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Cataract Surgery

Cataract surgery has come a long way since it originated in the years BC. (Yes! There are cave drawings depicting ancient cataract surgery!) The surgery today is an outpatient procedure with a rapid recovery period. The majority of these procedures take only 15 minutes or less. Patients are discharged to home the same day. Most patients are able to return to light activity and desk work as soon as 24 hours after surgery.

Post-operatively, patients may not lift more than ten pounds and may not perform strenuous activity for one week. Patients also must avoid head down positions for the first week. Most surgeons will not allow swimming for up to two weeks. The vision in the operative eye typically clears quickly (withiin days), but may take a few weeks to fully clear.

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cataract surgery

WHAT TO EXPECT: STEP BY STEP

Surgical Consultation & Measurements

Your first visit includes a detailed series of eye measurements and a full examination. You will then meet with your surgeon to review the results and create your personalized surgical plan. These visits can take up to 2 hours from start to finish.

Surgery Day

Cataract surgery is an outpatient procedure — you go home the same day. The surgery itself takes about 10–15 minutes. You will be awake but relaxed with a light sedative (not general anesthesia). There is no pain, and you will only see soft, colorful lights during the procedure — no instruments. The surgical team will keep the atmosphere calm and will talk to you throughout.

Recovery

Most patients feel like themselves by the next day with only mild irritation. Vision typically improves within a few days. You will avoid strenuous activity for about a week and wear glasses or sunglasses when outside. A clear plastic shield is worn over the eye while sleeping after surgery.

Eye Drops After Surgery

Some patients need no drops at all; others may use one to three types. Preservative-free artificial tears are safe to use after surgery as long as you wait a few minutes before applying any medicated drops. Your surgeon will tailor a post-operative drop regimen specifically for you.

Contact Lens Wearers

Soft lens wearers should stop wearing contacts at least 10 days before your testing appointment. Hard or rigid lens wearers need a minimum of 30 days out of contacts — and often longer, depending on how many years you have worn them. Please talk to us about your specific situation so we can tailor the timing for you.

Are You a Candidate for Cataract Surgery?

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Cataract Self-Test

CHOOSING YOUR LENS

During surgery, your cloudy natural lens is removed and replaced with a new artificial lens. The choice of lens is really about your glasses goals — not about the health of your eyes. Your surgeon will review all of your measurements and what matters most to you, then present the options that are genuinely appropriate for your individual situation.

We think about vision in three zones:

– Distance — beyond arm’s reach (driving, watching TV, outdoor activities)

– Intermediate — approximately arm’s reach (computer monitors, kitchen tasks)

– Near — elbow distance (phone, tablet, printed reading material)

Lens Options Overview

STANDARD

Monofocal Lens

Excellent, reliable vision at one focal point — distance, intermediate, or near. Glasses are needed for the other distances. A very common and effective choice.

ADVANCED TECHNOLOGY

Astigmatism Reduction

If you have significant corneal astigmatism, it can be treated during surgery with a toric lens, a laser, or a combination — reducing your dependence on glasses. Wearing glasses or contacts after surgery is also an option if you prefer.

ADVANCED TECHNOLOGY

Depth of Focus (DOFi)

Provides clear vision from far through intermediate, reducing the need for glasses for most daily activities. Low power readers will still be needed for print.

ADVANCED TECHNOLOGY

Multifocal Lens

Widest range of glasses-free vision in a single lens. A small percentage of patients notice some glare when driving at night; this typically improves over time.

SPECIALIZED

Light Adjustable Lens (LAL)

Placed during surgery and then precisely fine-tuned with a special light device in the office over the following weeks. Our most customizable option — ideal for complex eyes or blended vision goals. UV-protective glasses must be worn until the lens power is locked in.

ADVANCED TECHNOLOGY

Blended / Monovision

Different focal points are set between your two eyes to extend your functional range without glasses. Typically requires prior experience with monovision via contacts or LASIK. The LAL offers a unique way to trial this approach after surgery.

A NOTE FROM OUR SURGEONS; not every lens is the right fit for every eye. Your surgeon will review all your measurements and personal goals and will only present the options that are genuinely appropriate for you. You tell us what matters to you — we will help guide the rest.

Laser-assisted Cataract Surgery

The femtosecond laser is cutting edge technology used to assist in cataract surgery. The laser does several stages of the cataract surgery, including the critical steps of opening the capsule (the shell surrounding the cataract) and softening the cataract. It also reduces mild to moderate levels of astigmatism. Laser-assistance can minimize the amount of ultrasound energy required to remove the cataract, allowing for less swelling and a faster recovery. It can improve the safety of surgery in certain patients. The laser can also aid in the precision of intraocular lens (IOL) placement. Precise IOL positioning is crucial, especially for some patients choosing the premium IOLs listed above.

Intraoperative Wavefront Aberrometry

Intraoperative wavefront aberrometry is newly available technology which allows the surgeon to verify or refine the power of the IOL during surgery. This is helping to further minimize the need for glasses after surgery in many patients. It is especially useful in patients who have had prior refractive surgery including LASIK.

Risks of Cataract Surgery

While cataract surgery is extremely successful, there are, of course, risks with any surgery. The surgeon will review risks specific to each patient prior to surgery. All questions about risk will be addressed in the office. A common question involves whether the cataract will ever “grow back.” Cataracts do not recur after surgery. Some patients may develop a clouding of the capsule (the shell holding the artificial lens) in the months or years after surgery. This is called a posterior capsule opacification. This condition is treated easily with a laser procedure called a laser capsulotomy. The procedure takes only minutes and is painless.

Cataracts FAQ

A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

A cataract can occur in either or both eyes. It cannot spread from one eye to the other.

Yes. Although most cataracts are related to aging, there are other types of cataract:

  • Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
  • Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
  • Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
  • Radiation cataract. Cataracts can develop after exposure to some types of radiation.

The lens lies behind the iris and the pupil (see diagram). It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Researchers suspect that there are several causes of cataract, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.

Age-related cataracts can affect your vision in two ways:

  1. Clumps of protein reduce the sharpness of the image reaching the retina.
    The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop from protein clumpings.
    When a cataract is small, the cloudiness affects only a small part of the lens. You may not notice any changes in your vision. Cataracts tend to “grow” slowly, so vision gets worse gradually. Over time, the cloudy area in the lens may get larger, and the cataract may increase in size. Seeing may become more difficult. Your vision may get duller or blurrier.
  2. The clear lens slowly changes to a yellowish/brownish color, adding a brownish tint to vision.
    As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem. Over time, increased tinting may make it more difficult to read and perform other routine activities. This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina.
    If you have advanced lens discoloration, you may not be able to identify blues and purples. You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.

The risk of cataract increases as you get older. Other risk factors for cataract include:

  • Certain diseases such as diabetes.
  • Personal behavior such as smoking and alcohol use.
  • The environment such as prolonged exposure to sunlight.

The most common symptoms of a cataract are:

  • Cloudy or blurry vision.
  • Colors seem faded.
  • Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
  • Poor night vision.
  • Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)
  • Frequent prescription changes in your eyeglasses or contact lenses.
  • These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

  1. Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”
  2. Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.
    After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.
    Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.
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