Cataract Surgery

What It Is

The lens sits behind the colored part of the eye (the iris) and helps focus light onto the retina. Over time, especially with aging, proteins in the lens can clump and make it cloudy. This is a cataract.

Cataract surgery is generally considered when a cataract interferes with daily activities such as reading, driving, or seeing at night. There is usually no urgent need to remove a cataract early, and the timing is often a shared decision between the person and an eye surgeon.

The surgery is done by an ophthalmologist. The most common method breaks up the lens using ultrasound and removes it through a very small cut.

Common Terminology

Cataract

A clouding of the eye's natural lens.

Intraocular lens (IOL)

A clear artificial lens placed inside the eye to replace the natural lens.

Phacoemulsification

A technique that uses ultrasound to break the cloudy lens into small pieces so it can be removed through a tiny cut.

Lens capsule

The thin, clear membrane that holds the natural lens; the artificial lens is usually placed inside it.

Posterior capsule opacification

Clouding of the lens capsule that can develop months or years after surgery; sometimes called a secondary cataract.

YAG laser capsulotomy

A quick laser procedure that makes an opening in a clouded capsule to clear vision.

Ophthalmologist

A medical doctor who specializes in eye care and eye surgery.

Why It Is Done

Cataract surgery is generally done:

• When a cataract makes vision blurry or dim enough to affect daily activities.
• When glare or halos from lights, especially at night, interfere with tasks like driving.
• When a cataract makes it hard for a doctor to examine or treat other eye conditions, such as problems with the retina.
• Less commonly, when a cataract causes other eye problems, such as inflammation or increased eye pressure.

How It Is Performed

This is a general description of a typical procedure:

• The eye is numbed with drops or an injection, and medicine to help relax is often given.
• The surgeon makes a very small cut at the edge of the cornea.
• An opening is made in the front of the lens capsule, and the cloudy lens is broken up and removed, often with ultrasound.
• The artificial lens is folded, inserted through the small cut, and unfolds into place.
• The cut is usually self-sealing, and the procedure itself often takes less than an hour.
• Some surgeons use a laser for certain steps, a method called laser-assisted cataract surgery.

Before the Procedure

Before surgery, in general:

• An eye exam checks the cataract and the overall health of the eye.
• Measurements of the eye's length and the curve of the cornea are taken to choose the power of the artificial lens.
• Different types of lenses may be discussed, such as lenses for distance vision, multifocal lenses, or lenses that correct astigmatism.
• The care team typically reviews current medicines and may prescribe eye drops to use around the time of surgery.
• People are usually asked to arrange a ride home.

Recovery Overview

Recovery is usually fairly quick, though it varies. In general:

• Vision may be blurry at first and often improves over days to weeks.
• Mild itching, scratchiness, or light sensitivity are common for a short time.
• Eye drops are commonly prescribed for a period after surgery to help prevent infection and inflammation.
• A protective shield may be worn, especially at night, for a while after surgery.
• Follow-up visits are typically scheduled soon after surgery, and a new glasses prescription is often checked once the eye has healed.

Risks and When Complications May Be Discussed

Cataract surgery is generally considered safe and effective, but possible risks include:

• Inflammation or swelling in the eye.
• Infection inside the eye (endophthalmitis), which is rare but serious.
• Increased eye pressure.
• Retinal detachment, which is uncommon.
• Clouding of the capsule later on, which can usually be treated with a YAG laser.
• Sudden vision loss, increasing eye pain, many new floaters, flashes of light, or a curtain-like shadow over vision are generally treated as urgent concerns for an eye doctor.

Questions to Ask a Healthcare Professional

General questions people often find useful to bring to an appointment:

• At what point is cataract surgery generally considered worthwhile?
• What types of artificial lenses are available, and what are the trade-offs?
• Will glasses still be needed after surgery?
• How are other eye conditions taken into account?
• What does recovery generally involve, and which activities are limited for a time?
• What symptoms after surgery should be reported promptly?

Sources

This guide was written in plain language from the following authoritative references.

1. Cataract Surgery — National Eye Institute (NEI)
2. Cataract — MedlinePlus (U.S. National Library of Medicine)
3. Cataract surgery — NHS

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