Convalescence

It is a fair generalisation to say that an eye requires about four to six weeks for full healing to take place following a cataract operation. On the other hand, most of the healing takes place in the first two weeks. It is usual for patients to return to work after two weeks. After phakoe-mulsification, glasses can be prescribed at this point but after larger incision surgery the prescription of new glasses is usually done after a month. The visual recovery is undoubtedly quicker after small incision surgery but the ultimate visual result is probably no better than when a larger incision is used. Most hospitals provide a "hand-out" of do's and don'ts for the patients. The important thing is for the patient to avoid rubbing the eye and to seek immediate medical advice if the eye becomes painful, because this can indicate infection, which requires immediate treatment to prevent blindness. Following routine cataract surgery, it is usual to instill antibiotic drops combined with a steroid (usually in one bottle) four times daily for three to four weeks.

Infection is the rare but dreaded complication and this is usually heralded by pain, redness, discharge and deterioration of vision. The infection might be acquired from the patient's own commensal eyelid flora or from contamination at the time of surgery. The commonest types of bacterial infection are streptococcal and staphy-lococcal species. About 10-20% of patients develop opacification of the posterior lens capsule behind the implant after months or years. This is simply cured by making an opening in the capsule with a special type of laser. This is a day-case procedure, which requires no anaesthetic and takes two or three minutes. When corneal sutures have been used, these can sometimes need to be removed and this can also be done on a "while-you-wait"basis in the outpatient department.

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