Eye Surgery: From Cataract to LASIK – Types, Recovery, and Risks

Medically reviewed by Steven Gayer, MD, June 18, 2024.

Eye Surgery

Eye surgery is used to treat a variety of conditions, including cataracts, glaucoma, detached retinas, retinal tears, diabetic retinopathy, and nearsightedness or farsightedness.

What is cataract surgery?

A cataract is a cloudy area in the lens of the eye that can make it hard to see clearly. In cataract surgery, the doctor uses tiny tools to remove the cloudy lens and replace it with an artificial lens. Cataract surgery is very common in the United States, and the surgery has a low complication rate.

You may be given pupil-dilating eye drops on the day of surgery. Additionally, you will receive numbing eye drops, a regional anesthesia block, or both to prevent you from feeling pain. The block is provided through an injection near the eye. You might also be given medicine to help you relax. This medicine is most often given through an IV—a tiny tube placed in a vein, usually in your arm.

General anesthesia is rarely needed for cataract surgery.

What are some other types of eye surgery?

Other common types of eye surgery are explained below. The descriptions incorporate information provided by the National Eye Institute.

Blepharoplasty. To repair droopy eyelids, the doctor makes a small incision or incisions to remove skin and muscle and to remove or reposition fat.

Corneal transplant. The doctor uses a special tool to keep your eye open while removing the damaged part of your cornea and replacing it with healthy donor tissue. Doctors can do a full thickness corneal transplant (penetrating keratoplasty) or a partial thickness transplant (lamellar keratoplasty).

Eye muscle surgery. Strabismus is a condition in which the eyes don’t move together as a pair; one eye might drift inward, outward, upward, or downward. Surgery isn’t the only treatment option, but when it is needed, a surgeon attempts to restore the eye muscles to a proper position by using techniques that weaken or strengthen them. This could involve removing a section of muscle or reattaching a muscle to a different point in the eye.

Glaucoma surgeries. For glaucoma implant surgery, the doctor inserts a tiny tube called a shunt into the white of your eye; the tube helps extra fluid drain out of your eye, lowering your eye pressure. In a trabeculectomy, the doctor creates a tiny opening in the top of your eye, under your eyelid, to allow the extra fluid to drain.

LASIK (laser-assisted in-situ keratomileusis). In this laser eye surgery, the doctor uses a strong beam of light (laser) to change the shape of the cornea, which makes vision clearer for adults with nearsightedness, farsightedness, or astigmatism. Photorefractive keratectomy, commonly called PRK, may be used as a LASIK alternative for patients with dry eyes or thin corneas.

Retina surgeries. There are several procedures for repairing a damaged or detached retina, some of which may be used in combination. To create small scars that will fix a tear or hole and help hold your retina in place, the doctor may apply a freezing probe (cryopexy) or shine a laser to make a small burn (photocoagulation). In scleral buckle surgery, the surgeon places a tiny, flexible band around the white part of your eye (the sclera); this band gently pushes the sides of your eye toward your retina to help it reattach. In pneumatic retinopexy, the doctor injects a small air bubble into the middle of your eyeball to push your retina back into place before applying the freezing or burning treatment; the bubble will disappear on its own over time. A vitrectomy involves the use of a suction tool to remove most of the vitreous (the gel-like substance that fills the eye), allowing the surgeon better access to the retina and providing room for the bubble.

Special anesthesia note for patients who have had a retina procedure with a bubble placed: If you are scheduled for any type of surgery soon after undergoing this procedure, it is critical that you let your anesthesiologist know about it before your surgery. Some anesthetics can interact with and change the size of the air bubble, which may remain present in your eye for five days to several months after your eye surgery.

What are the considerations for anesthesia during eye surgery?

Although the level of sedation varies depending on the procedure and the patient, it will most often be at a level where you remain awake while feeling relaxed. Sedation is usually provided through an IV placed in a vein.

This minimal level of sedation is very important for eye surgery because the doctor does not want your head to move. This movement may occur if you are sedated to a point where you are confused or fall asleep and snore. For surgeries such as blepharoplasty, too much sedation can make your eyelids appear droopier than they typically are, resulting in an overcorrection by the surgeon.

For some eye surgeries, like LASIK, the application of numbing eye drops as a topical anesthetic is enough to keep you from feeling pain during the procedure. For other types of eye surgery, a regional anesthesia block may be needed. This block is administered through an injection near the eye.

One reason monitored sedation is preferred over general anesthesia for eye surgery is the positioning of the surgeon and anesthesiologist. For most other types of surgeries, the anesthesiologist is stationed by the patient’s head, with the surgeon near the middle of the body. For eye surgeries, the positions are reversed, with the anesthesiologist near the middle. That makes it more difficult for the anesthesiologist to intervene quickly to take corrective action if the patient has breathing difficulties, which are more apt to occur under general anesthesia.

There are nonetheless some circumstances in which general anesthesia is necessary or an option for eye surgery. General anesthesia keeps you unconscious during the entire procedure.

Are there special anesthesia considerations for children?

Yes. In most cases, children will receive general anesthesia. This is usually necessary because it is difficult for them to remain still under monitored sedation.

Are there medical conditions that can complicate eye surgery?

Yes. Conditions that interfere with a patient’s ability to remain in a relatively flat and still position during surgery can be problematic. Alert your anesthesiologist before surgery and consider a preoperative visit if you have any condition that may prevent you from lying flat, such as reflux, back pain, emphysema, or even a temporary cough. Discuss potential accommodations and the timing of surgery. Adjustments may be needed to have your surgery go well and ensure that you are comfortable.

What should I do to prepare for surgery?

You will be told not to eat or drink for a certain period of time before surgery. Make sure you know how far in advance you need to stop eating and drinking. You should also ask which of your medicines to continue to take before the surgery and which to discontinue and when.

Most eye surgeries are done on an outpatient basis, so you will go home the same day. You will not be able to take yourself home, so you will need to make arrangements for a friend or family member to provide transportation.

Will I see what is happening during my surgery?

Under general anesthesia, you will be unconscious and unaware of what is happening.

Under monitored sedation, you will remain awake, but your level of awareness may vary. With topical anesthesia (numbing eye drops), the eye being operated on might see very bright light, shadows, and sometimes bursts of color. With a regional anesthesia block, the eye will be fully anesthetized and won’t see or feel anything. In both cases, the eye that is not being operated on will be covered.

Will I feel any pain during my surgery?

You should not feel any pain during surgery because your eye will be numb from numbing drops or an anesthetic injection.