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Guide to Cataract Eye Surgery: Types, Costs, & More

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Cataract surgery is a medical procedure designed to restore clear vision by removing a clouded lens from the eye and replacing it with a synthetic one. A cataract forms when the eye’s natural lens becomes cloudy or opaque, leading to blurred or dim vision. When these visual impairments interfere with daily activities, cataract surgery may be recommended. As one of the most commonly performed surgical procedures in the U.S., cataract surgery boasts a 99% success rate, with over 3 million procedures conducted annually. This testament to its safety and efficacy makes it a leading choice for those seeking clearer vision.

Cataract Treatment Basics

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 focus light in a way similar to your natural lens, allowing you to see much more clearly. Because your cloudy lens is removed and the new 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 Eye Surgery

There are two main types of cataract surgery: Phacoemulsification (small-incision cataract surgery and Extracapsular surgery. Here is a quick look at how the two compare:

Type of Cataract SurgeryDescriptionFrequency of Use
Phacoemulsification (small-incision cataract surgery)Performed by making a small incision into the eye.More Common
Extracapsular SurgeryInvolves making a more extended opening into the eye, can result in a more irregular healing patternReserved for unusually advanced cataracts
woman with cataract
About 6.1 million people with cataracts have their clouded lens removed with surgery. While this is one approach to treating cataracts, it is far from the only option. It is important to understand the symptoms of cataracts, so they can be diagnosed early. Then, different approaches can be taken to manage and remove them.

Who Is a Candidate for Cataract Surgery?

women engaging in post procedure talk

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 that surgery is unnecessary.

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:

  • Some facilities may require you to 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.

What to Expect from Cataract Surgery

Prior to your surgery you will get medication to help with anxiety and your eye will be dilated. Numbing medication will be placed on and in the eye to ensure there is no pain.

Extracapsular surgery

Extracapsular surgery is similar to phacoemulsification, but a larger incision is made on the top part of the eye rather than a small incision made on the side. Then, the surgeon removes the hard center of the eye’s lens in a single large piece. After that, the remainder of the lens is vacuumed through the same opening. Once the lens is removed, an IOL is placed and, because the incision is large, sutures are often needed.

Phacoemulsification

Phacoemulsification involves making a small incision in the top part of the eye, usually at the 12 O/C position. Then, your surgeon will use a small probe to dissolve and remove the clouded lens of the eye.

Next, the surgeon inserts an IOL into the same opening created to remove the cataract. Once properly in place, your surgery is essentially complete. In some cases a special laser is used to assist in the surgery, but it is always necessary to make an incision to remove the cataract and insert the IOL. Because the incision is small, it is usually self sealing, no sutures are needed and the healing is faster.

With either type of surgery, you can leave the surgical facility in about 30 minutes, after your sedation has significantly has worn off.

Recovery From Cataract Eye Surgery

Surgeons performing an eye surgery under the microscope at the hospital - healthcare and medicine concepts

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 or put pressure on 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, often 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 a longer period of time.

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 2-4 weeks you’ll receive an eye exam and eyeglasses are prescribed as needed. This is usually about how long it takes for your vision to stabilize. Full recovery can rarely take longer.

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 haze behind the new artificial lens, which can lead to visual symptoms that are very similar to a cataract. This is called an after-cataract. It is easily treated with a brief procedure called a YAG laser capsulotomy, which removes the haze from the line of sight.

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. If your goal is to be minimally dependant on glasses or contact lenses after your cataract surgery you can discuss multifocal or premium IOLs with your surgeon prior to surgery. While no artificial lens can restore the full flexibility of the youthful natural lens, this option can provide a wider range of vision.

Because the cataract has reduced as well as distorted the vision after the surgery everything will appear brighter. It often takes a short period of adjustment, and sunglasses, to get used to this. In rare cases you can become more sensitive to light and the surgery can sometimes cause or worsen dry eye. These symptoms are usually manageable.

Cataract Surgery Success Rates

The vast majority of patients experience better vision after cataract surgery, assuming no other eye conditions are present. If you have cataracts in both eyes it is uncommon to have them operated on the same day. The initial results of the first eye can be used to fine tune the surgery for the second eye.

While 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

Out of pocket cost for basic cataract surgery is estimated to be about $2-3,000 per eye if there is no insurance coverage. Multifocal, astigmatism correcting and other specialty IOLs are an added expense, as is the use of laser assisted cataract surgery and other advanced technologies your surgeon may recommend for you.

Health insurance, including Medicare, covers the cost of basic cataract surgery, provided the impairment from the cataract interferes with daily life. This coverage includes only the single vision lens implant. 

How to Choose the Right IOL

There are three main types of IOLs:

Monofocal

The most common choice, corrects for one focus.

Multifocal

Can provide multiple levels of focus but can involve an adjustment period.

Toric lenses

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.

References

  1. Cataract Surgery. John Hopkins Medicine.
  2. Cataracts. (April 2022). National Eye Institute.
  3. How Is Cataract Surgery Performed? (March 2022). Vision Aware.
  4. The Ageing Lens and Cataract: A Model of Normal and Pathological Ageing. (April 2011). Philosophical Transactions of the Normal Society B.
  5. Cataract Surgery in Aged Patients: Phacoemulsification or Small-Incision Extracapsular Cataract Surgery. (October 2011). International Journal of Ophthalmology.
  6. Detecting and Managing Complications in Cataract Patients. (2016). Community Eye Health Journal.
  7. Cataract Surgery Complications. (November 2019). EyeWiki, American Academy of Ophthalmology.
  8. What Is a Posterior Capsulotomy? (November 2021). American Academy of Ophthalmology.
  9. Does Medicare Cover Cataract Surgery? Medicare Plans.
  10. Recovery. (February 2021). UK NHS.
  11. How Much Does Cataract Surgery Cost Without Insurance in 2021? (November 2021). Mira.
  12. Recovery After Cataract Surgery. (April 2016). Acta Ophthalmologica.

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