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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.
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.
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.
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:
During the first two weeks, avoid:
You can:
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:
Silmäasema’s nationwide appointment and surgery help line, tel. +358 10 190 200 (Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm)