Cataract removal

Cataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better. The procedure almost always includes placing an artificial lens in the eye.

Description

Cataract surgery is an outpatient procedure. This means you likely do not have to stay overnight at a hospital.

  • Adults are usually awake for the procedure. Numbing medicine (local anesthesia)is given using eye drops or sometimes a shot. This blocks pain. You will also get medicine to help you relax.
  • Children usually receive general anesthesia. This makes them unconscious and unable to feel pain.

The surgeon uses a microscope to look at the eye. A small cut is made in the eye. The lens is removed. How it is removed depends on the type of cataract. It may be done:

  • With special tools and suction
  • Using sound waves (ultrasonic energy) that break up the lens and suction to remove the lens pieces. This is called phacoemulsification. It is the most modern method, and can be done using a very small surgical cut.
  • Newer methods involve using lasers to make a more precise cut. This is needed for newer types of lens.

A man-made lens, called an artificial intraocular lens (IOL), is usually placed into the eye next. It will help improve your vision.

The doctor will close the wound with very small stitches. Sometimes, a self-sealing (sutureless) method is used. If you have stitches, they may need to be removed later.

The surgery usually lasts less than an hour. Most times, just one eye is done. If you have cataracts in both eyes, your doctor may suggest waiting 1 to 2 months between each surgery.

Why the Procedure is Performed

The normal lens of the eye is clear (transparent). As a cataract develops, the lens becomes cloudy . This blocks light from entering your eye. Without enough light, you cannot see as clearly.

Cataracts are painless. They are most often seen in the elderly. But sometimes, children are born with them. See: Congenital cataracts

Cataract surgery is usually done if you cannot see well enough because of cataracts. Cataracts usually do not harm your eye, so surgery can be done when it is convenient for you.

Risks

Complications of cataract surgery are rare.

Rarely, the surgeon is not able to remove the entire lens. If this happens, a procedure to remove all of the lens fragments will be needed at a later time. Most patients who need this procedure still do very well.

Very rare complications can include infection and bleeding. This can lead to permanent vision problems.

Before the Procedure

Before surgery, you will have a complete eye exam and eye tests by an ophthalmologist. This type of medical doctor specializes in eye health.

The doctor will use ultrasound or a laser scanning device to see the inside of your eye. These tests help your determine the best intraocular lens for you.

Your doctor may prescribe eye drops before the surgery.

After the Procedure

You will need to have someone drive you home after surgery.

You will usually have a follow-up exam with your doctor the next day. If you had stitches, you'll need to make an appointment to have them removed.

You may receive the following:

  • A patch to wear over your eye until the follow-up exam
  • Eye drop to prevent infections, treat inflammation, and help with healing

Tips for recovering after cataract surgery:

  • Wear dark sunglasses outside after you remove the patch
  • Make sure your hands are clean before touching your eye. Try not to get soap and water in your eye when you are bathing or showering for the first few days.
  • Take it easy. Light activities are best as you recover. Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.

Full results are usually seen after about 2 weeks. If you need new glasses or contact lenses, you can usually have them fitted at that time. It is important to have a follow-up visit with your doctor.

Outlook (Prognosis)

Most patients do well and recover quickly after cataract surgery. Most can see better after this surgery.

Alternative Names

Cataract extraction; Cataract surgery

References

Cionni RJ, Snyder ME, Osher RH. Cataract Surgery. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 6.

Davison JA, Kleinmann G, Apple DJ. Intraocular Lenses. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 11.

Masket S, Sarayba M, Ignacio T, Fram N. Femtosecond laser-assisted cataract incisions: Architectural stability and reproducibility. Journal of Cataract and Refractive Surgery. Volume 36, Issue 6, Pages 1048-1049, June 2010.

Updated: 4/14/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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