What type of anesthesia do they use for cataract surgery?
The majority of cataract surgeries done in the US are done with a local anesthetic and IV sedation. The local anesthesia may be accomplished in one of two ways: either an injection of anesthetic around the eye or anesthetic eye drops placed on the eye that is often combined with an injection of a small amount of anesthetic into the front of eye at the very beginning of the surgery. The injection of anesthetic around the eye generally produces a deeper anesthesia for the surgery then the topical method but it also comes with an increased risk. There is a very small chance but potentially serious risk of bleeding behind the eye and a rare chance of inadvertent penetration of the back of the eye with the injection needle. The topical anesthesia has lower risk but does not provide quite as deep of an anesthesia although the overwhelming majority of people having cataract surgery with a topical anesthetic do not experience any significant pain during the procedure.
Do I really even need cataract surgery? The other difference between the two anesthesia is with topical anesthesia you maintain your ability to move your eye around whereas with injection anesthesia the eye muscles are temporarily paralyzed so your eye doesn’t move during the surgery. When you have topical anesthesia it is important for you to try and stare straight ahead at the light in the microscope above you. Most people accomplish this quite easily.
How Does Cataract Surgery Improve Your Vision?
Along with the anesthetic to the eye, in most cataract surgeries, an anesthetist will also give you some mild sedative medication through an IV. This makes you relaxed but does not put you “out” although some people do fall asleep during the procedure from the effects of the sedation.
Many people who have cataract surgery with IV sedation don’t remember some of the surgery because of the amnesiac effect that occurs from the sedative. This often doesn’t happen when you return for surgery on your second eye. Despite often getting the exact same dose of sedative on the second surgery you have significant less amnesia the second time. This is caused by a quick build up in tolerance to the medication - the same phenomena that drives drug addiction. You don’t get the same feeling the second or third time around so you end up taking more and more. Many people when they have their second surgery feel that the surgery was significantly different than the first time even though it was done exactly the same. The reason is just that you remembered more the second time.
Can I cure my cataracts with eye drops? On rare occasions people need to have general anesthesia to have their cataracts removed. In today’s world that is mostly done for people who are incapable of cooperating and staying still for the surgery. For everyone else who can cooperate it is generally not worth the risks, which includes death, to put people to sleep for a surgery that is easily done under a local anesthetic. At Shore Eye Associates we use the topical medication along with IV sedation for almost all of our cataract surgeries. We believe that it gives the best mixture of a comfortable procedure with the lowest degree of risk.
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