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What Is Cataract Surgery?

There are several ways to remove a cataract. The most commonly used method is the phacoemulsification technique where the cloudy lens is broken up, using an ultrasound probe that allows removal of the pieces through a tiny incision. A soft, plastic intraocular lens is then carefully inserted, and visual recovery is very rapid. The incision may not even require sutures.

The second, less commonly used technique, is extra capsular lens extraction. With the extra capsular technique, a larger incision is necessary, and the whole cataract is removed intact, rather than breaking it up with ultrasound. Visual rehabilitation takes somewhat longer than it does with the phacoemulsification method, because a larger incision is required. Most often, the phacoemulsification technique is used, but each technique has its advantages.

What To Expect

A complete outpatient medical examination, including X-rays and laboratory tests, is performed during the week before surgery. On the day of surgery, the cataract is removed and the patient goes home the same day. In special circumstances, usually because of a medical illness, cataract surgery may be performed on an inpatient basis.

Most cataract surgery is done under either topical or local anesthesia with intravenous sedation. Patients may fall asleep during the operation and awake to find that the operation is finished.

Recovery is almost immediate. The eye may be patched for one or more night. Medications are used to prevent infection and to help the healing process. For about three weeks after surgery, a plastic shield must be worn at night and protective glasses during the day to prevent accidental injury to the eye.

Your surgeon will see you as an outpatient the day after surgery and perhaps three or four times more during the two months after surgery. It takes about two months to heal. During that time, your vision may vary. At home, you should observe a few precautions:

  • No heavy lifting
  • Avoid bending over with your head below your knees
  • No rubbing or scratching the operative eye
  • No sleeping on the operative eye
  • Avoid dusty areas
  • Use your eye drops on schedule

Risks and Outcomes

Cataract surgery is successful most of the time. Unfortunately, even in cases with an excellent surgical outcome, vision after the operation is sometimes poor because of disease elsewhere in the eye. Frequently, the existence of such a condition cannot be detected before surgery because the back of the eye cannot be seen through a cataract.

Cataract surgery, like any other kind of surgery, involves the risk of complications. Bleeding, infection or poor healing may occur. Any of these circumstances may interfere with vision, and may even lead to blindness. The likelihood that any of these events will happen is very small, and every precaution against their occurrence is taken.

Of the many hundreds of thousands of cataract operations performed every year in this country, about 98% of patients with otherwise healthy eyes have useful vision restored.

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