Aftercare advice: What to expect following cataract or lens replacement surgery

In this informative guide, esteemed consultant ophthalmic and oculoplastic surgeon Mr Jagmohan Chawla sheds light on what types of results patients should expect following refractive lens exchange, also known as lens replacement, or cataract surgery. Mr Chawla also shares his expert guidance on caring for the eyes following surgery of this type.

What types of results can I expect following lens replacement or cataract surgery?

Monofocal lenses

If you are having your lens replaced with a monofocal lens, this will give you good vision distance for distance and driving. However, you will need glasses for reading and near work. Depending on the results of surgery and/or any other pre-existing eye conditions, you may find that you are able to use ‘off the shelf readers’ from high street stores, which typically cost around £15.

If there you have any pre-existing conditions, prescriptions glasses will be necessary. These can be varifocals with plain glass at the top, half glasses (so that you can look over them) or simple reading glasses if you don’t mind putting them on and off.

Multifocal lenses

If you have had a multifocal lens implant, you may initially experience some problems such as clear halos or starbursts, particularly when driving at night. This can be minimised by not looking straight ahead at oncoming cars but looking slightly to the left. This will settle down in three to six months.

For reading, you will have to find the optimal position for you. This will be different to your previous distance. You may need to increase the light in your house, i.e. ‘daylight lamps’ which are readily available. The most expensive are ‘serious readers’. For all lens replacement or cataract surgery, improvement can go on for up to six months.

Dry eyes

You may have been told at the time of consultation that you have dry eyes and had drops prescribed for this. Dry eyes can be due to age, hormones, contact lens wear or autoimmune disease. After your operation, this can at times induce dryness or make it worse. Please be aware that you will probably have to continue with lubricant drops for many years or occasionally, on a lifelong basis.

Capsulotomy

In some patients, after the removal of the cataract or lens, you may experience clouding or blurring of vision. This may happen anywhere between six months and twenty years. This can be corrected by a short course of laser treatment.

Glaucoma

If you have glaucoma, you will have to continue with your drops lifelong and continue to have routine checks of your pressures.

What should I avoid doing after lens replacement or cataract surgery?

It is important to adhere to the following advice following lens replacement or cataract surgery:

• Do not rub your eye
• Do not expose yourself to smoke and dusty environments
• Do not dive or swim underwater
• Avoid strenuous physical exercise

Aftercare advice

Small incision cataract surgery with the insertion of a foldable intraocular lens is the most modern method of performing cataract surgery. The surgical incision measures less than three millimetres and the patient has no stitches.

The small incision means that your vision improves much more quickly following sutureless surgery as compared to conventional cataract surgery. There are no postural restrictions right from the first day after surgery – that means you can bend, sleep on either side, read and watch television if you want.

There may be a slight heaviness around the eye or foreign body sensation as the effect of the anaesthetic wears off. You may well be surprised to find how painless the eye feels after this major surgery.

The day following your cataract surgery, vision is generally bright but may be blurred as a result of early reaction and effect of the local anaesthetic if you have had an injection of anaesthetic around the eye. You may experience some discomfort in your eye. This will lessen and disappear completely over the next few days. You should use the clear plastic shield provided every night for one week. During the daytime, it can be removed.

You can wash your hair or have a shower the next day provided that soap or water does not enter the eye. Back washing the hair with someone’s help is a good idea. Swimming or immersion of the eye is not possible for two weeks.

When you can begin to drive again depends on the vision in your other eye. You should ask your surgeon about this. You can return to office work after a week or even after three days if you absolutely must. Manual work is safe after two weeks following small incision surgery.

You should be able to return to normal life in one to two weeks following your surgery. For a few days after surgery, you need to relax and avoid vigorous exercise.

You can read more about refractive lens exchange surgery and how it compares to laser vision correction in Mr Chawla’s other detailed article on the topic.

If you are considering lens exchange or cataract surgery and wish to schedule a consultation with Mr Chawla, you can do so by visiting his Top Doctors profile.