Cataract Surgery
Removal of a cloudy natural lens and replacement with an artificial lens to improve vision
What is cataract surgery?
A cataract is the clouding of the natural lens inside your eye. In phacoemulsification your surgeon breaks that lens up with ultrasound through a cut of about 2.2 to 2.8 millimetres and removes it, then places a clear artificial lens into the capsule that held the old one.
The new lens stays for life and does not need replacing. Which lens you have decides how much you will still rely on glasses: a standard monofocal lens gives sharp distance vision and you read with glasses, while multifocal, extended-depth and toric lenses cover more of the range or correct astigmatism. Your surgeon will measure your eye and go through the trade-offs with you before the day.
What it involves
Anaesthetic drops numb the eye, sometimes with a small injection beside it, and you stay awake. You will see light and movement and feel pressure, and you will not see the instruments. Keeping your head still and looking at the light is all that is asked of you.
The operation takes 15 to 20 minutes. The cut is small enough to seal itself, so stitches are rarely needed. You go home an hour or two later with a shield over the eye, and the second eye is usually done a week or more afterwards.
Recovery
Vision is hazy for the first day or two and then clears quickly; most people see well within a week. You will use antibiotic and steroid drops on a tapering schedule for about four weeks, and this is the part people most often stop too early.
Wear the shield at night for a week and avoid rubbing the eye, swimming, dusty places and heavy lifting for two weeks. Most people return to desk work in two or three days and drive once vision meets the legal standard, which your surgeon will confirm. Your final glasses prescription is checked at about four to six weeks.
Questions about cataract surgery
Will I still need glasses after cataract surgery?
With a standard monofocal lens you will see well in the distance and need reading glasses. Multifocal and extended-depth lenses cover more of the range and most people who choose them read without glasses, at the cost of more glare and haloes at night. A toric lens corrects astigmatism. Your surgeon will measure your eye and talk through which trade-off suits how you actually use your eyes.
Does the artificial lens ever need replacing?
No. The implant is designed to last for life and does not wear out. The thin capsule behind it clouds over in a proportion of people months or years later, which blurs vision again and is often mistaken for the cataract returning. That is cleared in a few minutes with a YAG laser in clinic and does not involve going back to theatre.
Will it hurt, and will I see what is happening?
The eye is numbed with drops, sometimes with a small injection beside it, so you should feel pressure and no sharp pain. You stay awake and see light, colours and movement, and you will not see the instruments. Tell your surgeon if anything is uncomfortable, since more anaesthetic can be given at any point.
Other ophthalmology treatments
Laser vision correction that reshapes the cornea to reduce dependence on glasses or contact lenses
Day CareTreatment aimed at controlling eye pressure and protecting the optic nerve from further damage
Day CareTalk to a care coordinator about cataract surgery
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one