Preparing for cataract surgery

A doctor giving an eye exam.

Cataracts – one of the most common eyesight issues – occur when the natural, clear lens becomes cloudy. This affects focusing and can cause symptoms such as experiencing blurry vision despite wearing glasses or having issues with driving at night. Surgery is typically the best option to treat cataracts, and it is important to prepare for the procedure correctly to achieve your vision goals. Baylor Medicine ophthalmologist Dr. Sumitra Khandelwal outlines cataract surgery preparation.

Preoperative appointment

Patients must understand the importance of preoperative appointments and should make accommodations ahead of time to attend all visits. These appointments are necessary and entail taking measurements to pick the correct lens implants.

“I tell patients that any sort of dry eye or challenges we have during the preoperative visit or the lens calculations can really affect the ability to pick the perfect lens, but can also postpone cataract surgery,” said Khandelwal, professor of ophthalmology at Baylor College of Medicine.

She suggests patients use lubricating eye drops before the preoperative visit because if the eyes are dry the day of the appointment, the measurements are not accurate, leading to possible postponement of surgery.

There are strict rules against wearing contact lenses before the preoperative visit because the contact lens rubs on the surface of the eye, affecting those measurements.

Prepare for anesthesia

Patients should be aware of the type of anesthesia used for the surgery and inform their doctor if they previously experienced the effects of anesthesia. They must notify their doctor of any allergies prior to going under anesthesia.

Eating after midnight the night before surgery is prohibited because the food in the system does not digest quickly and can cause serious dangers with anesthesia.

Keep track of medications

Unlike most surgeries, patients usually do not have to stop taking blood thinners with cataract surgery.

“Cataract surgery is a relatively blood-free procedure, and I’m usually ok with patients being on their blood thinners,” Khandelwal said.

Even though the sedation is light, ophthalmologists require patients to stop their semaglutide medications for one week before the procedure as if can affect anesthesia and cause complications. For weekly semaglutide medications, patients will hold the week’s dose and start back up after surgery, but if the dose is more than once a week, they should consult their primary care provider ahead of surgery. Patients with heart, stroke or neurological history should also get preoperative clearance for sedation from their primary care provider.

Ophthalmologists will most likely prescribe medication, and often patients are required to start them before surgery. These medications include an anti-inflammatory and an antibiotic. It is crucial to take these medications not just after surgery, but beforehand as well for the best outcome. Most patients also are prescribed eyedrops to use before and after surgery.

“It’s important to always educate yourself, so feel free to contact your surgeon’s office if you have questions prior to a pre-op visit – they welcome those questions,” she said.

Vision goals

Patients should think about the lens implant they want before surgery as many are available depending on their goals for vision after surgery. If the patient is a candidate for different lenses, the surgeon will explain those options to them. One patient might be fine wearing glasses for distance while another might prefer better vision for distance while needing reading glasses.

“There are lots of lens implant options, but it’s important for them to think about their activities because some lenses can affect nighttime vision. Patients should have an idea of what their goals are, what they enjoy doing and how much they drive at night,” Khandelwal said.

By Homa Warren

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