The operation

Pre-operative examination

The power of the artificial lens needing to be implanted is calculated by means of an echography of the eye (biometry), linked to a specific computer programme.
The patient`s general practitioner will be asked whether there are any contra-indications to having the surgery performed under local anaesthesia. In most cases an electro-cardiogramme and a routine blood test will be performed, if not already done during the past six months.


Most cataract surgery is performed under topical anaesthesia, i.e. by means of drops.
Dr. Vryghem was one of the first eye surgeons to introduce this method in Europe - in 1996 -and to use it systematically. The anaesthetic drops are administered shortly before surgery.
Although aware that the surgeon is performing the operation the patient will feel no pain. Nervous patients may be given a tranquilliser.
In rare cases the anaesthesia may be by injection, general anaesthesia being administered in the most exceptional cases, e.g. psychiatric patients.

Ambulatory surgery or hospitalisation

Most cataract surgery is ambulatory, i.e. the patient walks in half an hour before the time scheduled for the procedure and leaves a quarter of an hour after it. One or two checks are done in the week following surgery to make sure that all is well and to detect any sign of infection.
In special circumstances hospitalisation can be considered, in which event the patient enters the clinic the afternoon before surgery and leaves two days later. Two checks are done during these two days.

Organising the surgery

The eye is disinfected with antibiotic drops administered by the patient him/herself three days prior to surgery.
The pupil of the eye which is to be operated on has to be dilated 2 ½ hours before surgery by means of eye drops administered by the patient.
The surgery is performed in a sterile operation ward. The area surrounding the eye is disinfected and covered by sterile drapes.
The procedure itself takes ten minutes. The patient is asked to look into the light of the operation microscope .
A transparent protective cap is not needed immediately after the procedure but must be worn at night for one week.

Post-operative care

Antibiotic and anti-inflammatory drops must be inserted by the patient during the six weeks following surgery. The patient must avoid direct trauma to the eye, the carrying of heavy weights and contact with dusty environments.
In most cases the patient’s distance vision will be satisfactory without glasses; for reading, however, glasses will be needed. A prescription for new glasses will be delivered after six weeks.

Long term results

In one third of patients the lens capsula may become opaque months or years after surgery: this is called secondary cataract or posterior capsular opacification. Treatment consists of making an opening in the cloudy lens capsula (capsulotomy) by means of a YAG-laser, which will produce recovery of vision from the following day.

More about Phako-emulsification

The operation
Preparing for an operation

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