Anesthesia During Cataract Surgery: What You Need to Know

Most cataract surgeries are performed while a patient is under a local anesthetic. 

Are You Awake During Cataract Surgery?

In most cases, patients are given local anesthesia, which means that they are awake during the procedure and fully conscious of what is happening. Local anesthesia helps render the operation virtually painless, so patients don’t feel anything during surgery. 

Cataract surgery can be done in around 15 minutes. It is considered a routine form of surgery, and it is performed on millions of patients in the United States every year. Cataract surgery outcomes vary from individual to individual, but the overall success rate is very high.

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Types of Anesthesia

There are a few types of anesthesia, including local anesthesia, regional anesthesia, and general anesthesia. In some cases, patients can select with anesthesia they are most comfortable with for cataract surgery. 

It’s important to consult with a physician and/or anesthesiologist to discuss which types of anesthesia would be safe for you and which would be appropriate for your individual circumstances. Your treatment team will have recommendations on what they think will work best.

Local Anesthesia

Local anesthesia is most commonly used for cataract surgery. It is given to stop pain in a given area of the body. The patient is still conscious while under local anesthesia and may still feel pressure during an operation, but they won’t experience pain.

Regional Anesthesia

Regional anesthesia is when local anesthesia is injected near nerve clusters around where the surgery will take place. Like local anesthesia, regional anesthesia will make a portion of the body numb to pain.

Two common forms of regional anesthesia are epidurals and spinal anesthesia. 

General Anesthesia

General anesthesia is the type of anesthesia where the patient loses consciousness and has no awareness or sensation. This form of anesthesia is generally used for major operations, like open-heart surgery or knee replacements.

IV or Monitored Sedation 

This form of sedation is used for minimally invasive surgical procedures, like a colonoscopy, for instance. As its name suggests, this form of sedation utilizes an IV that makes the patient feel a sleepy sensation, calming the patient during a given procedure.

Why Is Local Anesthetic Used During Cataract Surgery?

Local anesthetic is the most common form of anesthesia used during cataract surgery because it allows the patient to be conscious and responsive to any instruction. The procedure itself only lasts around 15 minutes, and it is minimally invasive. 

Since there are risks with higher levels of anesthesia, it is usually recommended to use the lowest level that is appropriate for a given procedure.

The location of the surgery also affects which type of anesthetic is used, making local anesthetic a very safe and effective option. 

What Happens if You Move or Blink During Cataract Surgery?

You don’t have to worry about holding your eyes open or not blinking during cataract surgery.

An eye doctor will use eye drops that also act as an anesthetic. They will help to numb the eye and reduce pain and discomfort. Once the eye becomes completely numb, a doctor will use a device that holds the eyelid open, rendering the patient unable to blink. 

This tool is called an eye holder, and this device will keep the lid open while the surgical procedure is performed. Once the procedure is completed, the eye holder is removed, and the patient is able to blink and move their eye freely again.

Can You Be Put Under for Cataract Surgery?

General anesthesia is only utilized for cataract surgery on very rare occasions. Patients who are put under during cataract surgery generally are often squeamish and incapable of cooperation in a surgical setting. Most often, this form of anesthesia is not used for this type of surgery. 

Will I Still Need Glasses After Cataract Surgery?

Cataract surgery provides noticeable benefits for patients nearly immediately after the procedure. However, some patients may still find it necessary to wear glasses in order to have clear and unimpeded vision, although complications related to cataracts are often cured.

Cataract surgery returns vision to what it was prior to the cataract formation. It does not address vision issues that are not related to the cataract.

Can I Drive After Local Anesthesia?

Patients who receive local anesthesia for other procedures are generally okay to drive immediately after treatment, but patients cannot drive after cataract surgery simply because their vision is impaired. 

References

1. Real-World Cataract Surgery Complications and Secondary Interventions Incidence Rates: An Analysis of US Medicare Claims Database. (April 2022). Journal of Ophthalmology.

2. The Science of Local Anesthesia: Basic Research, Clinical Application, and Future Directions. (April 2018). Anesthesia & Analgesia.

3. A Retrospective Study on the Outcomes of Cataract Surgery in an Eastern Regional Health Authority Hospital of Trinidad and Tobago. (September 2015). PeerJ.

4. A Survey of Anaesthetic Preferences in Cataract Surgery. (February 2022). International Journal of Ophthalmology.

5. Contemporary Anesthesia Practice for Cataract Surgery: Analysis of the National Anesthesia Clinical Outcomes Registry. (December 2022). Journal of Cataract & Refractive Surgery.

6. Topical Anesthesia for Cataract Surgery: The Patients’ Perspective. (June 2014). Pain Research and Treatment.