Recovery After Cataract Surgery

In cataract surgery, the damaged lens is dissolved and removed. The phaco device used for this purpose dissolves the cataract using shock waves. The harder the cataract, the more shock waves are generated. On the inner surface of the cornea, which is the transparent layer at the front of the eye similar to a watch glass, there are endothelial cells that keep this layer transparent. Some of these cells die during surgery due to the shock waves generated by the phaco device that dissolves the cataract. As a result, fluid accumulates in the cornea, causing edema and blurred vision.

What are the complications after cataract surgery?

Cataract surgery is one of the most serious eye surgeries, and although the risk is low, there is a possibility of losing vision. This risk is higher in centers where cheaper materials are used, the same materials are used for multiple patients without replacement, attempts are made to save on protective eye medications, and low-quality intraocular lenses are used.

The most significant complications that may occur are bleeding during surgery. Although very rare, in some cases, there may be little that the doctor can do to prevent the loss of the eye. This risk is higher, particularly in overweight individuals with hypertension. The second significant problem is infections.

In centers that pay attention to cleanliness and use single-use FDA-approved materials, this risk is minimized with the help of intraocular antibiotics. Other preventable problems that may occur during cataract surgery include the cataract falling into the eye, difficulties in placing the intraocular lens, and errors in lens measurement due to the non-use of the latest technology.

To avoid these problems, the decision should be based on the doctor's experience, the hospital's conditions, and the quality of the materials used, rather than cost. It should be remembered that an individual's vision for the rest of their life depends on the success of this surgery, and quality imported materials come at a cost. It is not possible for centers that perform surgeries at a very low cost to use such quality materials, prefer single-use materials, or use quality intraocular lenses.

Edema After Cataract Surgery

The remaining cells, which cannot regenerate, work harder and fill in the gaps to resolve this edema.

If a large number of endothelial cells are lost, the edema becomes permanent, and vision permanently deteriorates, making the eye painful.

The treatment for this condition is corneal transplantation, commonly known as eye transplantation. This is a serious surgery, and vision may not be very good even after the transplant. Therefore, protecting the corneal endothelial cells during surgery is very important to avoid these situations.

To prevent damage to the cornea during cataract surgery, the surgery should be performed early without waiting for the cataract to mature, by an experienced surgeon using new-generation smart phaco devices. Additionally, high-quality and sufficient amounts of viscoelastics that protect endothelial cells during surgery should be used. The risk increases significantly in surgeries where cheaper materials or viscoelastics are used for cost-saving purposes.

Patients should pay attention to the other materials used in addition to high-quality lenses. Prof. Dr. Ahmet Akman, with experience in over 15,000 surgeries, ensures the best protection of the cornea during surgery by using original U.S.-made viscoelastics and new-generation smart phaco devices in all his surgeries.

When does vision improve after cataract surgery?

It is normal to have blurred vision in the first hours after cataract surgery. Due to the medications and lights used during the surgery, vision is blurry for the first few hours. After that, some corneal edema may develop, causing blurry vision for a day or two.

If the cataract is not very hard, vision is expected to start clearing up by the third day. By the first week, vision should be clearer. However, the patient may still feel blurry due to an unadjusted eyeglass prescription during this period, but if the trial lenses during the examination show good vision, there is no problem.

By the end of the first month, the eye should have reached its final level of vision without issues. If the measured vision is still not at the desired level, the existence of a problem should be investigated.

It should be noted that the concept of clear vision is relative. Some individuals may say they see well with only 10% vision, while others may complain of blurriness even with 100% vision. Therefore, whether the vision is clear or not is determined by the actual visual acuity measured during the examination.

Stinging Sensation After Cataract Surgery

The stinging sensation usually occurs due to irritation or dryness of the outer surface of the eye.

The eye drops used after cataract surgery can cause stinging by causing allergies in some patients and irritation in others. Additionally, if the patient has dry eye disease, which may not have been very noticeable before surgery, this stinging may occur due to the drops and the surgery. In this case, you should first have a check-up with your doctor. If there is no problem, artificial tears should be started to prevent dryness.

In particularly dry climates like Central Anatolia, stinging problems are very common among patients, whether they have had surgery or not. There are more advanced treatment methods for stinging that does not go away despite drops.

What should be considered after cataract surgery?

First and perhaps most importantly, avoid rubbing the eye, squeezing it tightly, and straining. Face washing and bathing should be avoided for 4-5 days. In the first week, avoid prostrating; if performing prayers, they should be done while sitting. Additionally, the drops recommended by your doctor should be used without interruption.

Is it necessary to wear glasses after cataract surgery?

It may be necessary. First, let's talk about distance vision, such as watching television. Measurements for the lenses to be implanted during cataract surgery are taken with various devices before the surgery. In our clinic, we use the most sensitive measurement device, the Zeiss IOLMaster 700.

Prof. Dr. Ahmet Akman and his team were the first in the world to publish a scientific paper on this device. However, no matter how precise the measurements are, these are mathematical measurements. Human biology does not always align with mathematics. Every patient's healing response may be different. Therefore, most patients reach results close to zero, but within a range of +0.50 to -0.50. Glasses are not required for these values.

In patients with astigmatism, if normal lenses are used, even if the above values are achieved, astigmatism will remain, and the patient will need to wear glasses. Therefore, toric lenses, which correct astigmatism, should be used for patients with astigmatism. Prof. Dr. Ahmet Akman is one of the leading surgeons in our country in this field, giving numerous talks and conferences every year and training colleagues on this subject.

Finally, even if distance vision is achieved without glasses, patients who have normal lenses will still need reading glasses to see up close, such as for reading text. The solution to this is the use of lenses known as smart lenses, which are actually not smart but have three focal points. When these lenses are used, close-up vision is achieved without glasses. For patients with astigmatism, the toric models of these lenses should be used.