Learn more about cataracts

Cataract Surgery is one of the most successful and safest procedures performed in the world. In fact, more than 3 million are performed each year in the United States. It is a quick outpatient procedure that we perform in one of our several state-of-the-art surgical suites. Patients often resume their normal daily activities the next day.

Based on your vision and examination, your doctor may recommend removing the cataract and replacing it with a clear lens implant. The procedure is painless and precise.

Your surgeon will remove the cataract through a tiny incision so small that it will seal without even needing a stitch. Once the cataract has been removed, your doctor will place a new, clear lens in the eye to restore sharper vision.

What are the different types of cataract surgery?

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

• Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”
• Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.

After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.

• No-Stitch Cataract Surgery. A popular technique in cataract surgery that eliminates the need for uncomfortable injection of anesthesia behind the eye and bothersome, sometimes troublesome sutures. 

  No-Stitch Cataract Surgery offers a patient impressive benefits – safety, less time in surgery, relief from the usual discomfort and stress, less risk of complications and improved likelihood of success for an operation already known for its high success rate.

  With this procedure, the eye is anesthetized by eye drops instead of by injection. This approach not only eliminates the uncomfortable sensation associated with injection, but also eliminates complications that can be induced by injection.

  These complications are rare, but can be serious, such as permanent loss of vision, bleeding or hemorrhage behind the eye and the temporary cessation of breathing or heartbeat. Omitting injection is more convenient for the patient who may be on anti-coagulation medication and spares the patient the unpleasant experience of emerging from surgery with a “shiner”.

  The incision used is so small that no sutures are required. Other techniques for extracapsular cataract extraction, with lens implantation, require a comparatively larger incision. Then stabilizing sutures are generally used under the muscles of the eye to hold it still for surgery.

  Patients undergoing No-Stitch Cataract Surgery receive only half the normal amount of tranquilizer prior to surgery because they must cooperate with the surgeon to assure success. The patient is awake but feels no pain when the ophthalmologist makes a tiny incision into the white part of the eye usually covered by the upper lid. Use of the eye drop therapy is possible only because of the small incision.

  The cataract is removed, using ultrasound and suction, through the very small incision. This incision is crafted in such a way that it becomes self-sealing, thereby requiring no sutures for closure. Then an intraocular lens is implanted behind the iris in the back of the eye. After the lens is implanted, the eye is repressurized with a special solution to make sure the wound is closed and leak proof.

  The patient’s usual medications need not be altered prior to surgery. They can be taken with a swallow of water just before the operation. Anti-coagulants are not stopped.

  Diabetics are asked to not take their diabetic medication by mouth or insulin injection the day of surgery. The insulin-dependent diabetic receives a modified dose after surgery, prior to the first meal. The patient may then return to their usual routine the next day.

  No-Stitch Cataract Surgery is not appropriate for the younger or anxious patient because the procedure does require good cooperation. It is not recommended for the individual who is unable to cooperate, or the patient whose surgery is likely to be complicated.

If you are interested in decreasing your dependence on distance and/or reading glasses, ask your doctor about our Hi-Tech Lens options. These lenses have advanced optics that focus in ways that standard implantable lenses cannot. The result can often be excellent vision without the need for spectacles. If you are a good candidate, your doctor will discuss this option with you.

A Multifocal or Pseudo-Accommodating Lens can provide excellent, clear vision after cataract surgery at a variety of distances — often eliminating the need for distance or reading glasses. These lenses address the issue of presbyopia or “the need for reading glasses” by utilizing advanced optical properties that can focus light for distances near and far.

A Toric Lens corrects astigmatism and can help patients who have worn glasses their whole life see much clearer in the distance — often without the aid of glasses. Your cataract surgeon will personally review these options with you, so that you can make the best decision for your eyes.

Cataract Multifocal Implants can often provide excellent vision after Cataract Surgery at both distance and near. Depending on your specific vision requirements, there are several types of presbyopia correcting multifocal lens implants.

Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

What happens before surgery?

A week or two before surgery, your doctor will do some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right type of IOL.

You may be asked not to eat or drink anything 12 hours before your surgery.

What happens during surgery?

At the hospital or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed.

The operation usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery. Others may need to be put to sleep for a short time.

If you are awake, you will have an anesthetic to numb the nerves in and around your eye.

After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. You will need someone to drive you home.

What happens after surgery?

Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.

For a few days after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.

In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.

Can problems develop after surgery?

Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.

Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.

An after-cataract is treated with a laser. Your doctor uses a laser to make a tiny hole in the eye tissue behind the lens to let light pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.

When will my vision be normal again?

You can return quickly to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.

If you received an IOL, you may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you will become used to improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.

As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.

Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little "cobwebs" or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Your eye must be examined by an eye surgeon as soon as possible. A retinal detachment causes no pain. Early treatment for retinal detachment often can prevent permanent loss of vision. The sooner you get treatment, the more likely you will regain good vision. Even if you are treated promptly, some vision may be lost.

Talk to your eye care professional about these risks. Make sure cataract surgery is right for you.