Surgery for Cataracts

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:

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 cataract surgery.
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 surgery.)
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

Before 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:

  1. 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 relax.
  2. 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.
  3. 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.
  4. 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.
  5. 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: