A cataract is a condition characterized by clouding of the lens in the eye, which can result in loss of vision. The lens is normally clear and helps to focus light onto the retina at the back of the eye, but when it becomes cloudy due to the buildup of protein, it can cause blurred or distorted vision.
Cataracts usually develop slowly over time and may affect one or both eyes. Factors that can increase the risk of developing cataracts include age, family history, diabetes, smoking, and prolonged exposure to sunlight.
What is Cataract Surgery?
Cataract surgery is a surgical procedure that is performed to remove a cloudy lens from the eye and replace it with an artificial one. The surgery is typically done on an outpatient basis and is considered to be very safe and effective. There are two main types of cataract surgery: phacoemulsification (also known as “phaco”) and extracapsular cataract extraction (ECCE).
Phacoemulsification involves making a small incision in the cornea and using ultrasound energy to break up the cloudy lens. The lens fragments are then suctioned out of the eye and a folded intraocular lens (IOL) is inserted through the incision and unfolded into place.
Extracapsular cataract extraction involves making a larger incision in the eye and removing the cloudy lens in one piece. The IOL is then inserted through the incision and placed into position.
Related: Cataract: Causes, Symptoms, Prevention, and Treatment
When to consider cataract surgery?
- Impaired vision
When a cataract interferes with daily activities such as reading, driving, or watching TV, or if it causes difficulty seeing faces or objects, it may be time to consider surgery. - The decline in quality of life
If a cataract is affecting a person’s ability to carry out daily activities, causing frequent falls or preventing them from participating in their usual hobbies, social activities, or job, cataract surgery can substantially enhance their quality of life. - Advancement of the cataract
Cataracts will usually continue to grow over time, and the cloudier the lens becomes, the harder it becomes to remove. If the cataract increases to an extent that it affects the individual’s daily life, then cataract surgery is recommended. - Safety concerns
Cloudy vision can increase the risk of accidents and falls, which may be especially hazardous in older adults. Cataract surgery can enhance safety and decrease the risk of falls. - Other eye problems
If an individual has other eye problems such as diabetic retinopathy or age-related macular degeneration (AMD) that are interfering with vision, cataract surgery might be beneficial in improving their vision.
Benefits of cataract surgery
There are many benefits to cataract surgery that can greatly enhance your quality of life. These benefits include the following:
- Improved quality of vision (sharper images, brighter colors)
- Less difficulty with routine tasks (particularly night driving)
- Decreased dependency on eyeglasses
- Greater independence, regardless of age or disability\Greater feeling of safety
Research shows that cataract surgery can also lead to:
- Reduced risk of falls
- Safer exercise, sports, and hobbies
- Improved ability to read, recognize faces, and perform everyday activities
- Better physical health
- Increased sociability
- Longer life expectancy
Preparation and aftercare for cataract surgery
Preparation:
- The ophthalmologist will conduct a pre-operative examination to determine if the individual is fit for surgery and to measure the eye for IOL implantation.
- The individual may need to stop taking certain medications that increase bleeding, such as aspirin, for a specified period before the surgery.
- Arrange for someone to drive the individual home after surgery.
- Follow the food and drink restrictions before the surgery.
Aftercare:
- Use the prescribed eye drops regularly to prevent infection and aid in healing.
- Avoid exposing the operated eye(s) to water from pools, hot tubs, or showers for at least one week.
- Wear a shield /eye patch over the operated eye while sleeping or during naps to avoid accidentally rubbing the eye.
- Keep the operated eye clean and dry.
- Avoid strenuous activities like exercise or heavy lifting (more than 25 pounds) for a week after the surgery.
- Attend a follow-up appointment with the ophthalmologist to monitor healing and to check for complications/ infections.
- Avoid dusty or smoky environments until the eye is entirely healed.
- Wear sunglasses to protect the eyes from harmful UV rays.
- Inform the doctor if any pain or sudden loss of vision arises in the operated eye.
The cataract surgery procedure
- Anesthesia
Eye drops are given to numb the eye and a mild sedative may be given to help the patient relax. - Making an incision
A small incision is made in the cornea, the clear front part of your eye. - Removing the clouded lens
In a procedure called phacoemulsification, an ultrasonic probe is used to break up the cataract into small pieces, which are then removed through the incision. In some cases, a laser may be used instead to make the incision and break up the cataract. An alternative technique, extracapsular cataract extraction (ECCE), is used for more advanced cataracts. In ECCE, the lens is removed in one piece through a larger incision. - Inserting an intraocular lens (IOL)
Once the cataract is removed, a foldable IOL is inserted into the same opening through which the cataract was removed. In some cases, a special type of IOL called a toric lens may be used to correct astigmatism, a condition that causes blurry vision. - Closing the incision
The incision is typically self-sealing and does not require sutures (stitches) to close it. - Postoperative care
The patient will need to use antibiotics and anti-inflammatory eye drops for a few weeks after surgery. A protective shield may be placed over the eye to protect it while it heals.
Cataract surgery is typically a same-day procedure that does not require an overnight hospital stay. The entire surgery usually takes around 15-30 minutes per eye, and many patients experience improved vision immediately after the procedure.
Recovery period and result
Cataract surgery is a highly effective option in improving visual clarity, contrast, and vividness in individuals with cataracts. While recovery times can vary, many experience a noticeable improvement within a day of surgery.
Recovery is generally easy and mild discomfort or irritation during the first few days following surgery is normal. Most people can return to normal daily activities within a few days with proper wound care and avoidance of strenuous activities.
Clarity of vision gradually improves within a few weeks of the procedure, with stabilized vision at around four to six weeks post-surgery. The overall results of cataract surgery are often remarkable, with many achieving substantial improvements in vision that can enhance the quality of life. Individuals should follow their ophthalmologist’s advice for the best results and a speedy recovery.
