Cataract surgery is one of the most commonly performed and safest surgical procedures performed in the U.S.
There are two main types of cataract surgery. The most common type is phacoemulsification, often just called small-incision cataract surgery.
The eye’s natural, clouded lens is removed, and a synthetic lens is put into its place. This surgery is relatively simple and boasts incredibly high success rates. Although surgery always carries risks, cataract surgery is safe, widely performed, and effective.
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Cataract Treatment Basics
Cataracts are characterized by blurry vision, light sensitivity, and a fading of color that often worsens with age. This is caused by proteins in the lens of your eye clumping, creating clouds that can interfere with light reaching your retina.
While there is no “cure” for cataracts, vision can be improved by removing your eye’s natural lens and implanting an intraocular lens (IOL) in its place. This synthetic lens can help refract light in a way similar to your natural lens, allowing you to see much more clearly. Because the lens is synthetic, you also cannot develop cataracts again in that same eye.
There are no ways to “dissolve” cataracts at home, and any products claiming to do so are falsely advertised. This is true of both human cataracts and those in animals.
Types of Cataract Surgery
There are two main types of cataract surgery:
- Phacoemulsification (small-incision cataract surgery)
- Extracapsular surgery
Phacoemulsification is the more common kind of cataract surgery, performed by making a small incision into the eye. Extracapsular surgery involves making a more extended opening into the eye.
Who Is a Candidate?
Cataracts are a progressive condition, usually worsening over time. In the early stages of cataracts, their effect on vision may be minimal or even nonexistent. At this point, a surgeon might determine you are not a good candidate for surgery.
Generally, it is best to wait for cataracts to affect your quality of life enough that other measures, like reading glasses and adjusting lighting conditions as necessary, cannot offset the symptoms caused by cataracts enough for you to live a comfortable life.
How to Prepare for Cataract Surgery
Preparing for cataract surgery is a fairly straightforward process, and most facilities will provide written pre-op instructions.
These are common preparation steps for cataract surgery:
- Get cleared for surgery at least one week prior by your primary physician.
- Arrange transportation to and from your surgery, as you cannot drive the day of your surgery.
- Use medicated eye drops on a set schedule leading up to your surgery.
- Avoid food and drink for at least 8 hours before the procedure.
- Avoid makeup and similar cosmetic products around the eyes the day of your procedure.
The Procedure: What to Expect
During both phacoemulsification and extracapsular surgery, your doctor will first give you medication to help with anxiety and put numbing gel and eye drops around and in your eye so the procedure is painless.
Phacoemulsification involves making a small incision in the eye. Then, your surgeon will use a small probe to destroy the lens of the eye.
This is done because breaking up the lens means that a smaller incision needs to be made, speeding up the healing process. The pieces are then removed using a different device.
Next, the surgeon inserts an IOL into the same opening created to first access the eye. Once properly in place, your surgery is essentially complete. You can leave after about 30 minutes after your sedation has worn off.
Extracapsular surgery is similar to phacoemulsification, but a larger incision is made on the top part of the eye rather than the small incision made into the side of the eye during phacoemulsification. Then, the middle of the eye’s lens is removed. After that, the remainder of the lens is removed through the same opening.
Once the lens is removed, the process is essentially the same as phacoemulsification. An IOL is put in place, and the surgery is complete.
Recovery From Cataract Surgery
For your first few days of recovery, you may be limited in what you can do. Many people experience some blurriness and light sensitivity for the first few days of their eye healing, with dryness, burning, and itchiness also fairly common.
It is important you don’t touch your eye. Your surgeon may recommend that you wear an eye guard while you heal.
Your doctor will probably prescribe medicated eye drops for the first week of your healing process, potentially longer. These help to reduce your risk of infection and inflammation.
Talk to your doctor about what activities they recommend you avoid and when you can return to them. Light labor is usually possible only a few days after your surgery, but you may need to avoid more intense physical labor and sports for weeks or months.
Quickly after your surgery, many of the symptoms you experienced from your cataracts will be gone. Within a week, you will likely experience a dramatic improvement in your vision.
As you recover, your doctor will want to see you for several follow-up appointments. After a month, you’ll receive an eye exam. This is about how long it takes for your vision to stabilize. Full recovery can take longer, usually up to about two months.
Risks & Side Effects
Cataract surgery is a form of eye surgery and carries risks, although it is considered a generally safe and medically valid treatment for cataracts.
Common risks associated with all eye surgery, including cataracts, include infection, inflammation, and bleeding, although it is rare these will cause severe complications in the case of cataract surgery, especially if a patient is quick to report any issues to their doctor.
A fairly common complication from cataract surgery is the development of scar tissue over the eye’s lens, which can lead to symptoms that are very similar to a cataract. This is called an after-cataract. It is easily treated via a procedure called a YAG laser capsulotomy, where the scar tissue is burned away with a laser.
One side effect of cataract surgery is that your eye’s lens can no longer adjust. Synthetic lenses don’t work in the exact same way as a natural lens.
Most cataract lenses are monofocal, meaning they have one point of focus. This can effectively make the eye the surgery was performed on either nearsighted or farsighted. You may need to wear reading or distance glasses after the surgery, or you can discuss multifocal IOLs with your surgeon prior to surgery.
IOLs can also cause you to become more sensitive to light and can sometimes cause dry eye. These symptoms are usually manageable, although night driving may be more difficult for you compared to someone with a standard level of vision.
Cataract Surgery Success Rates
About 98 percent of patients experience better vision after cataract surgery, assuming no other eye conditions are present. If you have cataracts in both eyes, the surgeries are staggered, meaning you don’t necessarily have to get the operation on your other eye if you are unhappy with the results of your first surgery.
Overall, the surgery is highly effective. Adjustments are often possible if any poor vision or similar complications occur due to a problem with the inserted IOL.
Costs & Insurance Coverage
Cataract surgery is estimated to cost about $2,338 according to one source, assuming a patient doesn’t have insurance.
Cataract surgery is not generally considered elective if your doctor believes it is necessary, meaning relevant insurance plans will usually cover the bulk of your costs. Health insurance, including Medicare, covers the cost of cataract surgery, provided the impairment from the cataract interferes with daily life.
How to Choose the Right IOL
There are three main types of IOLs:
The most common choice, corrects for one focus.
Can provide multiple levels of focus but can involve an adjustment period.
Can help correct astigmatism.
Talk to your cataract surgeon about your IOL options. Ask them the pros and cons of each choice, and discuss what you hope to get out of your surgery. You and your surgeon will decide on the choice that makes the most sense for your vision and lifestyle.
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