Understanding Cataract Surgery: A Simple Guide

Cataracts, a common eye condition, affect many people as they age. But what are cataracts, and how can they be treated?

A cataract is a clouding of the eye's natural lens, leading to blurry vision and difficulty seeing clearly. After age of 40, normal proteins in the lens start to break down. By age 60, many people may notice some cloudiness, although vision problems might not appear until years later.

Causes of Cataracts

For most people, cataracts result from the normal aging process and do not necessarily indicate an underlying disease or abnormalities. Several factors can lead to the development of cataracts, including:

• Family history of cataracts
• Some medical conditions, such as diabetes
• A history of eye injury or surgery
• Exposure to radiation treatment to the upper body
• Prolonged sun exposure without UV-protective sunglasses
• Certain medications, like corticosteroids
• Smoking

How Are Cataracts Treated?

Cataracts can only be removed through surgery. Surgery is usually recommended when cataracts interfere with daily activities. During the procedure, an eye surgeon removes the cloudy lens and replaces it with an artificial one called an intraocular lens (IOL).

What Are Intraocular Lenses?

An IOL is a tiny, artificial lens that replaces the eye's natural lens during cataract surgery. IOLs come in different focusing powers, similar to prescription glasses or contact lenses. Your ophthalmologist will measure your eye to determine the IOL's focusing power. There are various types of IOLs available:

• Monofocal IOLs have one focusing distance, usually set for clear distance vision. Reading glasses may still be needed.
• Multifocal and accommodative IOLs provide both distance and near focus at the same time.
• Extended depth of focus lenses offer correction for distance and intermediate vision.
• Toric lenses are designed for people with astigmatism (irregular shaped cornea) to correct the refractive error caused by the uneven cornea.

Planning for Cataract Surgery

When planning for cataract surgery, discuss your vision needs and expectations with your eye surgeon. 

Risks of Cataract Surgery

Like any surgery, cataract surgery carries some risks, such as:

• Eye infection
• Bleeding
• Ongoing swelling
• Detached retina
• Damage to other parts of the eye
• Seeing halos or glare
• Vision loss
• Possible dislocation of the IOL implant

What to Expect During Cataract Surgery

This outpatient procedure typically lasts about an hour, and you can go home the same day. Cataract surgery is usually performed in a surgery center or hospital. You'll be awake during the procedure, and your eye will be numbed with eye drops. Medication may be given to help you relax. While you might see light and movement, you won't see what the surgeon is doing.

Types of Cataract Surgery

1. Phacoemulsification: The most common technique, it uses ultrasound waves to break up the cloudy lens, which is then removed through a small incision.
2. Extracapsular Cataract Extraction: The cloudy lens is removed in one piece through a larger incision. This technique is now rarely used in the United States.
3. Laser-Assisted Surgery: This procedure uses a laser to make incisions and break up the cataract.

Postsurgery Care

After surgery, you won't be able to drive, so you’ll need to arrange for someone to take you home. You might need help at home as your doctor may limit activities, such as bending and lifting. Use eye drops as directed, and avoid getting soap or water in your eye. Don’t rub or press on your eye, and wear a protective eye shield while sleeping. Your eye surgeon will discuss when you can safely resume normal activities.