Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens. Normally, the lens of your eye is clear. A cataract causes the lens to become cloudy, which eventually affects your vision.
Cataract surgery is performed by an eye doctor (ophthalmologist) on an outpatient basis, which means you don't have to stay in the hospital after the surgery. Cataract surgery is very common and is generally a safe procedure.
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Why it's done
How a cataract affects your vision
How a cataract affects your vision
Normal vision (left) becomes blurred as a cataract forms (right).
Cataract surgery is performed to treat cataracts. Cataracts can cause blurry vision and increase the glare from lights. If a cataract makes it difficult for you to carry out your normal activities, your doctor may suggest cataract surgery.
When a cataract interferes with the treatment of another eye problem, cataract surgery may be recommended. For example, doctors may recommend cataract surgery if a cataract makes it difficult for your eye doctor to examine the back of your eye to monitor or treat other eye problems, such as age-related macular degeneration or diabetic retinopathy.
In most cases, waiting to have cataract surgery won't harm your eye, so you have time to consider your options. If your vision is still quite good, you may not need cataract surgery for many years, if ever.
When considering cataract surgery, keep these questions in mind:
- Can you see to safely do your job and to drive?
- Do you have problems reading or watching television?
- Is it difficult to cook, shop, do yardwork, climb stairs or take medications?
- Do vision problems affect your level of independence?
- Do bright lights make it more difficult to see?
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Complications after cataract surgery are uncommon, and most can be treated successfully.
Cataract surgery risks include:
- Drooping eyelid
- Dislocation of artificial lens
- Retinal detachment
- Secondary cataract
- Loss of vision
Your risk of complications is greater if you have another eye disease or a serious medical condition. Occasionally, cataract surgery fails to improve vision because of underlying eye damage from other conditions, such as glaucoma or macular degeneration. If possible, it may be beneficial to evaluate and treat other eye problems before making the decision to have cataract surgery.
How you prepare
Food and medications
You may be instructed not to eat or drink anything 12 hours before cataract surgery. Your doctor may also advise you to temporarily stop taking any medication that could increase your risk of bleeding during the procedure. Let your doctor know if you take any medications for prostate problems, as some of these drugs can interfere with cataract surgery.
Antibiotic eyedrops may be prescribed for use one or two days before the surgery.
Normally you can go home on the same day as your surgery, but you won't be able to drive, so arrange for a ride home. Also arrange for help around home, if necessary, because your doctor may limit activities, such as bending and lifting, for about a week after your surgery.
What you can expect
Before the procedure
A week or so before your surgery, your doctor performs a painless ultrasound test to measure the size and shape of your eye. This helps determine the right type of lens implant (intraocular lens, or IOL).
Nearly everyone who has cataract surgery will be given IOLs. These lenses improve your vision by focusing light on the back of your eye. You won't be able to see or feel the lens. It requires no care and becomes a permanent part of your eye.
A variety of IOLs with different features are available. Before surgery, you and your eye doctor will discuss which type of IOL might work best for you and your lifestyle. Cost may also be a factor, as insurance companies may not pay for all types of lenses.
IOLs are made of plastic, acrylic or silicone. Some IOLs block ultraviolet light. Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close.
However, many IOLs are flexible, allowing a smaller incision that requires few or no stitches. The surgeon folds this type of lens and inserts it into the empty capsule where the natural lens used to be. Once inside the eye, the folded IOL unfolds, filling the empty capsule.
Some of the types of lenses available include:
- Fixed-focus monofocal. This type of lens has a single focus strength for distance vision. Reading will generally require the use of reading glasses.
- Accommodating-focus monofocal. Although these lenses only have a single focusing strength, they can respond to eye muscle movements and shift focus to near or distant objects.
- Multifocal. These lenses are similar to glasses with bifocal or progressive lenses. Different areas of the lens have different focusing strengths, allowing for near, medium and far vision.
- Astigmatism correction (toric). If you have a significant astigmatism, a toric lens can help correct your vision.
Discuss the benefits and risks of the different types of IOLs with your eye surgeon to determine what's best for you.
During the procedure
During phacoemulsification — the most common type of cataract surgery — the rapidly vibrating tip of the ultrasound probe emulsifies and helps break up the cataract, which your surgeon then suctions out (top). An outer housing of the cataract (the lens capsule) is generally left in place. After removing the emulsified material, your surgeon inserts the lens implant into the empty space within the capsule where the natural lens used to be (bottom).
Cataract surgery, usually an outpatient procedure, takes an hour or less to perform.
First, your doctor will place eyedrops in your eye to dilate your pupil. You'll receive local anesthetics to numb the area, and you may be given a sedative to help you relax. If you're given a sedative, you may remain awake, but groggy, during surgery.
During cataract surgery, the clouded lens is removed, and a clear artificial lens is usually implanted. In some cases, however, a cataract may be removed without implanting an artificial lens.
Surgical methods used to remove cataracts include:
Using an ultrasound probe to break up the lens for removal. During a procedure called phacoemulsification (fak-o-e-mul-sih-fih-KAY-shun), your surgeon makes a tiny incision in the front of your eye (cornea) and inserts a needle-thin probe into the lens substance where the cataract has formed.
Your surgeon then uses the probe, which transmits ultrasound waves, to break up (emulsify) the cataract and suction out the fragments. The very back of your lens (the lens capsule) is left intact to serve as a place for the artificial lens to rest. Stitches may be used to close the tiny incision in your cornea at the completion of the procedure.
Making an incision in the eye and removing the lens in one piece. A less frequently used procedure called extracapsular cataract extraction requires a larger incision than that used for phacoemulsification. Through this larger incision your surgeon uses surgical tools to remove the front capsule of the lens and the cloudy lens comprising the cataract. The very back capsule of your lens is left in place to serve as a place for the artificial lens to rest.
This procedure may be performed if you have certain eye complications. With the larger incision, stitches are required.
Once the cataract has been removed by either phacoemulsification or extracapsular extraction, the artificial lens is implanted into the empty lens capsule.
After the procedure
After cataract surgery, expect your vision to begin improving within a few days. Your vision may be blurry at first as your eye heals and adjusts.
Colors may seem brighter after your surgery because you are looking through a new, clear lens. A cataract is usually yellow- or brown-tinted before surgery, muting the look of colors.
You'll usually see your eye doctor a day or two after your surgery, the following week, and then again after about a month to monitor healing.
It's normal to feel itching and mild discomfort for a couple of days after surgery. Avoid rubbing or pushing on your eye.
Your doctor may ask you to wear an eye patch or protective shield the day of surgery. Your doctor may also recommend wearing the eye patch for a few days after your surgery and the protective shield when you sleep during the recovery period.
Your doctor may prescribe eyedrops or other medication to prevent infection, reduce inflammation and control eye pressure. Sometimes, these medications can be injected into the eye at the time of surgery.
After a couple of days, most of the discomfort should disappear. Often, complete healing occurs within eight weeks.
Contact your doctor immediately if you experience any of the following:
- Vision loss
- Pain that persists despite the use of over-the-counter pain medications
- Increased eye redness
- Eyelid swelling
- Light flashes or multiple new spots (floaters) in front of your eye
Most people need glasses, at least some of the time, after cataract surgery. Your doctor will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses. This is usually between one and three months after surgery.
If you have cataracts in both eyes, your doctor usually schedules the second surgery after the first eye has healed.
Cataract surgery successfully restores vision in the majority of people who have the procedure.
People who've had cataract surgery may develop a secondary cataract. The medical term for this common complication is known as posterior capsule opacification (PCO). This happens when the back of the lens capsule — the part of the lens that wasn't removed during surgery and that now supports the lens implant — becomes cloudy and impairs your vision.
PCO is treated with a painless, five-minute outpatient procedure called yttrium-aluminum-garnet (YAG) laser capsulotomy. In YAG laser capsulotomy, a laser beam is used to make a small opening in the clouded capsule to provide a clear path through which the light can pass.
After the procedure, you usually stay in the doctor's office for about an hour to make sure your eye pressure doesn't rise. Other complications are rare but can include increased eye pressure and retinal detachment.
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By Mayo Clinic Staff
Aug. 19, 2021
A long-term consequence of cataract surgery is posterior capsular opacification (PCO). PCO is the most common complication of cataract surgery. PCO can begin to form at any point following cataract surgery.What are the negatives of cataract surgery? ›
It is very common to have blurry or unclear vision in the days and sometimes even weeks after cataract removal. Most of the time, this is caused by normal swelling in the eye which occurs as a part of surgery. Patients with larger, denser and/or firmer cataracts are more likely to experience more inflammation.How long does it take to recover from cataract surgery? ›
These side effects usually improve within a few days, but it can take 4 to 6 weeks to recover fully. If you need new glasses, you will not be able to order them until your eye has completely healed, usually after 6 weeks.Does Mayo Clinic do laser cataract surgery? ›
“This procedure offers another option, and when patients have options, patients' their overall satisfaction is greater.” Call 715-838-3937 to learn more or to make an appointment.When is it too late to have cataract surgery? ›
Although it's never too late to have a cataract removed, it is better to have cataracts removed while they are immature, as this reduces the length of surgery and the recovery time. Earlier removal also means that you avoid the significant visual impairment associated with very mature (hypermature) cataracts.Why is my eyesight getting worse after cataract surgery? ›
The "big 3" potential problems that could permanently worsen vision after cataract/IOL surgery are: 1) infection, 2) an exaggerated inflammatory response, and 3) hemorrhage. Fortunately, these are quite rare nowadays, occurring less than 1% of the time.What medications should be avoided before cataract surgery? ›
MEDICATIONS To minimize the risk of blood loss during your surgery, you must avoid or stop taking medications that contain aspirin, that are anti-inflammatory medications, or contain blood thinning agents. These should be discontinued 7-10 days prior to your surgery.Will I ever need glasses again after cataract surgery? ›
During cataract surgery, your eye's clouded lens is removed and replaced by an artificial intraocular lens (IOL). While cataract surgery is an effective way to restore your vision, it's important to understand that there are some instances where you may still need glasses after your procedure.What percentage of cataract surgery is successful? ›
Most people do exceedingly well with cataract surgery. Its success rate is about 99 percent. Complications from cataract surgery are rare but may include corneal swelling and/or inflammation in the eyes.How long should I sleep with an eye shield after cataract surgery? ›
While home, you may be allowed to remove your eye shield, but you should wear it when sleeping for at least a week to prevent eye injury. Full recovery from cataract surgery should be complete in about a month, although it can take up to three months for your eye to be completely healed.
You can read or watch TV right away, but things may look blurry. Most people are able to return to work or their normal routine in 1 to 3 days. After your eye heals, you may still need to wear glasses, especially for reading.How painful is cataract surgery? ›
Cataract surgery is not painful. While patients are awake during surgery, there is little or no discomfort involved. A mild sedative may be administered before the surgery, which calms the nerves, and eye drops are used to numb the eye.Which is better laser or regular cataract surgery? ›
Using a laser allows the surgeon to make precise incisions in less time. It can improve accuracy and consistency. In some cases, the laser can provide more correction than traditional surgery. The laser can reduce the amount of ultrasound energy needed to soften the lens prior to removal.What I wish I knew before cataract surgery? ›
Here are some things that you may want to avoid before and after cataract surgery to ensure that you heal properly. Avoiding eating and drinking before your surgery. Don't wear makeup to the surgery appointment, and avoid wearing makeup until your ophthalmologist allows it so that you can better prevent infection.Who is not a good candidate for laser cataract surgery? ›
Those who are not in good general health.
Many autoimmune conditions cause dry eye syndrome. A dry eye may not heal well and has a higher risk of post-surgery infection. Other conditions such as diabetes, rheumatoid arthritis, lupus, glaucoma or cataracts often affect results.
Doctors suggest winter as a good time to get the surgery done as the season can help you recover quickly. But it is not really stringent, all you need to keep in mind is if the vision is getting excessively blurred and your daily activities are getting hampered, then get the cataract removed as soon as possible.What is the average age for cataract surgery? ›
In most people, cataracts start developing around age 60, and the average age for cataract surgery in the United States is 73.Does it hurt to delay cataract surgery? ›
For the vast majority, cataract surgery is not urgent, and can be safely delayed until the person wishes to pursue surgery. Delaying surgery does not cause harm to the eye, however the vision just gets worse over time until the cataract is removed.How long does it take for the brain to adjust to cataract surgery? ›
Depending on the IOL you choose for your cataract surgery, it may take three to six weeks before your vision fully stabilizes. You may find it especially difficult to adjust to monovision.Why can't you drink water before cataract surgery? ›
Don't: Eat or Drink Right Before the Surgery
While under sedation, there is a chance of stomach acid going into your lungs, which can cause damage. You will need to fast for about 12 hours before surgery to ensure you are safe from this effect.
When the eye is completely numb, an instrument will be used to hold your eye open while the procedure is completed. This instrument ensures that you will not blink during cataract surgery. Cataract surgery is one of the safest, most successful surgeries involving the eye.What painkiller is used in cataract surgery? ›
We can administer analgesics by mouth or parenterally. Acetaminophen or paracetamol is widely used and can be supplemented with NSAIDs or opioids.Will both eyes be the same after cataract surgery? ›
There is probably little to no difference between the two in visual outcomes, one to three months after surgery. There was probably little to no difference between the two in the answers people gave in questionnaires after surgery. The questionnaires asked about visual function and patient satisfaction with vision.What percentage of people still need glasses after cataract surgery? ›
In studies, between 60% and 88% of patients who have cataract surgery with a MultiFocal lens report that they never wear glasses. For cataract patients who value their ability to see clearly at a range of distances without glasses, a MultiFocal IOL can be a great option.Are your eyes better after cataract surgery? ›
After cataract surgery, expect your vision to begin improving within a few days. Your vision may be blurry at first as your eye heals and adjusts. Colors may seem brighter after your surgery because you are looking through a new, clear lens.What is the best type of cataract surgery to have? ›
Laser-assisted cataract surgery is the latest and most advanced method of performing cataract surgery. And many ophthalmologists prefer laser cataract surgery over traditional cataract surgery as a pre-treatment to “soften” cataracts.What is the fastest way to recover from cataract surgery? ›
- Limit Strenuous Activity. ...
- Shield Yourself from Irritants or Trauma. ...
- Keep Out of the Pool, and Shower Carefully. ...
- Avoid Driving. ...
- Follow Doctor's Orders.
Phacoemulsification (a type of ultrasound) is the most common method used to remove the cataract. After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL).Should I sleep in a recliner after cataract surgery? ›
Your pupil should return to normal size within 6-8 hours; however some patients may experience a prolonged dilation time up to 24 hours. Do I need to sleep in a recliner after surgery? No, you do not need to sleep in any particular position following cataract surgery, unless otherwise instructed.Can I bend over to tie my shoes after cataract surgery? ›
People should avoid bending over for up to 48 hours after their cataract surgery, but sometimes this is unavoidable. For example, tying up shoes or putting on pants.
Most patients are able to resume driving 24 hours after cataract surgery.Can you see what is happening during cataract surgery? ›
During cataract surgery
You'll be awake during surgery, but you won't be able to see what's happening in your eye.
Displacement of the intraocular lens causes changes to vision and, if it falls into the vitreous cavity, it can produce traction due to the eye's own movement, resulting in retinal detachment and/or vitreous haemorrhage.Can a cataract surgery be redone? ›
Cataract surgery is irreversible. This is because the cloudy natural lens that results in a cataract is removed during surgery and cannot be placed back in.How do I know if my lens has moved after cataract surgery? ›
History, signs, and symptoms
Patients with a dislocated IOL may experience a decrease or change in vision, diplopia, and/or glare. Additionally, they may report ocular pain or headaches from intermittent angle-closure and/or inflammation. Some patients also report seeing the edge of the IOL.