Cataract Surgery: How To Prepare

Cataract surgery is a relatively common procedure that treats cataract, a clouding of the eye’s lens. Also known as lens replacement surgery, this procedure involves surgically removing the cloudy lens and replacing it with a specialized prosthetic called an intraocular lens (IOL). Though this treatment is quite routine, if your ophthalmologist has recommended it, some preparation will be necessary. Surgery outcomes improve dramatically when you follow your healthcare provider's instructions. Here's what you should know before you have the procedure.

Location

Previously, cataract surgery required patients to spend several days in the hospital. Now, this procedure takes place in an outpatient setting requiring a relatively quick recovery. Barring unforeseen complications, you'll go home the same day. The treatment is mostly performed using local anesthesia—so you’re not put to “sleep." Most cataract surgery cases are done in outpatient surgery centers. As healthcare tries to find new innovative ways to streamline healthcare delivery, some practice settings are starting to offer cataract surgery in office-based procedure rooms. Notably, these surgeries are performed by a specific type of specialist called an ophthalmologist.

The ophthalmologist’s operating room will typically have the following equipment:

• Operating table: Cataract surgery is done while you’re laying down flat on a specialized, adjustable operating table.
• Surgical microscope: A wall-mounted or wheeled surgical microscope enables the healthcare provider to visualize the area in high magnification.
• Lights: Other adjustable lights will be necessary to ensure the practitioner is able to get a clear picture of what they’re working on.

What to Wear

Cataract surgery is a very quick, outpatient procedure. Your healthcare provider will provide you with a list of what to wear, but here’s a quick breakdown of what’s typically recommended:

• Dress comfortably: During surgery, you won’t need to change into a gown, so practitioners advise wearing comfortable, loose-fitting clothes. No change of clothes is necessary, though you may want to bring an extra shirt as fluids used in the surgery may drip down, Make sure to wear a shirt or top that has buttons.
• Go scent-free: On the morning of the procedure, wash your face with soap and water, but avoid wearing or applying perfume, aftershave, lotion, or moisturizing creams.
• Avoid jewelry: Don’t wear jewelry of any sort on the day of the operation. In addition, steer clear of make-up and nail varnish.

Food and Drink

Consultations with the ophthalmologist prior to the procedure will help clarify what you can and cannot eat or drink prior to the procedure. Be sure to listen carefully and feel free to ask any questions you have. Depending on how the surgery will be conducted, there may be differences in terms of what is and is not recommended. These might include:

• Local anesthesia: If the procedure is being done using only local anesthesia—that is, only the affected area will be numbed to pain—it is possible you will be asked to avoid food and drink prior to the procedure.
• General anesthesia: For the subset of those who will have the treatment performed under general anesthesia—that is, if you’re in the minority that’s going to be put to sleep during the procedure—there are many more restrictions. Healthcare providers will need you to avoid eating food or drinking anything other than water for at least six hours prior to the surgery. 
• For those with diabetes: Special considerations are necessary if you have diabetes, especially with regards to medications (see below). Importantly, it’s typically advised that you bring along a juice-box or a sweet drink to have in case your blood sugar levels dip.

Medications

In consultations before surgery, you’ll need to provide a full accounting of all prescribed and over-the-counter medications you are taking, as well as any supplements or herbal health products. Bring a list or any pill bottles you have. In particular, practitioners want to know if what you’re taking would cause worse bleeding as that would have implications for the surgery. The healthcare provider may advise you to temporarily stop taking these, though this determination is made based on safety, and in most cases, you can still take these pills.

For those with diabetes or who take warfarin, your practitioner may request that you take an INR blood test the week before the procedure, and, if levels are high, before the operation. The results of these tests may cause a need to delay the work. In addition, if you take a diuretic in the morning, it’s often advised to hold off until after the surgery.

In addition, healthcare providers may have you take specialized eye drops to prepare the eye for surgery. These are typically antibiotics and anti-inflammatory drugs aimed at ensuring the recovery goes as smoothly as possible. Furthermore, for those who are feeling excessive anxiety about the procedure—an understandable reaction—medications may be prescribed to help people relax.

Most importantly, be sure to keep your practitioner in the loop and let them know about anything and everything you are taking.

What to Bring

The duration of the actual surgery may be short, but you should budget about three to four hours for the entire visit. There are several things you need to bring:

• Health information: While assessment of your medical records and medication will have already happened in initial consultations and evaluations, it’s a good idea to have handy information about your medications as well as your insurance card.
• Someone to drive you home: Following surgery, you won’t be able to drive, so make sure to bring along a friend or family member who can give you a ride. If this is impossible, talk to the clinic and see if they can provide transportation.
• Change of shirt: This isn’t strictly necessary—as noted above, you won’t need to change clothes for cataract surgery—but you may want to bring an extra shirt as lubrication fluid for the eye may drip onto what you’re wearing during the procedure.

A Word From Verywell

Severe cataracts can be visually debilitating and can be progressive. The good news, though, is that cataract surgery is highly successful and very well tolerated. Complications are infrequent and a vast majority of patients—over 85 percent—are satisfied with the procedure as well as its results.                                                                  

Given all of this, it’s absolutely essential that you’re open and forthright with your healthcare provider, especially if you are experiencing symptoms like clouding in portions of the visual field. Don’t delay in getting the help you need. Outcomes improve when patients are informed and engaged in the process. With the help and support of caring medical staff, family, and friends, a clearer, brighter, cataract-free future is within sight.