Cataract Surgery: What to Expect
This article will provide an overview of cataract surgery, including how doctors perform it. It will also discuss when cataract surgery is necessary, how much it costs, and what to expect during recovery.
Cataract surgery is a procedure to remove the lens from an eye when a cataract develops. An ophthalmologist will replace the affected lens with a new artificial lens called an intraocular lens (IOL).
One or both eyes may develop cataracts. If both eyes require surgery, ophthalmologists will schedule the procedures at least 1 week apart to allow the first eye to heal.
What are cataracts?
A cataract is a clouding or loss of transparency in the lens of your eye.
Cataracts are very common as people age. The condition is 70% likely to affect people in the United States who are older than 75 years.
Symptoms and effects of cataracts include:
- blurry and double vision
- dullness in colors
- lights that seem too bright
- halos around lights
- frequent changes to your glasses or contact lens prescription
Surgery is the only treatment for a cataract. However, cataracts usually progress slowly and you may be able to live with a cataract if it is not affecting your safety or quality of life.
If you receive a cataract diagnosis, your eye doctor may recommend surgery for reasons including the following:
- impaired vision to the point that noninvasive therapies — such as lighting changes, corrective lenses, or magnifiers — are no longer effective
- symptoms preventing you from driving safely
- difficulty reading, watching TV, or participating in other hobbies due to reduced vision
- cataract interfering with your doctor’s ability to monitor or treat a different eye condition
Your ophthalmologist will talk you through the benefits and risks of cataract surgery to help you determine if it is right for you.
The cost of your cataract surgery will depend on many factors, including the severity of your cataract, the type of IOL doctors use, and your individual health insurance.
Talk with your ophthalmologist and insurance provider before your cataract surgery to get an estimate of expected costs. This will allow you to know exactly what your policy covers and plan for any out-of-pocket expenses.
Doctors use a scalpel or laser to create an incision in your cornea, which is the clear dome over your eye.
The surgeon will remove the lens with the cataract through the incision. They may break up the lens into smaller pieces or remove it in one piece.
Ophthalmologists then insert the IOL through the same incision. There are a variety of IOLs available with different features and focusing powers.
Doctors typically will not use sutures to close the incision. The incision should heal on its own over time.
Ophthalmologists perform cataract surgery in hospitals and outpatient surgery settings. You will likely go home the same day.
Before your cataract surgery, your doctor and care team will talk you through the procedure and tell you how to prepare.
The day of your surgery, you can generally expect the following steps:
- You will speak with a preoperative nurse. They can answer any questions and will make sure you understand and sign the surgical consent.
- You will change into a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
- A surgical team member will start an IV. You may receive a general anesthetic that will put you to sleep during the surgery. In other cases, the doctor or nurse will apply numbing drops or inject a local anesthetic around your eye. You will likely receive a sedative to help you relax.
- You should not feel pain during the procedure. Depending on the type of anesthetic, you may see light, motion, or both. However, you will not see or feel what is happening to your eye.
- You will move to a recovery room after the procedure. Your care team will monitor your vital signs until you are alert and stable.
You may be able to go home after about 15–30 minutes in the recovery room. You will not be able to drive and will need to arrange for a ride home.
Recovery after cataract surgery is a gradual process. Recovery time varies depending on the specific procedure, type of anesthetic, your medical history, your age, and other factors.
Your doctor may ask you to wear an eye patch or an eye shield after your surgery. The eye patch protects your eye from injury as you recover. Your doctor may also prescribe eye drops to help the healing process.
During your recovery, your doctor will recommend at-home care including:
- keeping soap and water out of your eye
- avoiding rubbing or pressing on your eye
- limiting physical activities, including exercise
- stopping your driving for a period of time
Most people can return to their usual activities within a couple of weeks. Full recovery takes about 8 weeks. Talk with your doctor about your individual recovery timeline.
Will I feel pain?
You may have eye discomfort, sensitivity, or itchiness after your surgery. Although, cataract surgery usually has minimal pain. Contact your doctor if you are in pain despite following your treatment plan. This may be a symptom of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after cataract surgery. Call your doctor for questions or get immediate medical care if you have:
- areas of bleeding
- problems breathing, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
- changes in alertness, such as passing out, dizziness, unresponsiveness, or confusion
- fever of 101ºF or 38ºC
- inability to urinate, pass gas, or have a bowel movement, if you received a general anesthetic
- painful eye, double vision, or a decrease in vision
- unexpected drainage, pus, redness, or swelling of your eye
As with all surgeries, cataract surgery involves risks and potential complications. Potential complications of cataract surgery include:
- areas of bleeding inside the eye
- eye infection
- displacement of the IOL
- contraction of the tissue around the IOL
- retina detachment, swelling, or tearing
- inflammation or swelling
- night vision problems, such as seeing glare, halos, or starbursts around lights at night
- pain that does not go away with over-the-counter pain medication
Posterior capsular opacification
Secondary cataracts, medically known as posterior capsule opacification, can occur when the capsule or tissue that supports your IOL becomes cloudy. Secondary cataracts can develop months or even years after cataract surgery. Treatment with an outpatient laser procedure is typically effective.
These are some other questions people often ask about cataract surgery. Vicente Diaz, MD, MBA, reviewed the answers.
Can cataracts be removed without replacing the lens?
No. Because the cataract is a clouding of the lens itself, the only effective treatment is surgical removal and replacement of the lens.
How long do cataract lenses last?
Depending on the type of IOL and the eye health of the person receiving it, doctors expect IOLs to last for the person’s lifetime.
Can I have cataract surgery twice?
Once you have cataract surgery on one eye, you typically will not need to replace the lens again on that eye. If you require cataract surgery on both eyes, your ophthalmologist will schedule separate procedures at least 1 week apart.
Cataract surgery is a procedure to remove and replace a lens on an eye that has a cataract. A cataract occurs when a cloudy area develops in the lens and impairs vision.
Ophthalmologists create a small incision in the cornea, then remove the damaged lens. They insert a new artificial lens that should last for the lifetime of the person receiving it.
Cataract surgery is usually a common, safe, and effective procedure. However, like any surgery, it does have some risk of complications. Talk with your eye doctor about your individual risk factors to determine if cataract surgery is right for you.