Anesthesia and Cataract Surgery: What Gets Used?

Anesthesia is a complex subject. It surrounds both awareness and sensation—two important aspects when it comes to having cataracts removed. 

When it comes to cataract surgery, getting put under (the layman’s term for a general anesthetic when you go completely to sleep) isn’t usually necessary. Instead, a combination approach of controlled, temporary loss of sensation and mild sedation is the most common practice.

However, a general anesthetic is used in a small number of cases.

Sedation vs. Getting Put Under for Cataract Surgery: Everything You Need to Know

• Sensation anesthetic: numbing the eye area
• Twilight sedation
• General anesthetic (GA)

Sensation anesthetic: numbing the eye area

Numbing the eye so you can’t feel anything is achieved using topical eye drops. These are extremely effective, disrupting the nerve signals that go from the eye to the brain and stopping any pain. This form of pain relief is short-lasting, and the numbness wears off quickly after surgery.

Sometimes an additional option is used, called an eye block or sub-Tenon block. This is longer lasting and will leave your eye quite numb for around six hours afterward. It’s applied in the corner of the eyelid, under the eyelid but not onto the eye itself—don’t worry, it’s not an injection. It causes the eye muscles to relax completely, so it’s less likely to move around during the procedure. 

Twilight sedation 

The anesthetist will insert an IV, through which a combination of relaxing medications will be delivered directly into your bloodstream. These work very fast, either sending you into a light sleep or allowing you to have a very low level of consciousness. Most people have no recollection of the operation. 

There are different levels of sedation, from light through to deep. Your surgeon will discuss this with you before the operation and take your preferred options into account.

The one big difference between twilight sedation and getting put under for cataract surgery is that you continue to breathe on your own. Don’t worry, the anesthetist will monitor you closely during the procedure, ensuring your vital signs remain stable.

Sedation wears off reasonably quickly—within a couple of hours or so. Even so, you shouldn’t drive yourself home and will need to arrange transportation.

General Anesthetic (GA)

This is generally not needed for most cataract procedures. Although modern GA techniques are very safe, they have a higher level of risk than sedation. This is particularly true if you suffer from any heart or lung conditions.

The times that a GA might be considered include:

• In a pediatric procedure.
• When a patient suffers from significant anxiety.
• If a patient suffers from certain medical conditions, such as cerebral palsy, any condition that causes seizures, nystagmus (involuntary eye movements), or certain conditions that affect the brain.
• An allergy or hypersensitivity to local anesthetic agents.
• Any other reason that means you might not be able to lie still for the procedure.

A GA involves various drugs being given through an IV, including those that paralyze the muscles. Breathing is taken over by a ventilator and the anesthetist will closely monitor your vital sounds throughout, adjusting any of the medications as necessary. 

Eye drops and sedation are by far the most common anesthetic options used for cataract surgery.

We Always Use the Most Appropriate Anesthetic at the WBEC

When you entrust your cataract care to the West Boca Eye Center, not only do you benefit from cutting-edge procedures, but also the same level of attention to sedation. Whether your needs are best met through sedation and topical eye drops, or you’re one of the few who needs to be put under for cataract surgery, you’ll be informed and looked after every step of the way.

Discover more about our world-leading cataract services at https://www.westbocaeyecenter.com/services/cataract-surgery

Anesthesia is a complex subject. It surrounds both awareness and sensation—two important aspects when it comes to having cataracts removed. 

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