Cataract postoperative care :
recovery and follow-up
Cataract postoperative care (visual recovery, risks, complications, secondary cataract) is detailed here by Dr Julien Gozlan.
Cataract postoperative care: visual recovery
Cataract postoperative care is generally simple and rapid. The vast majority of patients regain functional vision the day after the procedure.
D0
Day of surgery
During cataract postoperative care, return home is scheduled 2 hours after the procedure. Mild discomfort (foreign-body sensation), watering and blurred vision are normal and transient. The protective shield is kept on until the following morning.
D+1
Postoperative check-up
Consultation usually the next day. The shield is removed and the ocular status checked. Vision is often already significantly improved. Postoperative treatment is started, with anti-inflammatory eye drops 4 times a day for 1 month.
D+7
First week
During cataract postoperative care, vision continues to improve and gradually stabilises. Resumption of driving is permitted if visual acuity is sufficient, and sedentary professional activities are possible from D2.
M+1
Stabilisation and final spectacle prescription
Cataract postoperative care concludes at 1 month with the definitive stabilisation of refraction and prescription of final glasses if necessary. In case of a multifocal or EDOF implant, a 3-month neuronal adaptation period is normal.
Potential risks and complications
Although cataract postoperative care proceeds without complication in the vast majority of cases, the surgery is not without risks. Information is paramount to give free and informed consent to the procedure. Dr Gozlan systematically discusses them during the preoperative consultation.
Complication
Frequency
Standard treatment
Posterior capsule rupture
< 1 %
Intraoperative management
Secondary cataract
30 %at 5 years
YAG laser capsulotomy
Irvine-Gass syndrome (macular oedema)
1 %
Anti-inflammatory eye drops
Endophthalmitis (severe infection)
0.03 %
Emergency antibiotics
Retinal detachment
< 1 %
Emergency vitreoretinal surgery
Warning signs after surgery
Endophthalmitis is a very rare complication during cataract postoperative care (0.04 % of cases), occurring within 3 days after the procedure. Early management is crucial to prevent blindness. Watch out for the appearance of any of the 3 cardinal signs below.
Severe eye pain
Intense, throbbing or continuous pain that is not relieved by your usual painkillers (such as paracetamol) is a major warning signal.
Sudden vision loss
A sudden and marked decrease in your visual acuity, or the sensation of a dark veil or curtain obscuring part of your visual field.
Marked eye redness
An eye that becomes very red, congested and irritated, particularly if this redness is accompanied by eyelid swelling (chemosis) or cloudy discharge.
If you experience any of these signs during cataract postoperative care, contact Dr Gozlan or an ophthalmic emergency service immediately.
Secondary cataract
Posterior capsule opacification
Occurring well after cataract postoperative care (usually 1 to 5 years), residual epithelial cells may proliferate on the posterior surface of the capsule and make it opaque, causing a progressive decrease in vision similar to the initial cataract. This phenomenon occurs in about 30 % of cases at 5 years.
A simple YAG laser treatment
YAG laser capsulotomy is performed in the consultation room. The procedure takes about 2 minutes. The implant is not touched and no anaesthesia is required. Vision is restored almost immediately.
Frequently asked questions
During cataract postoperative care, driving may resume the day after surgery if vision is judged sufficient by the surgeon at the postoperative check-up. It is imperative not to drive on the day of the procedure.
During cataract postoperative care, light activities (walking, stationary cycling) are possible from D+2. Swimming and contact sports should be avoided for 3 to 4 weeks to prevent any risk of infection or ocular trauma.
During cataract postoperative care, return to office or screen work is often possible from D+2 or D+3. For dusty or physical work, a 1- to 2-week break may be recommended.
The implant does not opacify. However, in 20 to 30 % of cases, the posterior capsule on which the implant rests may progressively opacify: this is secondary cataract. It is treated easily and painlessly in a few minutes with a YAG laser, in consultation.
It depends on the type of implant chosen. With a monofocal implant, glasses are often still needed for certain distances. With a multifocal or EDOF implant, dependence on glasses is greatly reduced or even eliminated for many patients.
During cataract postoperative care, the shield is placed at the end of the procedure and kept on until the postoperative check-up the following morning. After this check-up, it is no longer needed during the day, but may be useful at night for a few days to avoid rubbing the eye.
During cataract postoperative care, eye and eye-area make-up is not recommended for at least two to three weeks after the procedure, due to infection risk. Make-up of the face outside the ocular area is possible from the following day with caution.