Cataract surgery is usually only performed when there is severe vision impairment or if another eye condition, such as glaucoma, co-exists. The surgery is low-risk with a high success rate. If both eyes require surgery, they are performed as separate surgeries, typically four to eight weeks apart.
Cataract surgery takes about one hour to perform and causes minimal pain. The surgery is performed on children under general anesthesia. Adults usually stay awake and are given local anesthesia, but they can choose to go under general anesthesia if they prefer. There are two types of cataract surgery: phacoemulsification and extracapsular surgery.
Phacoemulsification is the most common type of cataract surgery. During phacoemulsification surgery, an ultrasonic device is inserted in the eye through a small incision. The device emits ultrasonic waves that break up the lens. The lens is then suctioned out of the eye. The lens is typically replaced with an artificial lens, called an intraocular lens (IOL).
During extracapsular surgery, a small incision is made in the eye (a larger incision than is made with phacoemulsification surgery) and the core of the lens is removed in one piece. Remaining pieces of the lens are suctioned out. The natural lens is usually replaced with an IOL.
Some people cannot have an artificial IOL lens placed in their eye, due to certain eye conditions. If an artificial lens is not placed in the eye, the patient will have to wear contact lenses to help with vision.
The possible risks associated with cataract surgery are bleeding, infection, nearsightedness or an increased chance of retinal detachment.
Cataract surgery is an outpatient surgery that is usually performed in a doctor's office. After the surgery and a short observation period, the patient will be sent home with aftercare instructions. Aftercare instructions for the first few days following surgery usually include the following:
- Wear a patch over the eye
- Wear sunglasses with UVA and UVB protection, when outdoors
- Refrain from rubbing the eye
- Wash hands before touching the eyes
- Keep shampoo and soap out of the eyes
- Minimize bending over
- Avoid strenuous activity, such as aerobic exercise, sexual activity or driving
- Take oral antibiotics and eyedrops as prescribed (usually for one week)
Following the doctor's instructions minimizes the chances of complications and speeds cataract surgery recovery time.
The physician will schedule regular check-ups to examine the healing progress of the eye, following cataract surgery. Usually, one exam is scheduled for the day after surgery. If the physician placed sutures in the eye, an appointment will be scheduled for about five days after the surgery, to remove them. The frequency of follow-up visits after the first checkup is determined by how the eye looks and any other co-existing eye conditions. The physician will let the patient know when it is safe to return to normal activities, such as driving and exercising.
It takes time for the eye to heal after cataract surgery. At first the patient may notice blurry vision. Colors may also seem brighter than they did before. This is because the new IOL lens is clearer than the natural lens was. Within a couple of months, though, vision should improve, and the patient should become accustomed to the appearance of brighter colors.
Complete cataract recovery time typically takes 8 to 10 weeks. The physician will let the patient know when the eye has completely healed. At this time, the patient can be fitted for glasses or contact lenses, if necessary.