Cataract Surgery FAQs
What is the treatment for cataracts?
At present, the only effective treatment is surgical removal of the cloudy lens. This can be done in a hospital or outpatient surgical suite. If the cataract is minimal, treatment may be delayed for a while by changing your glasses prescription.
How successful is the surgery in restoring sight?
Cataract surgery is one of the most effective and safest operations performed today. The high success rate is due to advances in microscope technique, high tech instruments, and use of intraocular lenses.
Does everyone see better after cataract surgery?
Some patients do not obtain clear eyesight after the surgery for a variety of reasons. Some have preexisting disease affecting the retina or optic nerve that prevents normal sight; others have one of the rare complications of cataract surgery.
Will I be awake during the operation?
The type of anesthesia you have will depend on your general health. In most cases you will remain awake and aware throughout your procedure. You will be given medication by mouth to help you relax during your surgery. An IV may be started for additional medication if any is needed. Before you are taken into surgery, drops will be instilled in your eye to numb the eye. You should not feel pain or discomfort during your procedure.
How soon after cataract surgery can I resume normal activity?
Most patients can be up and around on the day of surgery, and in a short time can return to most activities that do not require heavy lifting or straining. It is safe to use your eyes for reading, office work, or watching TV almost immediately. Depending on the procedure used and the size of the incision, you will be able to resume full, normal activity in a few days to a month or so.
What will my vision be like after the surgery?
Cataract surgery removes the crystalline lens, a major focusing element of the eye. Without a lens, your vision would be very poor. Good vision, however, depends on many factors, such as how your vision will be corrected after surgery, as well as your vision before surgery and the eye’s overall conditions.
You will have an intraocular lens (IOL) implanted during surgery. An IOL is a permanent replacement for your natural lens. After it has been placed inside your eye during surgery, it requires no care. You cannot feel or see it, and it is not noticed by others. There are several options available to patients depending on the needs and circumstances of each individual patient. Your surgeon will discuss the best options to correct your vision for near, distance or both based on your examination and preoperative testing. You may or may not be dependent on prescription glasses depending on the option that you select.
It may take several weeks before the operated eye is fully healed and vision is stabilized. If you have a special need for very sharp vision before then, you may have eyeglasses prescribed early, so long as you understand that they may need to be changed soon afterward.
What are the complications of cataract surgery?
Though rare, infection, bleeding, glaucoma, corneal problems, chronic intraocular inflammation, and retinal detachment are possible. Most of the complications, if they do occur, are usually temporary or can be treated successfully with medication; rarely, they require a second surgical procedure.
When should a cataract be removed?
You should have your cataract removed when it begins to interfere with your vision so much as to make a difference in your life or livelihood. Since everyone’s visual needs differ, this point will differ from one person to another. It is not necessary to wait until the cataract is “ripe” (totally opaque) before having it removed.
Who makes the decision about when a cataract is to be removed?
You do. You will be advised that you are a candidate for the surgery and what kind of improvement in vision you can expect from a cataract removal that is free of complications. You will then have to decide if the cataract is causing you enough trouble to warrant surgery (there is no need to remove a cataract until it significantly interferes with vision). There are certain rare circumstances that require cataract removal regardless of vision: if it becomes overly mature (“overripe”), if it contributes to glaucoma, or if it prevents observation or treatment of other eye diseases.
How is a cataract removed?
There are several procedures for removing the cloudy lens. In each, a small incision is made in the front of the eye and an instrument is inserted into the eye to remove the lens. Your eye remains in its normal position during the operation. It is never removed from its socket.
With the intracapsular method, which is rarely used today, the entire lens is taken out in one piece, along with its capsule (the membrane enclosing the lens). With the extracapsular method, the front part of the capsule is opened and the lens taken out, leaving the back part of the capsule in its normal position.
The current extracapsular techniques are referred to as “small incision” surgery. The most common of these involves phacoemulsification (FAKE-oh-ee-mull-sih-fuh-KAY-shun), in which a needle-like ultrasonic instrument is introduced into the eye. It delivers high-frequency sound waves to break up the opaque lens into tiny fragments that are then gently suctioned out through the instrument’s hollow tubing.
You may also opt to have bladeless laser refractive cataract surgery. This treatment is customized for each patient and allows the surgeon to correct astigmatism with accurate corneal incisions. The LenSx® Laser uses the sophisticated technology called OCT (Ocular Coherence Tomography) to provide the surgeon with precise and detailed images of the inside of your eye. Your surgeon customizes the treatment plan for your eye and guides the LenSx® laser to create small incisions on the cornea, incision of the anterior covering of the cataract, and then fragment the cataract. Once the incisions are made the cataract is removed from the eye and an intraocular implant is placed inside the eye.
For more information visit the American Academy of Ophthalmology's website.