Cataracts
Surgery
Surgery for a cataract involves removing the clouded lens of the eye (the cataract). The lens can be replaced with an artificial lens called an intraocular lens implant (IOL). Or, if an IOL cannot be used for any reason, it will be left out and contact lenses or, rarely, eyeglasses can compensate for its absence. Most people will get an IOL during surgery.
Before surgery, review with your doctor the pros and cons of each type of IOL available. Or, if you will not be getting an IOL, the pros and cons of contact lenses or eyeglasses.
- Intraocular lens (IOL). A variety of IOL types are available. Your doctor will choose the type of IOL that may work best for you.
- Contact lens. A contact lens is placed on the surface of the eye. A contact lens may not be a good choice for young children or older adults who have a hard time properly placing the lens in the eye.
- Cataract glasses. Cataract glasses were used for decades when there were no other options for lens replacement. Because they are thick and heavy, they are rarely used now.
For most adults, surgery is only needed when vision loss caused by a cataract affects your quality of life. The goals of surgery in adults with cataracts include:
- Improving vision.
- Helping you return to work, leisure, and other daily activities.
The choices for treating cataracts in children depend on how likely the cataracts are to interfere with development of normal vision. Surgery for cataracts in children may be necessary.
Before you have surgery for cataracts, tell your doctor all of the medicines you are currently taking. Your doctor may advise you to stop taking a medicine, such as an alpha-blocker (for example, terazosin) before the surgery to prevent complications.
Second surgery
For adults who have cataracts in both eyes, surgery is not normally done on both eyes at the same time. The first eye needs to heal, and your doctor will determine how much eyesight has improved before surgery is done on the second eye.
If you have both glaucoma and cataracts, you may have surgery for both conditions at the same time. Depending on which condition caused the vision loss, vision may improve after surgery.
Surgery Choices
There are two types of cataract surgery. The decision about which one to use depends on what kind of cataract you have and how much experience the surgeon has with each type of surgery.
- Phacoemulsification. In this type of surgery, the incisions are small, and sound waves (ultrasound) are used to break up the lens into small pieces. Currently, this is the most common method of doing cataract surgery.
- Extracapsular surgery. In this type of surgery, the lens and the front portion of the lense capsule wrapped around the lens is opened. The lens is then carefully removed in one piece. Some techniques use a small incision and manually break up the lens into small pieces. Extracapsular surgery is also called extracapsular cataract extraction (ECCE).
In the past, cataracts were removed by intracapsular surgery, in which the entire lens and lens capsule were removed. Intracapsular surgery is rarely, if ever, used today. It is more difficult and has a higher rate of complications than extracapsular procedures.
About 1 out of 4 people who have cataract surgery develop clouding of the posterior lens capsule (called aftercataract) within 5 years after surgery.4 But this clouding is usually not a serious problem, and it is easy to treat with a laser surgery (Nd:YAG laser posterior capsulotomy) if it develops. This type of surgery is done in an office setting.
What To Think About
For adults, cataract surgery is almost always elective and can be done at your convenience. The surgeon, or someone familiar with routine surgical practices, will usually be available for any follow-up exams and treatment.
If you do not have another eye condition, such as glaucoma or problems with your retina, your chances of seeing better after cataract surgery are very good. But you may still need reading glasses or glasses for near vision.
Just because you have a cataract does not mean you need to have it removed. Only you can decide whether cataracts are affecting your vision and your life enough to have surgery. Learn what you should ask about cataract surgery before deciding whether to have the surgery.
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| Author: | Jeannette Curtis | Last Updated: October 1, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Christopher J. Rudnisky, MD, FRCSC - Ophthalmology | |
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