Cataract Surgery

What is cataract surgery?

Cataract surgery is a type of eye surgery to remove a cataract (cloudy lens) and improve your vision. Your eye, like a camera, has a lens that focuses light. Your lens is made mostly of water and proteins. As a cataract forms, the proteins naturally start to break down, causing the lens to become cloudy and yellowed. Aging is the most common cause of cataracts. However, certain medical conditions and medications, injuries and previous eye surgeries can also cause cataracts.

A cataract prevents light from properly passing through your lens. As a result, you develop symptoms like blurry vision, halos around bright lights or double vision.

Cataract surgery removes the cloudy lens and replaces it with a clear, artificial lens. An ophthalmologist performs the surgery and helps you select the type of intraocular lens (IOL) that’s best for you.

Most people have an IOL implanted as a part of their cataract surgery. IOLs are clear so light can pass through and be focused by your eye as it should. IOLs offer different focusing powers to correct nearsightedness and farsightedness.

Your surgeon may also offer specialty IOLs to correct astigmatism and presbyopia. While these aren’t covered by insurance, they may help you depend less on glasses or contacts after your cataract surgery.

Cataract surgery is currently the only proven way to treat cataracts in adults. For most people, surgery restores vision and has no complications. It’s a quick, outpatient procedure with a fast recovery. You may only need surgery in one eye. If cataracts in both eyes require surgery, your ophthalmologist will schedule two surgeries a week or two apart.

How painful is cataract surgery?

Most people feel little or no pain during or after cataract surgery. You’ll receive a topical anesthetic (eye drops) to numb your eye during the surgery. Shortly after surgery, your eye may feel gritty or slightly tender, but over-the-counter pain medicine should improve this.

Who needs cataract surgery?

You may need surgery if cataracts in one or both eyes are causing vision problems that interfere with your usual activities.

Your eye care specialist may also recommend cataract surgery if they need to see the back of your eye to manage other eye conditions like:

• Age-related macular degeneration.
• Diabetes-related retinopathy.

It’s important to know that cataract surgery won’t treat vision loss from these other conditions. It only improves vision loss due to cataracts.

How do I decide if it’s time for cataract surgery?

Cataracts aren’t a medical emergency. So, if you’ve just learned you have cataracts, don’t feel rushed or pressured into scheduling surgery. You can usually wait to have the surgery until the timing is best for you.

When you first notice cataract symptoms, a new prescription for glasses or contacts might help. But cataracts usually get worse over time. Once cataracts keep you from doing what you need or want to do, it may be time for surgery. Talk to your eye surgeon about the best timing for surgery in your individual situation.

How common is cataract surgery?

Cataract surgery is one of the most common surgeries in the U.S. and globally. Researchers estimate that each year, surgeons perform over 3 million cataract surgeries in the U.S. and 20 million around the world. About half of all people who live into their 90s will need cataract surgery.

How should I prepare for cataract surgery?

Before your surgery day, you’ll meet with your ophthalmologist for a thorough eye exam. As part of this exam, your ophthalmologist will:

• Check your eye health.
• Look for any signs that you shouldn’t have surgery.
• Determine risk factors that could complicate your surgery.
• Measure your eye to find the correct focusing power for your IOL.
• Tell you if you need to use prescription eye drops.

Use this time to share any concerns or questions with your ophthalmologist. You may want to ask:

• What are the risks of surgery for me?
• What are the benefits for me?
• What type of IOL do you recommend for me?
• Will I need glasses or contacts after the surgery?
• How long will my recovery be?
• When can I expect to return to my usual activities?

You won’t be able to drive right after your surgery. So, be sure to ask someone to drive you to and from your surgery.

How is cataract surgery done?

Cataract surgery is an outpatient procedure. So, you can go home soon after the surgery ends.

To perform cataract surgery, your surgeon will:

1. Numb the surface of your eye. This is called topical anesthesia. You’ll receive eye drops in your eye so you won’t feel anything during the surgery. You may also receive medicine to help you relax. You’ll be awake during your surgery, but you won’t see anything coming at you. You’ll only see a rainbow of lights.
2. Make a tiny incision in your cornea. Your surgeon will use a laser or a blade. Usually, the incision doesn’t need stitches to close.
3. Break up and remove the cataract. The most common way to do this is a technique called phacoemulsification. Your surgeon will use ultrasound waves to break up your lens into many tiny pieces. Then, they’ll suction out those pieces.
4. Insert your new lens. Your surgeon will insert your new lens through the same incision. Most IOLs can fold up for easy insertion. Your IOL then unfolds into the space where your cloudy lens had rested.
5. Protect your eye. Your surgeon will tape a shield (like an eye patch) over your eye to protect it.

How long does cataract surgery take?

Cataract surgery usually takes 10 to 15 minutes. With preparation and recovery added in, your appointment may be several hours. Ask your ophthalmologist the timeframe so you can tell the person who’s driving you.

What can I expect after cataract surgery?

After your surgery is over, your surgeon will monitor you for 15 to 30 minutes. They’ll also schedule your first follow-up appointment. Then, you can go home.

Things may look blurry right after your surgery. This is normal. Your vision will gradually improve over the next few days and weeks. Other temporary side effects can include:

• Gritty feeling in your eyes.
• Red or bloodshot eyes.
• Watery eyes.

What are the benefits of cataract surgery?

Cataract surgery is the only way to get rid of a cataract and sharpen your eyesight. There aren’t any medicines or eye drops proven to improve declining vision due to cataracts.

After surgery, you can expect to:

• Enjoy sharper, clearer vision.
• Be less bothered by glare when looking at bright lights (such as when driving at night).
• See colors more vividly.
• Rely less on glasses, in some cases.

How successful is cataract surgery?

Cataract surgery is successful in improving vision in about 97% of people who have it.

What are the risks of this procedure?

Cataract surgery is a safe, routine procedure. Problems during and after cataract surgery are rare in an experienced surgeon’s hands. Your risk of complications may be higher if you have certain eye diseases or medical conditions.

Possible risks of cataract surgery include:

• Eye bleeding or swelling.
• Ongoing eye pain.
• Blurred vision or vision loss.
• Visual disturbances, such as glare, halos and shadows.
• IOL displacement (your new lens moves out of place).
• Posterior capsular opacification (the membrane that holds your lens becomes cloudy).
• Retinal detachment, affecting 2 in 1,000 people.
• Infection, affecting fewer than 1 in 1,000 people.

Your ophthalmologist can successfully treat most of these complications. Before your surgery, ask your ophthalmologist about your individual level of risk. Plus, ask how they can treat any complications that may arise.

How long does it take to recover from cataract surgery?

In most cases, full recovery from cataract surgery takes four weeks. But people often notice improvement in their vision within a few days. There should be little pain or discomfort during this period.

How do I care for myself at home?

Your surgeon will tell you how to take care of yourself at home. It’s a good idea to ask your surgeon for specific details on when you can:

• Drive.
• Swim.
• Wear eye makeup.
• Exercise.
• Bend over.
• Lift heavy objects.
• Return to work or other activities.

You may wish to have a family member or friend present to hear this information. Or ask your surgeon to write it down for you.

Some general tips for your return home include:

• Use eye drops as your surgeon recommends.
• Don’t get water, shampoo or soap in your eye.
• Don’t rub or put pressure on your eye.
• Wear sunglasses when you go outside.
• Wear your eye shield when you sleep and other times as your surgeon recommends.

When should I call my healthcare provider?

Call your ophthalmologist right away if you experience:

• Eye pain or redness
• Crusting or mucous discharge around your eye.
• Worsening vision or vision loss.
• Eye floaters or flashes.

A note from Cleveland Clinic

The thought of surgery makes most people anxious. If you’ve learned you may need cataract surgery — an eye surgery to remove a cataract (cloudy lens) and improve your vision — you might be wondering what your vision will be like afterward and what recovery involves. Take comfort in the fact that millions of people have cataract surgery each year. And the vast majority have improved vision with no complications.

As with any surgery, bring all of your questions to your provider. Get the information you need to feel at ease with this decision. Everyone’s medical history and eye health are different, so it’s important to talk to your provider about what you can expect in your unique situation.