What Happens During Cataract Surgery

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Doctor examining patients eyes

Having a cataract makes your vision cloudy. The goal of cataract removal is to let you see more clearly. An eye surgeon will remove your eye's cloudy lens and put a clear, artificial lens in its place. This new lens will be a permanent part of your eye.

Cataract removal surgery is common. About two million people in the United States have this surgery every year.

It's a safe procedure, too. Most people who have cataract surgery go home the same day without any problem. That’s because surgeons can remove cataracts with just a tiny incision. This technique isn’t new. Doctors have been using it for nearly 50 years.

Cataract Removal Step by Step

Most people stay awake during cataract surgery. However, you won't feel the procedure. Your surgeon will use a medicine to numb the area around your eye. The doctor may also give you other medication to help you feel calm. So, though you're awake, you'll be comfortable.

Next, your surgeon will put drops in your eye. These widen (dilate) the black area (pupil) in the center of your eye. The pupil is actually a hole. Dilating it lets more light in and gives your doctor a better look into your eye. 

Your surgeon will make a small incision on the side of the front part (cornea) of your eye. A special instrument lets the doctor break up the cloudy part of the lens and suctions it out. The thick outer layer of the lens (the lens capsule) stays in place.

The surgeon inserts an artificial lens into the lens capsule. This new lens is made of plastic, silicone or acrylic. But, it will feel like a natural part of your eye. The incision to put in the new lens will be so small it will heal on its own. No stitches are needed.

The name for this cataract procedure is phacoemulsification. It's a common type of cataract surgery. But, it isn't right for everyone.

A less common type is extracapsular surgery. It requires a larger cut in the cornea and usually stitches to close it. The surgeon doesn't break up the cloudy lens. Instead, the surgeon takes it out in one piece. You might have this type of surgery if you have certain eye complications. Or, you might need it if your new lens isn’t flexible enough to fit through a small incision.

Cataract surgery usually takes about an hour. Doctors remove just one cataract at a time. If you have cataracts in both eyes, you'll probably need two separate procedures.

Risks and Benefits

Most people who have cataract surgery can see more clearly within eight weeks. When your vision gets better, your quality of life may improve, too. Activities like driving and reading may become easier and more enjoyable. If you can see more clearly, you're also less likely to fall or injure yourself.

However, all surgeries come with risks. For cataract surgery these include:

  • Bleeding in your eye

  • Detached retina

  • Droopy eyelid

  • Increased pressure inside your eye

  • Infection

  • Swelling or inflammation

  • Vision loss or blindness

People who have other eye conditions or serious health problems are more likely to develop one of these problems. In general, however, they are rare. Also, doctors do not recommend cataract surgery for people at high risk for complications. Talk with your doctor about your personal risk factors and plans to minimize or correct them if they occur. If you are still concerned, seek a second opinion and advice from another eye surgeon. 

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Sep 17

  1. Cataract Surgery. American Academy of Ophthalmology. http://www.aao.org/eye-health/diseases/what-is-cataract-surgery

  2. Cataract Surgery. American Optometric Association. http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions...

  3. Cataract Surgery: What you can expect. Mayo Clinic. http://www.mayoclinic.org/tests-procedures/cataract-surgery/basics/what-you-can-expect/prc-20012917

  4. Cataracts. Cleveland Clinic. http://my.clevelandclinic.org/services/cole-eye/diseases-conditions/hic-cataracts

  5. Facts About Cataract. U.S. National Eye Institute. https://nei.nih.gov/health/cataract/cataract_facts

  6. What can patients expect from cataract surgery? Cleveland Clinic Journal of Medicine. http://www.ccjm.org/cme/cme/article/what-can-patients-expect-from-cataract-surgery/c441220e6cee7e53c...

  7. Cataract Surgery Infographic. American Academy of Ophthalmology. http://www.aao.org/eye-health/news/cataract-surgery-infographic

  8. 3 Unexpected Benefits of Cataract Surgery — Not Just Better Vision. Cleveland Clinic. https://health.clevelandclinic.org/2016/07/cataract-surgery-benefits-beyond-improved-vision/

  9. FDA approves first gel for sealing corneal incision after cataract surgery. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm381139.htm

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