Preparing for cataract surgery
Cataract surgery needs little elaborate preparation, yet there are a few important points to keep in mind in the weeks and days beforehand. This page explains, step by step, what lies ahead.
Step 1: The preliminary examination appointment
Weeks before the operation itself, a detailed preliminary examination appointment takes place. This appointment is medically necessary: without the measurements taken there, no suitable artificial lens can be chosen.
At this appointment your eye is measured precisely (biometry, topography), the artificial lens is chosen and the informed-consent consultation takes place. The appointment typically takes 1 to 2 hours, because the eyes need 20 to 30 minutes to respond fully to the dilating drops.
Which medicines need to be discussed before surgery?
Most medicines can be continued as usual. There are, however, two groups your doctor must know about:
Prostate medicines (alpha-blockers): always tell your surgeon
Medicines such as tamsulosin (Flomax, Alna) and other alpha-blockers, often prescribed for benign prostate enlargement, can lead to a rare but well-known problem during cataract surgery: what is called intraoperative floppy iris syndrome (IFIS). The iris becomes slack when it should not. If the surgeon knows in advance, he or she can take the right precautions, and the risk is then well manageable. So always mention this medicine, even if you stopped taking it long ago.
Blood thinners: usually no need to stop
Many patients take blood thinners such as low-dose aspirin (ASS), Marcoumar or newer agents (NOACs such as Xarelto or Eliquis). The good news: for cataract surgery under local anaesthesia (anaesthetic eye drops), it is usually not necessary to stop these medicines.
Your ophthalmologist will coordinate this with your GP or treating internist. Never stop blood thinners on your own and without medical advice: that can be more dangerous than the operation itself.
- ASS (low-dose aspirin)
- Metformin (diabetes)
- Thyroid medicines
- Blood pressure medicines
- Marcoumar (phenprocoumon)
- Xarelto, Eliquis (NOACs)
- Plavix (clopidogrel)
- Tamsulosin (Flomax, Alna)
- Alfuzosin
- All alpha-blockers
Eye drops before the operation
In the 1–3 days before surgery you will receive a preoperative drop schedule. It usually consists of an anti-inflammatory agent (NSAID eye drops) and an antibiotic. That may sound like a lot of effort, but each application takes only a few seconds.
Follow the drop schedule exactly. These drops reduce the risk of an eye infection after surgery and improve the healing result. Your doctor will explain the exact times and amounts at the preliminary examination appointment.
What applies on the day of surgery?
For most patients, the day of surgery is less demanding than expected. The procedure itself takes only 10–20 minutes; the total time at the hospital or day clinic is typically 2–4 hours.
✓ What you should do
- →Bring your glasses (even if your vision is poor)
- →Bring your e-card (the Austrian health-insurance card) and photo ID
- →Bring an up-to-date list of your medicines
- →Arrange for someone to drive you home
- →Use the preoperative eye drops as prescribed
- →Allow enough time (2–4 hours)
✗ What you should avoid
- →No eye make-up, no mascara
- →No perfume or aftershave around the face
- →Do not wear contact lenses
- →Do not drive yourself to the clinic
Checklist for the day of surgery
Tick off the points before you set off, or print the list.
All 8 points on one page, to take with you and tick off.
What happens immediately after the operation?
Straight after the procedure you receive an eye shield, either a small dressing or protective goggles. Do not rub the operated eye on that day. A slight foreign-body sensation, watering and temporarily blurred vision are completely normal in the first hours.
You start the first eye drops of your doctor's aftercare schedule on the day of surgery itself. Visual acuity, the sharpness of your vision, usually improves noticeably within 24–48 hours.
Detailed information on the first days, the drop schedule and permitted activities is on the aftercare page.
Frequently asked questions about preparation
Do I have to stop wearing contact lenses before the preliminary examination appointment?
Yes. For the biometry you should not wear rigid contact lenses for at least 2–4 weeks and soft contact lenses for at least 1 week before the measurement appointment. Contact lenses change the shape of the cornea, which would distort the measurement.
Can I eat and drink normally on the day before surgery?
Yes. With local anaesthesia (anaesthetic eye drops) there are no dietary restrictions. Eat and drink as usual. Only if general anaesthesia is planned does fasting apply from 6 hours before the procedure.
What if I am very anxious about the operation?
Raise your anxiety openly at the preliminary examination appointment. If needed, a mild sedative can be given. Since the procedure under anaesthetic eye drops causes hardly any pain and you stay awake, most patients report that the fear of surgery was far greater than the surgery itself.
Does someone have to stay with me the whole time?
Someone to drive you home is essential; you must not drive any vehicle on the day of surgery. It is not necessary, however, for anyone to wait during the whole stay (2–4 hours). Many patients come alone and call someone to collect them.
When will I find out which lens I am getting?
The lens is chosen at the preliminary examination appointment, together with your doctor. After the biometry it is clear which powers are available. The options are: the standard monofocal lens (free of charge), monovision with two monofocal lenses, one eye set for distance and one for near (free of charge, requires a contact-lens trial first), and premium lenses with an out-of-pocket payment. You make the decision yourself after a detailed consultation.
A specialist will go through the preparation with you and answer what you still want to know. Find someone to talk to near you.
Find a specialist near you