior capsule opacity 

In a few percent of patients who have had a cataract operation, the body’s own cells cloud the posterior capsule, which means that the eye develops posterior capsule opacity, also known as a secondary cataract. A secondary cataract causes loss of visual acuity. It cannot be predicted before the surgery. Secondary cataracts are treated on an outpatient basis. The surgeon uses a YAG laser to make an opening in the posterior capsule, allowing light to pass through for clear vision. Secondary cataracts do not cause permanent damage. 


Light reflections 

Around 6% of people who have undergone cataract surgery experience light reflections (halos) from the artificial lens when driving in the dark. Approximately 1% experience such strong reflections that they make it very difficult to drive in the dark. 

After cataract surgery

You may have foreign body feeling at the outer edge of your eye. This is completely normal and is caused by the incision, which will heal itself in two weeks. Vision in your operated eye may be temporarily blurry during the evening and morning following the operation, and the eye may be sensitive to light. Your vision will start to become clearer a few days after the surgery.  


An eye shield has been put on your eye at the hospital, and you should wear it until the next morning. After that, the shield should be worn at night for two weeks. 


You can start cleaning your eyelids the following morning as follows: 

  • Always wash your hands first. 
  • Gently wipe your eyelids with a cotton swab or cotton pads dampened with water 
  • Start from the outer edge of your eye and proceed towards your nose. 
  • Clean your eyelids this way in the morning and evening for two weeks. 
  • Apply eye drops following the instructions given in the prescription. 
  • Wash your hands. Tilt your head back and place the drop bottle close to your eye, without touching the eyelashes or the eye. 
  • Pull your lower eyelid down and look up. Squeeze the eye drop bottle lightly until one drop enters your eye. 
  • Take a pause of 5–10 minutes between applying different prescription eye drops. Take a pause of 30 minutes between applying prescription eye drops and moisturising drops.  
  • Moisturising eye drops will help to reduce dryness and the stinging sensation when applied regularly. 


During the first two weeks, avoid: 

  • touching and rubbing your eyes 
  • physical exertion, dusty and dirty work  
  • sauna, swimming and water gym  
  • eye make-up (permanent eyelash tinting and eyelash extensions are only allowed one month after surgery at the earliest)  
  • visiting a dentist or dental hygienist, unless urgent treatment is required  


You can:  

  • do light chores, such as cooking  
  • read, watch TV and do crafts 
  • exercise outdoors. In windy or rainy weather, protect your eyes with glasses, sunglasses or a protective shield.  
  • when bathing or showering, make sure that water does not get in the operated eye!  
  • wear your old glasses if you feel it helps 
  • take a painkiller if necessary 


Sick leave 

Your surgeon will usually give you sick leave for 1–4 weeks depending on the type of work you do 1–3 days, if necessary. Note that, when granting sick leave, the surgeon cannot determine whether you are remunerated or not. 


Customer is responsible to notify the surgeon before the surgery of possible occupational vision requirements and restrictions to surgical treatmens. 


Driving

Be prepared not to drive for a period lasting from a few days to a few weeks. Visual impairment caused by any other reason than cataract or refractive error will not be eliminated by lens replacement.


If you did not have sufficient vision to drive a car before surgery, you should have your vision tested by an optician or ophthalmologist before driving after the surgery. Such a test can be carried out about a week after the operation.  


Follow-up examination  

A medical examination is necessary one to two months after the surgery. By that time, the new lens will be properly in place and glasses can be prescribed. A nurse can book you an appointment before you are discharged from the hospital.  


IF YOU FEEL AN INTENSE ACHE IN THE OPERATED EYE, YOUR VISION DETERIORATES, OR IF YOU EXPERIENCE EYE DISCHARGE OR FEEL PAIN OR NAUSEA: 

  • Contact the operating surgeon primarily by text message. The contact information can be found on the business card given to you at the hospital. 
  • During the night or at the weekend, contact the municipal accidents and emergencies unit 

Silmäasema’s nationwide appointment and surgery help line, tel. +358 10 190 200 (Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm)