Cataract surgery is a widely performed procedure designed to restore vision by removing a cloudy natural lens and replacing it with an artificial one. While many modern techniques for cataract removal utilize small, self-sealing incisions that typically do not require sutures, there are instances where stitches are still necessary.
Why Stitches Are Used in Cataract Surgery
Modern cataract surgery often involves creating micro-incisions that are designed to be self-sealing, eliminating the need for stitches in many cases. These tiny incisions leverage the eye’s natural internal pressure to seal the wound securely, contributing to quicker recovery and reduced discomfort.
However, stitches are sometimes used to ensure the incision closes properly and to maintain the eye’s integrity, especially in specific surgical situations. For example, if a larger incision is required due to a very dense cataract or a particular surgical approach, sutures may be needed to close the wound securely. Stitches can also be employed in cases where the incision is irregular, or if there is a higher risk of complications like infection. Furthermore, sutures help prevent surgically induced astigmatism, a condition where the cornea’s curvature changes after surgery, leading to blurred vision.
When Stitches Are Removed
The timing for stitch removal following cataract surgery depends on factors like the type of suture used and the patient’s healing progress. While some stitches dissolve on their own over weeks or months, non-dissolvable sutures require removal by an ophthalmologist.
Stitch removal typically occurs days to weeks after the surgery, once the incision has sufficiently healed and is stable. For instance, some non-absorbable sutures may be removed around one month post-surgery. In cases where sutures cause significant astigmatism or irritation, they might be removed earlier, sometimes within 15 days. Conversely, in certain scenarios, such as to ensure refractive stability, sutures might remain for up to 8 or 12 weeks.
The Stitch Removal Procedure
The removal of stitches after cataract surgery is a routine and quick procedure performed in the ophthalmologist’s office. Before starting, the eye is typically numbed with topical anesthetic eye drops, such as proparacaine, to minimize sensation. The patient is usually awake and may be asked to look in a specific direction to provide the surgeon with clear access to the stitch.
The ophthalmologist uses specialized instruments designed for precision and delicate work on the eye. These tools often include fine-tipped forceps and microscopic scissors, sometimes referred to as “Vannas scissors.” The surgeon carefully grasps the tiny suture, which can be microscopic in diameter—approximately three times smaller than a human hair.
The stitch is then gently cut at one end and carefully pulled out using the forceps. The knot of the stitch is often buried beneath the surface of the eye to minimize irritation, and the surgeon extracts it with precision. The entire process is very quick, lasting only a few seconds per stitch. While usually painless due to the numbing drops, some individuals might experience a slight tugging sensation or mild pressure as the stitch is removed.
What to Expect After Stitch Removal
After stitches are removed, it is common to experience mild, temporary sensations in the eye. These might include a gritty feeling, mild irritation, or a sensation similar to having a foreign object. These feelings are usually normal and resolve quickly, often within a day or two.
The eye may also appear slightly red or watery immediately after the procedure. Patients are generally advised to continue using any prescribed eye drops, such as antibiotic or anti-inflammatory drops, as directed by their surgeon to aid in healing and prevent infection. It is important to avoid rubbing or pressing on the eye, especially during the initial days after stitch removal, to allow the area to continue healing properly.
Most patients can resume light daily activities soon after, but should follow their doctor’s specific instructions regarding strenuous activities, swimming, or wearing eye makeup. Any unusual symptoms, such as increased pain, persistent redness, significant vision changes, or discharge from the eye, should be reported to the ophthalmologist immediately.