Our eyes have lenses for focusing light. Usually, the lens is clear, but if it becomes cloudy—a common side effect of aging—it is called a cataract. Cataracts prevent light from traveling through the lens, so your eye cannot focus correctly, leading to blurry vision and other symptoms.Cataract surgery removes the cloudy lens and replaces it with a clear artificial lens to correct your vision.
Who Needs Cataract Surgery?
Many things contribute to cataracts. Sometimes, they are the result of natural age-related changes. Smoking, drinking, and exposure to too much sunlight can make cataracts develop faster, as can some health treatments and conditions, like diabetes, long-time steroid use, radiation, and eye surgeries to treat other conditions.People with cataracts need cataract surgery if the condition affects their vision or if the doctor needs to see the back of the eye to manage other vision problems.
Intraocular Lens Types
The doctor replaces the cloudy lens during cataract surgery with an artificial intraocular lens. These come in different types, some of which may even eliminate a previous need for glasses.Monofocal intraocular lenses are the most common. They are measured for either close, medium, or long-range vision. People usually get a monofocal lens for long distances and use reading glasses as needed.Other intraocular lenses include multifocal intraocular lenses, which allow near and far focus simultaneously, and accommodative intraocular lenses for focusing at different distances. Another option is a toric intraocular lens, which corrects refractive errors for people with astigmatism.
Types of Cataract Surgery
There are two types of cataract surgery. The first type is extracapsular surgery. The surgeon makes a long opening in the eye and removes the hard section of the lens, using suction to remove the rest of the cataract.Small-incision cataract surgery or phacoemulsification is the modern approach. It uses a smaller incision and ultrasonic waves to dissolve the hard core of the cataract. The doctor then uses the same incision to remove the rest of the cataract using suction. The shift from extracapsular to small-incision cataract surgery has improved surgical outcomes and made patients more accepting of having the surgery in the first place.
Risks and Complications
Complications after cataract surgery are rare, but they are greater in patients with other eye diseases or medical conditions. In some cases, people who have underlying eye conditions like macular degeneration or glaucoma do not see their vision improve until the other condition is treated.Possible complications of cataract surgery include inflammation, bleeding, infections, swelling, retinal detachment, glaucoma, drooping eyelid, and vision loss.
A common complication of cataract surgery is secondary cataract or posterior capsular opacification. This condition affects the membrane in the eye that holds the intraocular lens.The only symptom is cloudy vision, which can appear weeks to years after the cataract surgery. Your doctor can treat secondary cataracts with a laser procedure to eliminate cloudiness.
During the Procedure
Cataract surgery is an outpatient procedure. Patients go home shortly after the surgery, but they will not be able to see properly, so someone has to drive them home.The procedure is very quick, often taking less than 20 minutes. Doctors use a special microscope and tools to see your eye and make the tiny incision. This incision closes on its own and does not require stitches, but it is necessary to wear an eye shield to protect the eye as it heals.
After the Procedure
Some people see results as soon as a few hours after surgery. Initially, colors appear brighter, and any blurriness, redness, burning, or itchiness should resolve within a few days.Doctors typically prescribe medication or eye drops to prevent infection and control inflammation and eye pressure. Most people take the eye shield off the next day, but doctors usually recommend continuing to wear it at bedtime.
Blurry Vision After Surgery
Blurry vision after cataract surgery is normal. It usually occurs because of swelling in the eye and should resolve over a few weeks. Patients with larger or denser cataracts may experience more inflammation, but blurriness should still clear up within a month.Over-the-counter anti-inflammatories can help. If blurriness has not improved at all one week after surgery, talk to your doctor.
Seeing Glare and Halos After Surgery
Glares, halos, and other unwanted images may occur after cataract surgery. These are an issue mainly at night and are most common with multifocal lenses.The effects often go away with the right glasses prescription, but they can also be signs of a secondary cataract. If these images continue for three to four months after surgery, your doctor may suggest treatment options.
Floaters and Flashes After Surgery
Some floaters after cataract surgery is normal, and they usually resolve on their own in a few weeks. But if you see bursts of floaters, a shadow in your side vision, or flashes of light, see your doctor right away. These are signs of retinal detachment, a serious condition that occurs when the retina pulls away from the back of the eye.