A cataract is a clouding of the lens of the eye; cataract surgery is performed to improve vision by replacing the clouded lens with an artificial one. Cataracts affect millions of people in the United States each year. Most cataracts are the result of aging, though some form as a result of genetic factors, disease or injury. Cataract surgery is common, and considered safe and effective.
Reasons for Cataract Surgery
Cataracts can cause blurry vision, and increase the glare from lights. In their early stages, cataracts usually are not troublesome but, as they thicken, surgery to remove them may be required. Typically, surgery is needed because cataracts are interfering with everyday activities, or the treatment of another eye problem.
Candidates for Cataract Surgery
Cataracts caused by aging develop gradually, and patients may not notice the early vision changes they cause. It is only when their cataracts start interfering with vision that patients may become aware of them. An ophthalmologic examination will detect cataracts, and rule out other causes for vision issues, such as glaucoma or macular degeneration. Patients who become aware of visual difficulties related to cataracts usually experience, especially at night, clouded, blurred or dim vision.
Benefits of Cataract Surgery
Cataract surgery's benefits are many, greatly enhancing the quality of life. They include the following:
- Improved quality of vision (sharper images, brighter colors)
- Less difficulty with routine tasks (particularly night driving)
- Decreased dependency on eyeglasses
- Greater independence, regardless of age or disability
- Greater safety
Research indicates that the improved vision provided by cataract surgery reduces the risk of falls, making exercise, sports and hobbies safer. This, combined with the improved ability to read, recognize faces, and perform everyday activities with greater ease, results in improved physical health, increased sociability and longer life expectancy.
The Cataract Surgery Procedure
After the pupil is dilated, and the area in and around the eye is numbed with anesthesia, a tiny incision is made to insert an ultrasonic probe. The probe emulsifies (breaks up) the cloudy lens into tiny pieces that are then suctioned out of the eye. Once the cloudy lens has been removed, an artificial lens is implanted.
The new lens, known as an intraocular lens (IOL), is often inserted through the original incision. Some varieties of IOLs serve multiple purposes, such as blocking ultraviolet light or working as bifocals. Depending on the type of IOL used, sutures may or may not be needed.
Surgery is usually performed on an outpatient basis in a doctor's office, takes only 20 to 30 minutes, and is relatively painless. A very high percentage of patients demonstrates improved vision after the procedure.
Risks of Cataract Surgery
Although cataract surgery is a common procedure and considered quite safe, any surgery poses risks. In the case of cataract surgery, there is a slightly increased risk of retinal detachment, a painless but dangerous condition. Other risks of cataract surgery include bleeding and infection. The risk of complications after cataract surgery is greater if the patient has another eye disease or serious medical condition. Danger signs of complications after cataract surgery include increased pain in or redness of the eye, light flashes or floaters, diminished vision, nausea, vomiting or intense coughing.
Recovery from Cataract Surgery
Immediately after surgery, an eye patch is worn; some doctors advise wearing a protective shield, even when sleeping, for several days. Vision may be blurry at first, but improves within a few days. Some itching and discomfort are also present for a few days, but it is important that a patient not rub or exert pressure on the treated eye. Heavy lifting should be avoided. Eye drops to prevent inflammation and infection, and control eye pressure are prescribed.
Even though full healing can take up to 2 months, because cataract surgery is performed on one eye at a time, daily activities can be resumed in a few days. Most patients need to wear eyeglasses, for at least some tasks, after surgery. If the other eye also has a cataract, which is usually the case, the second surgery is scheduled a month or two after the first.
Cataract Surgery FAQs
What is cataract surgery?
Cataract surgery is a procedure to remove the cloudy lens (cataract) from the eye and typically replace it with an artificial intraocular lens (IOL) to restore clear vision.
Why do I need cataract surgery?
Cataract surgery is recommended when cataracts cause significant vision problems that interfere with daily activities, such as reading, driving, or watching television.
How is cataract surgery performed?
The surgery is usually done on an outpatient basis. The surgeon makes a small incision in the eye, removes the cloudy lens, and implants the new IOL. The procedure generally takes about 10-15 minutes.
Is cataract surgery painful?
Most patients experience little to no pain during the procedure. Local anesthesia and sedation are used to ensure comfort.
What is the recovery time?
Recovery varies by individual, but many people notice improved vision within a few days. Most can resume normal activities within a week, although complete healing can take several weeks.
Are there risks associated with cataract surgery?
As with any surgery, there are risks, including infection, bleeding, and retinal detachment. However, serious complications are rare.
Will I need glasses after surgery?
Some people may still need glasses for reading or other activities, depending on the type of IOL chosen and their overall vision needs.
What type of lens will I get?
There are several types of IOLs, including monofocal (for one distance), multifocal (for multiple distances), and toric (for astigmatism). Your surgeon will help you choose the best option based on your vision needs.
Can cataracts come back after surgery?
While the artificial lens cannot develop cataracts, some patients may experience clouding of the capsule that holds the lens, known as posterior capsule opacification. This can be treated with a quick and painless laser procedure.
How do I prepare for cataract surgery?
Your doctor will provide specific instructions, which may include avoiding certain medications, fasting before the surgery, and arranging for transportation home afterward.
When should I contact my doctor after surgery?
You should contact your doctor if you experience severe pain, sudden vision changes, flashes of light, or a significant increase in redness or swelling.
How can I ensure the best outcome?
Follow your doctor's pre- and post-operative instructions closely, attend all follow-up appointments, and report any unusual symptoms promptly.
If you have additional questions or concerns, always feel free to consult with your eye care provider!
