By Tina D. Turner, M.D.

Once a patient decides to have cataract surgery, the patient and surgeon should discuss plans for the surgery, such as the anesthesia that will be used, the patient’s expectation for his or her vision, and what the patient should expect during and after the surgery.

Anesthesia and Medication

Commonly, cataract surgery is performed with topical anesthesia. This is accomplished by instilling a very strong numbing medication into the eye. It is usually accompanied by medication in the patient’s arm intravenously to help him or her feel relaxed and comfortable.

This is the least risky form of anesthesia and most patients do extremely well with topical anesthesia and some intravenous sedation. Sometimes, medication is injected around the eye socket to numb the eye and paralyze eye and eyelid movement. These injections carry their own risk, however, and are being used less frequently.

General Anesthesia

On occasion, general anesthesia may be needed. Since cataract surgery performed with topical anesthesia requires patient awareness and cooperation, general anesthesia is usually required for children, patients with developmental delays, and patients with dementia. During cataract surgery, patients must lay flat and still; therefore, patients with movement disorders, such as Parkinson’s Disease or restless leg syndrome, may also require general anesthesia.

Patients who have difficulty breathing while lying flat, or who have back or neck pain/disorders that prevent them from being comfortable when lying flat may also require general anesthesia for cataract surgery.

Discuss Your Options

After deciding to have cataract surgery, the patient and physician should discuss the options for correcting his or her vision post-surgery. Artificial lenses, which are implanted in the eye during cataract surgery to replace the natural lens that is being removed, can make vision clear once again and, in some cases (but not always), reduce the need for corrective eyeglasses after surgery.

The surgeon will take special eye measurements before surgery, including the length of the eye and the curvature of the cornea, to determine what power the artificial lens should be.

Cataract surgery can decrease an individual’s dependency on eyeglasses and, in some cases, eliminate the need for eyeglasses after surgery. However, some patients will still need eyeglasses to fully correct their distance and/or reading vision to 20/20.