In most cases, cataract formation occurs as a result of aging. However, it may also be triggered by injury to the eye, eye surgery, exposure to radiation, or excess sun exposure. Cataracts may also be a birth defect.
Surgery is the not the only treatment for cataracts. Your doctor may only consider cataract surgery for you if nonsurgical options have not been effective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on cataract surgery.
Who performs cataract surgery?
An ophthalmologist will perform your cataract surgery. An ophthalmologist is a doctor with specialized training in diseases, conditions and surgery of the eye.
How is cataract surgery performed?
All cataract surgery involves an incision in the side of your cornea. Your cornea is the clear dome that covers the front of your eye. There are, however, different approaches to the surgery that your doctor may choose. Ophthalmologists perform cataract surgery in hospitals and outpatient surgery settings.
Surgical approaches to cataract surgery
Small incision cataract surgery, also known as phacoemulsification or phaco, is the most common form of cataract surgery. It uses a small incision in the side of your cornea and a tiny ultrasound probe to soften and break up your lens. Your doctor removes your lens with suction through the small incision. The intraocular lens (IOL) implant is inserted through the same small incision.
Extracapsular cataract surgery uses a slightly longer incision in the side of your cornea. Your doctor removes your lens in one piece and inserts your IOL through this incision.
Your doctor may or may not use stitches or sutures to close your incision. If your doctor uses sutures, they may need to be removed at a future visit.
Your doctor will determine which type of surgery is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different cataract surgery procedures and ask why your doctor will use a particular type of procedure for you.
Types of anesthesia that may be used
Your doctor will perform cataract surgery using local or general anesthesia.
- General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
- Local anesthesia involves eye drops to numb the eye or injecting an anesthetic around nerves in your eye so you do not feel anything. You will likely have sedation to keep you relaxed and comfortable.
What to expect the day of your cataract
The day of your surgery, you can generally expect to:
- Speak with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent.
- Remove all clothing and jewelry and dress in 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.
- The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of cataract surgery?
As with all surgeries, cataract surgery involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgical procedures include:
- Anesthesia reaction, such as an allergic reaction and problems with breathing
Potential complications of cataract surgery
Complications of cataract surgery are rare, but can be serious. Potential complications include:
- Bleeding inside the eye
- Capsular contraction, which occurs when the tissue that supports your IOL (called the capsule) scars and contracts during healing. This may cause vision changes and prevent accommodative lenses from functioning properly.
- Dislocated or de-centered IOL
- Glaucoma or increased pressure inside your eye
- Inflammation or swelling
- Night vision problems, such as seeing glare, halos or starbursts around lights at night. These effects are usually temporary.
- Posterior capsule tear or a tear in the thin structure that holds your natural lens and will hold your IOL
- Retinal tear or detachment, which is a medical emergency. Symptoms include a sudden appearance of flashes or floaters. Seek immediate medical care for symptoms of retinal detachment to prevent permanent vision loss.
- Secondary cataracts, sometimes called posterior capsule opacification or PCO, which occur when the capsule or tissue that supports your IOL becomes cloudy. Secondary cataracts can develop months or even years after cataract surgery. They are typically treated with an outpatient laser procedure.