When your doctor determines that both eyes have a cataract, the eye having a denser cataract will be operated on first. After a couple of days or weeks, the second eye can then be operated on.
This approach gives the first eye time to recover and the vision to stabilize as you wait for another surgery to be performed in the other eye.
Modern cataract surgery is normally safe and very effective. There are few complications involved. As a result, some surgeons are undertaking simultaneous bilateral cataract surgery (SBCS). That is, the cataract surgery will be performed in both eyes during the same day.
In certain European countries, this form of surgery is usually performed with recommendable results and less complication rates, according to surgeons who are proponents for SBCS.
An advantage of SBCS is that there are fewer office visits, as well as faster recovery in your binocular vision used for driving and other major tasks. You also resume your normal activities more quickly.
People having cataracts in both eyes and who are very nearsighted or farsighted benefit a lot from simultaneous bilateral cataract surgery. These patients experience visual imbalance after their first surgery and prefer simultaneous bilateral cataract surgery.
Once the refractive error is rectified with an intraocular lens (IOL), the patient no longer puts on their glasses. However, if the eyeglass lens was removed, they would experience wooziness, have double vision, and have depth perception difficulties.
If no glasses are worn as they wait for a second surgery, the eye won’t perform normally. Their binocular vision and depth perception will be disrupted until a surgery is done.
Despite this shortcoming, most cataract surgeons are not ready to perform simultaneous cataract surgery. Eye infection risks and related complications after cataract surgery are very low. If infection was to occur along with other severe complications, the outcome could be visually overwhelming for some time or even permanently.
Performing surgery on one eye can allow time for evaluation by both the patient and surgeon. This can influence the choice for a second surgery, i.e. if the first eye was performed for an accommodating IOL or multifocal IOL to replace reading glasses after the cataract surgery, should a similar IOL be done to the second eye, or could there be a better visual result using a different IOL, based on the initial surgery?
When you go for a surgical consultation and pre-operative eye exam, be sure to discuss the pros and cons of SBCS with your surgeon, including all other cataract surgery choices. This will help you decide on the appropriate surgery.
Cataracts: Is surgery necessary?
If cataract interferes with a child’s normal vision development, surgery will be necessary.
In adults having cataracts, surgery is often performed on one eye. After the first eye heals, then your surgeon will decide on a second surgery, depending on the eyesight’s improvement.
Two surgeries might be performed at the same time if you have two conditions, i.e. cataract and glaucoma. Your vision might improve after the surgery, but this will depend on which of the two conditions caused your vision loss.
We have two major types of cataract surgery available, and they are both carried out at an outpatient center. The type of cataract will determine the surgery to be used. The surgeon’s experience on either surgery will also matter.
- Phacoemulsification is small-incision surgery. This surgery involves small incisions and sound waves that help break up your lens into tiny pieces. This is the most used surgery. A laser might be used by your doctor to perform the surgery.
- Standard extracapsular cataract extraction (ECCE). When performing this kind of surgery, the lens, including the front part of your lens capsule circling the lens, is opened. The entire lens is then removed carefully.
The problem associated with this surgery is clouding that happens to your posterior lens capsule, also known as aftercataract, which may occur five years after your surgery. Clouding is not serious and is easily treated using laser surgery.
What does having a cataract mean?
Having cataract doesn’t necessary mean you have to get it removed. However, if the cataract is affecting your eye vision and your daily activities, you can have the surgery. Understand the surgery before undergoing one.
In adults, cataract surgery is almost elective and may be carried out at one's convenience. Followup treatment and exams are routinely monitored by your surgeon or anyone familiar with surgical practices.
If you have to drive, surgery is advisable. For the aged in retirement homes, you can decide to forgo surgery and get vision aids.
If you only have a cataract problem and no other condition, you have high chances of recovering your sight after your surgery. However, glasses might be required for people with near vision.
What increases cataract risk?
Factors that increase the risk of developing a cataract include:
- Age – Age sometimes comes along with cataracts.
- Genetic influence – Family history greatly influences the development of cataract. Some genetic disorders in people can also increase cataract risks.
- Chronic ailments – Certain chronic diseases pose a threat to cataract development. Controlling these diseases can lower cataract risk.
- Diabetes - People suffering from diabetes are at high risk of developing cataracts. Damage to your eye’s lens occurs after prolonged high blood sugar or glucose levels.
- Glaucoma – Surgery performed to treat glaucoma can increase cataract threat.
Other things which can contribute to cataract risk include:
- Smoking – Smokers are likely to get cataracts through damage to their lens caused by chemical formation known as free radicals. Cell damage can occur as a result of an extremely high degree of free radicals, including the ones in the lens.
- Infection as a result of pregnancy – If a woman develops certain infections when pregnant, like chicken pox or rubella, the unborn baby can develop cataracts.
- Ultraviolet (UV) light exposure - Ultraviolet B (UVB) is associated with the development of cataracts.
- Continued use and high doses of steroid drugs - Long-term use of high doses of steroid drugs for conditions, i.e. emphysema or asthma, increases an individual’s risk to develop cataracts.
If you feel that you are vulnerable or at risk of having a cataract, it’s advisable to see your doctor for regular checkups.
How to get ready for your cataract surgery
When getting ready for a cataract surgery, you can be requested to:
- Undergo tests – Some weeks or days prior to your surgery, your surgeon will perform ultrasound tests to determine the shape and size of the eye. This will assist in determining the right lens implant or IOL (intraocular lens).
- Avoid taking certain drugs – To avoid the risk of bleeding during surgery, your doctor can recommend that you take a temporary break from all medication. Inform your surgeon if you happen to be using prostate medication, because certain drugs may interfere with your cataract surgery.
- Use eye drops to minimize infection risk - Antibiotic eye drops can be prescribed by your surgeon to be used for 1 – 2 days before your surgery. You might also be requested not to eat or drink anything twelve hours prior to your surgery.
- Prepare to recover – It is possible to go home after your surgery. Arrange for your transport, because you can’t drive yourself. If possible, arrange for assistance at home, because your surgeon can limit activities, i.e. lifting or bending, for almost seven days after the surgery
Cataract surgery is fairly safe with very few negative side effects. For certain people, getting the surgery performed in both eyes at the same time is optimal.