Cataract Surgery: Long-Term Care

Cataract surgery (also known as lens replacement surgery) involves replacing a lens clouded by cataract with a specialized prosthetic called an intraocular lens (IOL). This relatively quick procedure usually takes between 15 and 45 minutes and is performed on an outpatient basis, so you are able to go home the same day. A successful outcome relies on adequate follow-up as well as your adherence to guidelines for recovery. As with all aspects of surgery, the more you understand what to expect, the better off you’ll be.

Benefits of Surgery

In the period after cataract surgery, your main tasks are two-fold—to ensure that the incision heals without infection and that the IOL becomes properly incorporated into the eye. Typically, while you’re able to get home quickly after surgery, it takes up to two weeks before you’re back to normal.

Cataract surgery has a high success rate, with about 94% of cases resulting in 20/40 vision or better, and about 61% resulting in 20/20 or better. To ensure the best possible long-term outcome, you can take several steps during recovery.

• Wear the eye shield: Following cataract surgery, you’ll be given a protective eye shield to wear at night for about one week.
• Take your eye drops: Eye drops are necessary following surgery to reduce inflammation in the eye and prevent infection. Do your best to follow your healthcare provider’s orders carefully and report any symptoms you’re experiencing.
• No eye-rubbing: It’s absolutely essential that you avoid contact with the affected eye, especially in the early days after your surgery. Contact can cause damage or lead to infection.
• Sunlight protection: Make sure to protect the eye from direct sunlight by wearing sunglasses.
• Keep the eye free of liquid and debris: Avoid swimming during recovery, and do your best not to let dust or other debris access the eye. Eye make-up wearers should likely abstain until they get a go-ahead from their healthcare provider.
• Avoid bending: Bending over, as you would to tie shoelaces or pick something up from the floor, actually places a little extra pressure on your eyes, which can affect healing. As such, avoid this behavior for at least one week after treatment.
• Physical restrictions: Avoid strenuous activities, such as lifting heavy objects, running, jumping, and so on. Your healthcare provider will tell you how long to wait before resuming such activities.
• Follow-up: Follow-up appointments are an essential part of a successful recovery. Your healthcare providers will check to make sure your eye is healthy, the IOL is in the right position, and there are no complications. Specific schedules for these appointments vary based on the case, but you’ll usually need to be back a day or two after surgery and again one or more times in the next few weeks or months.

Make sure you communicate with your medical team about how you’re feeling and how well you’re sticking to their recommendations. Make sure to get clearance before you start driving or as you’re planning to resume physical activities.  

Complications are rare with cataract surgery, but you should seek out medical help immediately if you experience any of the following symptoms following treatment, as these can be signs of infection:

• Severe pain
• Increasing discomfort in the affected eye over time
• Vision loss
• Dry eye
• Increasing redness in the eye
• Discharges from the eye 

Possible Future Surgeries

While cataract surgery is highly successful, in some cases additional procedures are necessary to take on complications or other issues. These surgeries are performed on one eye at a time, so, for some, a second cataract surgery will need to be scheduled. In addition, there are a number of other treatments that may be necessary.

• YAG capsulotomy: In some cases, the eye’s capsule that holds the IOL in place thickens, in a condition called posterior capsular opacification (PCO). (This is sometimes called a “secondary cataract” but it’s not actually a cataract.) PCO leads to blurry vision and a special treatment called YAG capsulotomy is needed to correct the issue. This painless procedure relies on guided lasers to trim the capsule film on the back of a lens implant to a proper size; no incision is involved.
• Corneal surgery: Another issue that can arise following cataract surgery is corneal edema, a swelling of the cornea. While this usually resolves on its own over a couple of days or can be managed with specialized eye drops, in some cases the cornea needs to be surgically repaired or replaced.
• Vitrectomy: Among the more serious complications that can arise following cataract surgery is a condition called endophthalmitis, which is an infection of the inside of the eye. Treatment varies based on severity, with antibiotics most often taking care of the problem; usually, these are administered via intravitreal injections after culturing the eye. However, when this does not work, vitrectomy surgery is called for. This involves removing blood, scar tissue, or other substances directly from the vitreous portion of the eye. In addition, the ophthalmologist may be able to reattach or repair the retina.
• Retinal detachment surgeries: In less than 1% of cases, the eye’s retina detaches after cataract surgery. Alongside vitrectomy, there are a couple surgical methods that are employed to correct this issue. Among these are pneumatic retinopexy, in which a bubble of air is injected into the eye, moving the retina into position, as well as scleral buckling, in which a piece of silicone is implanted to correct the issue.

Lifestyle Adjustments

Some lifestyle modifications will be needed following cataract surgery, especially in the first couple of weeks of recovery. These modifications include the following:

• Avoid driving: As you’re recovering from surgery, your eye will undergo healing, and it will be a while before you’re able to see properly. Make sure to make the necessary arrangements during the first couple of weeks, and don’t get behind the wheel until your healthcare provider gives you an OK.
• Exercise limitations: For the first few weeks, your healthcare provider may advise you to refrain from activities that can interfere with your eye’s healing. This includes swimming, lifting weights, or taking part in certain sports or physical activities. Again, make sure to get your healthcare provider’s clearance before you get back to physical activity.
• Glasses or contacts: IOLs nowadays can be designed to correct other vision problems, and there are many types. Depending on the type of IOL you get, you may need additional vision correction, which is part of the reason why healthcare providers schedule follow-up appointments.

A Word From Verywell

While the prospect of undergoing eye surgery can be very intimidating, it’s important to remember that cataract surgery is a common operation with a high success rate. The benefits of being able to see clearly outweigh the risks. Don’t hesitate to talk to your healthcare provider and be sure to let them know if you’re experiencing any issues after surgery.