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Directorate of Ophthalmology0121 424 2000Information for Patients

Information about Cataract surgery

This leaflet has been designed to answer the questions most frequently asked by patients before they have cataract surgery. It will hopefully enable you to be more informed about what the surgery and aftercare entails. It is not possible in an information leaflet like this to cover all aspects of cataract surgery. Your consultant or a member of his team will be pleased to answer any questions.

Cataract InformationYou have been placed on the waiting list for your Left/Right cataract operation to be performed under local anaesthetic as a day case operation. The name of your consultant is:

Mr …………………………………………….After today you will be contacted for a pre-operative assessment.

What is a cataract?Your eye surgeon has recommended cataract surgery because the lens in your eye has become cloudy, making it difficult for you to see well enough to carry out your usual daily activities.

What causes a cataract?Cataracts can form at any age. Most develop as people get older, but we don’t yet know why, although research is being done into a number of possible causes. In some people we know they can result from conditions such as diabetes, certain medical conditions, and alongside other long-standing eye problems.

Cataract Information of 11JAD/JCT Solihull Eye Clinic February 2003 Version 1 Reviewed Oct 2010, Next Review date November 2013

Directorate of Ophthalmology0121 424 2000Information for Patients What treatment is available and what are the alternatives?The most effective treatment for cataracts is an operation to remove the cloudy lens. There really is no alternative to surgery.

If the cataract is not removed, your vision may stay the same, or it may get worse. Waiting for a longer period of time may make the operation more difficult.

About the operationThe purpose of the operation is to replace the cloudy lens (cataract) with an artificial lens (implant) inside the eye. An experienced eye surgeon will perform the operation or may supervise a doctor in training.



You will have a local anaesthetic, which means you will be awake during the operation. You may be able to see what is happening during the operation and you will be aware of a bright light.

Just before the operation you will be given drops to enlarge the pupil. During the operation you will be asked to keep your eye still, and lie as flat as possible. The operation normally takes about 20 minutes, but can take up to 45 minutes.

Most cataracts are removed by the surgeon by making a very small cut in the eye, softening the lens with sound waves and removing it through a small tube (see diagram). The back capsule of the lens is left behind and an artificial lens is then inserted to replace the cataract. Sometimes stitches are put in the eye.


The cut healsnaturally

Plastic Lens insidelens capsule


Benefits and risks of cataract surgery and consentThis booklet gives you information that will help you to decide whether to have cataract surgery. You might want to discuss it with a relative or carer. Before you have the operation you will be asked to sign a consent form, so it is important that you understand the booklet before you decide to have the operation.

If you have any queries or questions, you may want to write them down on the last page of the booklet, so you can ask the hospital staff in clinic.

Benefits of the operation are clearer vision, less glare and better colour vision. Because the lens implant can be selected to correct existing problems that you may have focusing, most people find their vision improves considerably, but they will need new glasses.

If you wish to have more information about the risks of surgery and the consent procedure please ask for our separate leaflet on consent. This is available from staff nurse Davies at the eye clinic, Solihull Hospital or Sister Jane Waller at the eye clinic at Heartlands Hospital.

Some possible complications during the operationComplications are rare, and in most cases can be treated effectively. In a small proportion of cases, further surgery may be needed.

Vary rarely, some complications can result in blindness

There is a very small chance you may loose the eye if it has to be removed due to a severe infection after the operation



The most common complication (posterior capsular opacification) occurs when the back of the lens capsule (left in the eye to support the implant) becomes cloudy

To treat this the doctor uses a laser beam to make a small opening in the cloudy membrane; It is a quick and painless procedure and can be performed in the Outpatient Department

The vast majority of patients have improved vision following cataract surgery

It must be stated that there is an extremely small risk of death during the operation. If you are elderly, death may happen at any time, including the time of the operation. Death may happen during surgery without necessarily being related to the procedure.

Tearing of the back part of the lens capsule with disturbance of the gel inside the eye that may sometimes result in reduced vision

Loss of all or part of the cataract into the back of the eye requiring a further operation

Bleeding inside the eye, which is rare.

Some possible complications after the operation

Bruising of the eye or eyelids

High pressure inside the eye, which is temporary.

Clouding of the cornea, is not common and is almost always temporary

Incorrect strength or dislocation of the implantCataract Information of 11JAD/JCT Solihull Eye Clinic February 2003 Version 1 Reviewed Oct 2010, Next Review date November 2013


Swelling of the retina – (macula oedema), which may result in poor vision, but again is not common

Detached retina, which can lead to sight loss. This is rare.

Infection of the eye (endophthalmitis) which can lead to loss of the sight or even the eye. This is a rare complication.

Allergy to the medication used

Your vision may be worse after the operation, but this is uncommon.

You may require more than one operation

Pre Operative assessmentAt the pre operative assessment you must bring with you:1. All your medication

2. All your glasses

The consultation will be with a nurse in the Eye Clinic, a definite operation date will be given if you are declared fit.A few tests may be undertaken, including a special eye test, which measures your eyes to make sure that the correct intraocular lens is put into your eye during the operation (a biometry).

This test will be performed by a technician using a special machine and you will have some anaesthetic drops put into your eyes before the test is carried out. You may also have some blood tests and heart tracing (an ECG) but these are not always necessary.


Directorate of Ophthalmology0121 424 2000Information for Patients The day of surgeryThe operation will be performed at Solihull Hospital Day Procedures Unit, which is on the first floor of the hospital, opposite the restaurant.

You should have a responsible adult to come in with you, as an escort

You may come in using public transport, but you must go home in a car or taxi

If your operation is in the morning you may have a light breakfast. If it is in the afternoon you may have a light lunch

Take all your medication as normal unless instructed otherwise

Wear loose comfortable clothing (preferably trousers). Leave all jewellery at home and do not wear makeup. You will be able to wear your own clothes during the operation

After your operation you will be able to go home within a few hours

You may be sent home with a pad and shield on your eye, or just a shield and some eye drops, or without anything on the eye.

The local anaestheticThe surface of your eye is anaesthetised using local anaesthetic drops. These may sting a little at first. Next, in some patients a small cannula (access port for injections) is placed in the vein in the back of your hand. Then local anaesthetic is injected using a very fine needle into the fat surrounding the eye, or the doctor may instill some anaesthetic drops to anaesthetise the eye and not use an injection. If you have the injection it may sting for a few seconds.

It is possible to give you a small amount of sedation during this injection. An eye patch may be placed over your eye and light Cataract Information of 11JAD/JCT Solihull Eye Clinic February 2003 Version 1 Reviewed Oct 2010, Next Review date November 2013

Directorate of Ophthalmology0121 424 2000Information for Patients pressure is applied to make the eye softer for the surgery. After three to five minutes your eye should be starting to go numb. You may notice that your face also goes numb from the scalp down to the upper lip.

Sometimes it is necessary to give you a second injection as in some people the nerves are more resistant to local anaesthetic and sometimes the local anaesthetic solution does not spread adequately around the nerves. The local anaesthetic normally lasts for around two hours.

Risks of anaesthesiaApproximately one in twenty patients can get some bruising around the eye with the anaesthetic injection. The chance of vision being permanently damaged by the local anaesthetic technique is extremely low and probably between one in 10,000 and one in 25,000 operations.

Your operation

The doctor for your operation is

…………………………………………………………………..

Date:……………………………

Today you have had a……………………………………………………………………….

operation under local anaesthetic.

Looking after yourself after the operation:


Directorate of Ophthalmology0121 424 2000Information for Patients 1. Rest quietly for the rest of the day

2. Do not interfere with the eye shield or the dressing (if you have one). If the pad falls off, throw it away, wash the plastic shield with soap and water (dry thoroughly) and replace it over the eye, secure in place with sellotape.

3. If you have any discomfort or pain, take tablets that you would normally take for headache e.g. paracetamol. If you have severe pain or vomiting please contact the Eye Clinic (telephone numbers are in this leaflet).

4. The local anaesthetic injection may cause the surrounding area of your eye and face to remain numb for a few hours and you may experience some double vision as it is wearing off.

Post operative information following cataract surgeryFollowing your surgery you could now be wearing an eye shield. If so, you should keep this on until tomorrow morning. When you get up, remove the shield, throw away the pad and the tape; wash the shield and keep this to wear at night for two weeks. You can secure this with transpore/micropore tape or sellotape.

You may find the eye is a little sticky – you can clean this very gently with gauze and cooled, boiled water, wiping from your nose side outwards. You can then start to put in your drops according to your instructions.

First day – what to expect Your vision may still be blurred. This is because your pupil may

still be dilated from the drops used for the surgery. It should improve as the day progresses. If you experience a sudden drop in vision of if your vision is much worse than before the operation you should contact the cataract nurse.


Directorate of Ophthalmology0121 424 2000Information for Patients You eye will feel “gritty” as if there is something in it. This will

improve. You may experience some soreness.

If you have any pain then you should take your normal painkillers, these should help. If you have eye pain that is not helped by painkillers then you should contact the cataract nurse.

Your eye may be red, sometimes a small blood vessel may have leaked during surgery. This is nothing to worry about and will settle over the next few weeks.

As mentioned before, your eye may be a little sticky on the day following surgery and it will be “watery” – these are both normal. If you develop a persistent sticky discharge your should contact the cataract nurse

To speak to the cataract nurse, please ring:0121 424 2000 and ask for the Cataract Nurse Practitioner (Bleep No. 2009)Monday – Friday 9am – 5pmWednesday 9am – 2pm

After 5pm for emergencies only contact::Birmingham Eye Casualty at City Hospital on 0121 507 6780

The nurse is contacted via the bleep that has been set up for this purpose only for the first week following surgery – please do not use for any other queries.

Your post operative check appointment will be sent to you. If you have a query regarding this then contact the appointment desk on the following numbers:

Solihull patients 0121 424 4463Heartlands patients 0121 424 0545Cataract Information of 11JAD/JCT Solihull Eye Clinic February 2003 Version 1 Reviewed Oct 2010, Next Review date November 2013


Further sources of informationRoyal Nation Institute for the Blind224 Great Portland StreetLondonW1E 5AA

Royal College of Ophthalmologists17 Cornwall TerraceLondon NW1 4QW


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