The standard cataract surgical procedure is typically performed in either a hospital or in an
ambulatory surgery center. The most common form of cataract surgery today is a process called
phacoemulsification. With the use of an operating microscope, your surgeon will make a very small
incision in the surface of the eye in or near the cornea. A thin ultrasound probe is inserted into the eye
that uses ultrasonic vibrations to dissolve (phacoemulsify) the clouded lens. These tiny fragmented
pieces are then suctioned out through the same ultrasound probe. Once the cataract is removed, an
artificial lens is placed into the same thin capsular bag that the cataract occupied. This intraocular
lens is essential to help your eye focus after surgery.
There are three basic techniques for cataract surgery:
Phacoemulsification: This is the most common form of cataract removal as explained above. In
this most modern method, cataract surgery can usually be performed in less than 30 minutes
and usually requires only minimal sedation and numbing drops, no stitches to close the wound,
and no eye patch after surgery.
Extracapsular cataract surgery: This procedure is used mainly for very advanced cataracts
where the lens is too dense to dissolve into fragments (phacoemulsify) or in facilities that do not
have phacoemulsification technology. This technique requires a larger incision so that the
cataract can be removed in one piece without being fragmented inside the eye. An artificial lens
is placed in the same capsular bag as with the phacoemulsification technique. This surgical
technique requires a various number of sutures to close the larger wound, and visual recovery
is often slower. Extracapsular cataract extraction usually requires an injection of numbing
medication around the eye and an eye patch after surgery.
Intracapsular cataract surgery: This surgical technique requires an even larger wound than
extracapsular surgery, and the surgeon removes the entire lens and the surrounding capsule
together. This technique requires the intraocular lens to be placed in a different location, in front
of the iris. This method is rarely used today but can be still be useful in cases of significant
When to Consider Surgery
During cataract surgery , your doctor will remove the old, clouded
lens and replace it with an artificial intraocular lens, or IOL. Fortunately,
cataracts only affect your lens, and therefore, there is no rush to undergo
Typically, doctors will recommend surgical treatment when your condition
has started to affect your daily life. If you find that it is difficult to
complete certain daily tasks, or if you are no longer able to see objects or
faces clearly, it may be time for surgery. If you frequently drive at night,
you should undergo surgery sooner, as the nighttime glare can pose a
serious risk for accidents. (In the meantime, you should avoid night
driving, resuming it only when you have recovered from your cataract
Alternatively, your ophthalmologist may recommend surgery if you do not
receive a good score on your visual acuity, glare, contrast sensitivity, or
Ishihara color tests. Ultimately, the decision to undergo surgery is your
own, but your doctor can help you decide when it would be most
beneficial to your health and quality of life.
Treatment for Early Stage Cataracts
Before surgery becomes necessary, there are a number of methods that
your doctor may employ in the treatment of your cataracts. In the early
phases, he or she may recommend new glasses or contacts, anti-glare
lenses, and magnification devices. In most cases, however, these
treatments will only work for a time. As your cataracts grow, surgery will
typically be in your best interests.
What to Expect with Cataract Surgery
Your surgeon will measure your eye to determine the proper focusing power for your IOL. Also,
you will be asked about any medicines you take. You might be asked not to take some of these
medicines before surgery.
You may be prescribed eyedrop medicines to start before surgery. These medicines help prevent
infection and reduce swelling during and after surgery.
The day of surgery:
Your ophthalmologist may ask you not to eat any solid food at least 6 hours before your surgery.
Cataract removal surgery may be done in an outpatient surgery center or in a hospital. Here is
what will happen:
Your eye will be numbed with eye drops or with an injection
around the eye. You may also be given a medicine to help
You will be awake during surgery. You may see light and
movement during the procedure, but you will not see what the
doctor is doing to your eye.
Your surgeon looks through a special microscope. She
creates tiny incisions (cuts, created by laser or a blade) near
the edge of your cornea. The surgeon uses these incisions to
reach the lens in your eye. Using very small instruments, he
or she will break up the lens with the cataract and remove it.
Then she puts your new lens into place.
Usually your surgeon will not need to stitch the incisions
closed. These “self sealing” incisions eventually will close by
themselves over time. A shield will be placed over your eye to
protect it while you heal from surgery.
You will rest in a recovery area for about 15–30 minutes.
Then you will be ready to go home.
Days or weeks after surgery:
You will have to use eye drops after surgery. Be sure to follow your doctor’s directions for
using these drops.
Avoid getting soap or water directly in the eye.
Do not rub or press on your eye. Your ophthalmologist may ask you to wear eyeglasses or
a shield to protect your eye.
You will need to wear a protective eye shield when you sleep.
Your ophthalmologist will talk with you about how active you can be soon after surgery. He
or she will tell you when you can safely exercise, drive or do other activities again.