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Cataract Surgery

What Are Cataracts?

Everyone is born with a lens in the eye, as a natural clouding occurs this is when it is called a cataract. When we look at something, light rays travel into our eye through the pupil and are focused through the lens onto the retina. The lens must be clear to focus light properly onto the retina, therefore, when the lens becomes cloudy it is then called a cataract.

Vision Problems with Cataracts

If your vision has become blurry, cloudy, or dim and/or if glare and night driving has become more bothersome, a cataract may have developed in one or both of your eyes.

As a cataract slowly begins to develop, you may not notice any changes in your vision at first. But as the cataract progresses, you may begin to find that it interferes with your daily activities. Performing a complete eye exam, your eye doctor can tell you whether cataract or another problem is the cause of your change in vision.

While cataracts are one of the most common causes of decreased vision, especially as we age, they are treatable with cataract surgery. Since most cataracts are part of the normal aging process, they cannot be reversed. There are no medications or eye drops that will make cataracts go away—surgery is the only treatment.

A cataract may not need to be removed right away if your lifestyle isn’t significantly affected. In some cases, the glasses prescription may change more rapidly and updating your eyeglass prescription may help to improve your vision. It is best to communicate well with your eye doctor regarding vision problems that you are experiencing to determine if you are ready for cataract surgery.

Cataract Surgery for Clearer Vision

When a cataract causes bothersome vision problems that interfere with your daily activities, your eye doctor may recommend surgery to remove the cataract. With cataract surgery, your eye’s cloudy natural lens is removed and replaced with a clear artificial lens implant (called an intraocular lens or IOL). Cataract surgery is performed as an outpatient procedure and does not require an overnight hospital stay.

You and your eye doctor can discuss the cataract surgery procedure, preparation for and recovery after surgery, benefits and possible complications of cataract surgery, cataract surgery costs and other important information. Together, you can decide if cataract surgery is appropriate for you.

Pre-operative Tests for Cataract Surgery

Before surgery, the length of your eye and the curve of your cornea will be measured. These measurements help your eye doctor select the proper lens implant for your eye. You will also discuss the various lens options available to you.

If you have had previous LASIK or other laser vision correction, you can still have cataract surgery, although sometimes referral to a corneal specialist may be recommended. In planning for cataract surgery, advise your eye doctor that you have had previous refractive laser surgery and provide the vision correction prescription you had before LASIK, if possible. This information will help your eye doctor calculate the correct IOL prescription for you. Previous refractive surgery can make determination of the correct IOL more difficult and your vision prescription prior to refractive surgery can help the surgeon calculate the correct IOL power.

Medications and Cataract Surgery

If you are having cataract surgery, be sure to tell your eye doctor about all medications and nutritional supplements you are taking. If you currently use or have ever used alpha-blocker drugs for prostate problems, such as Flomax®, Hytrin®, Cadura® or Uroxatral®, tell your eye doctor. These medications may prevent your pupil from dilating properly during surgery, leading to possible complications. If your surgeon is aware that you have had these drugs, he or she can adjust their surgical technique to adapt as needed, allowing for a successful cataract removal procedure. You should also tell your eye doctor about any other sedative or blood thinning medications you are taking.

The Cataract Surgery Procedure

The most common procedure used for removing cataracts is called phacoemulsification. A small incision is made in the side of the cornea (the front part of your eye), where your surgeon inserts a tiny instrument that uses high-frequency ultrasound to break up the center of the cloudy lens and carefully suction it out.

After the cloudy lens has been removed, the surgeon will replace it with an intraocular lens (IOL) implant made of plastic, silicone or acrylic. This new, clear lens allows light to pass through and focus properly on the retina. The IOL becomes a permanent part of your eye. In most cases, the IOL is inserted behind the iris, the colored part of your eye, and is called a posterior chamber lens. Sometimes, the IOL must be placed in front of the iris. This is called an anterior chamber lens. When the IOL is in place, the surgeon closes the incision. Stitches may or may not be used. After the surgery, a protective shield will be placed over your eye.

Cataract Surgery Recovery

You will spend a short period of time resting in the outpatient recovery area before you are ready to go home. You will need to have someone drive you home.

You will follow up with your surgeon the following day and receive treatment instructions. Following your surgery, it is very important to put in the eye drops exactly as prescribed by your eye doctor to promote healing. You will also need to take care to protect your eye by wearing the eye shield whenever you sleep, and by wearing special wraparound sunglasses in bright light. Be sure not to rub your eye.

During the first week of your recovery, you must avoid strenuous activity such as exercise or bending and heavy lifting (including anything over 10 pounds). You will also need to avoid getting any water, dirt or dust in your eye, which can lead to infection.

You may have some blurry vision a few days to weeks after surgery. If you experience any pain or loss of vision, be sure to call your surgeon.

Cataract Surgery Risks and Complications

As with any surgical procedure, there are risks associated with cataract surgery. Risks and complications can include:

  • Infection
  • Bleeding inside the eye
  • Increased pressure inside the eye (glaucoma)
  • Swelling of the retina
  • Swelling of the cornea
  • Retinal detachment
  • Loss of vision (partially or completely)

In some cases, the part of the lens covering that supports the IOL (called the capsule) can become cloudy several months or years after the first cataract was removed. This is called an “after cataract” or “secondary cataract.” If this occurs and blurs your vision, your eye doctor will make an opening in the center of the cloudy capsule with a laser to allow light to pass through the lens properly again. This procedure, called a Yag posterior capsulotomy, takes about five minutes in the doctor’s office and requires no recovery period.

Most people who wear bifocals or reading glasses for near vision may still need to wear glasses after cataract surgery for reading, and, in some cases, even for distance. If you choose to have a multifocal or accommodative IOL, your dependence on glasses may be minimized or, in some cases, eliminated completely.