Cataract surgery

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A cataract is a clouding or opacification of the normally clear focusing lens inside the eye. Your eye’s natural lens plays an important role in focusing images on the retina. When a cataract develops, the lens loses its clarity. Light rays cannot focus clearly, and the image you see is blurry. The only treatment for a severe cataract is to remove the eye’s natural lens and replace it with an artificial intraocular lens (IOL).

With a routine, outpatient surgical procedure, an ophthalmologist can remove the cataract by making a small incision in the cornea at the front of the eye. An ultrasonic oscillating probe is used to break up the center of the cataract and the pieces are suctioned from the eye. The small incision used usually does not require sutures to close, since the cataract is removed in tiny pieces.
A synthetic lens (IOL) is inserted at the time of cataract extraction to replace the focusing power of the natural lens. There are various types of IOLs that may help you to see better without glasses after surgery. 

The time to have cataract surgery is when the cataract is affecting your vision enough to interfere with your normal lifestyle, occupation or activities. Other factors to consider are the rate of progression of the cataract, as well as the health of the rest of the eye. It is rarely medically necessary to remove a cataract, and if there are significant other problems with the eye then surgery may not be appropriate. 

Modern cataract surgery is a very safe operation with low risk.
As with any surgical procedure, complications can occur during or after surgery, and some are severe enough to limit vision. The major complications include hemorrhage, infection, corneal clouding, retinal detachment or swelling, incomplete cataract removal, loss of vitreous and implant dislocation. Some of these complications may require additional surgery. These complications are rare (less than 5%) and in the vast majority of cases, vision and quality of life are improved. 

As with any surgical procedure, complications can occur during or after surgery, and some are severe enough to limit vision. The major complications include hemorrhage, infection, corneal clouding, retinal detachment or swelling, incomplete cataract removal, loss of vitreous and implant dislocation. Some of these complications may require additional surgery. These complications are rare (less than 5%) and in the vast majority of cases, vision and quality of life are improved.

Your individual implant power is calculated by mathematical formulas after measuring various parts of your eye. This can be done with ultrasound or with a new more precise method using advanced laser technology (AL-scan). Measuring the eye accurately is extremely important in cataract surgery, as it allows the eye surgeon to select the right power lens to implant for each patient. Corneal topography is another test that precisely measures the shape and power of your cornea, which adds further increased precision to our choice of lens power. For patients with significant astigmatism this is especially useful as it may help in selecting a lens than can help reduce your astigmatism after surgery. 

These advanced tests are an option available for patients who would like the best possible accuracy available for lens selection. In many cases the increase in accuracy reduces the need for glasses after surgery. These advanced tests are not covered by the provincial health plan but may be partially covered by private insurance plans. The cost for both tests is 300$ for both eyes. 

Some patients notice an improvement in their vision within hours after the surgery, while for others it can take days or weeks until the best vision is achieved.
While an effort is made to minimize the need for glasses after surgery, most patients will require glasses at least some of the time for their best vision. 

Three different eye drops will be required after surgery, and they will be tapered off gradually over one month. Several of the drops will be started two days before the surgery.
Normal physical activity is allowed after the day of surgery including gentle bending, lifting, exercising and face/hair washing. It is very important to NOT rub your eye, and a protective eye shield is to be worn at night for the week after surgery. 

A quick office visit is required on the day after surgery, and regular post- op visits are at one week and one month after the surgery.
If complications are encountered additional drops or medications may be required, as well as additional follow-up office visits. 

There are a variety of lens options that offer different advantages that can be implanted at the time of cataract surgery. The standard lens is fully covered by OHIP and is an excellent quality lens.