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Cataract removal

Definition

Cataract removal is a procedure to remove a clouded lens (cataract) from the eye. Cataracts are removed to improve vision. The procedure almost always includes placing an artificial lens in the eye.

Alternative Names

Cataract extraction; Cataract surgery

Description

The normal lens of the eye is transparent (clear). As a cataract develops, the lens becomes cloudy and blocks light from entering your eye. Without enough light, you cannot see as clearly.

Cataracts are painless. Mostly, they develop in the elderly. But sometimes children are born with clouded lenses that are caused by infections or other problems before birth. These are called congenital cataracts.

Surgery is usually recommended for people who cannot see well because of their cataracts. The surgery is performed in a hospital or surgery center in an outpatient clinic.

• Adults are usually awake for the procedure. You will receive local anesthesia (numbing medicine) to block pain and a sedative to relax you.
• Children usually receive general anesthesia to make them unconscious and unable to feel pain.

Looking through a microscope, the doctor will make a small incision (cut) in the eye. The surgeon then removes the lens. It can be removed in several ways, depending upon the type of cataract you have. Two ways to remove it are:

• With surgical instruments and suction
• With an instrument and machine that uses sound waves (ultrasonic energy) to break up the lens and suction it out. This is called phacoemulsification.

A man-made lens, called an artificial intraocular lens (IOL), is usually placed next. It will help improve your vision.

The doctor will close the incision with very small sutures (stitches) or use a self-sealing (sutureless) method. If sutures are placed, they may need to be removed later.

The surgery usually lasts less than an hour. Most times, just one eye is done. If both eyes need it, your surgeon may recommend waiting 1 to 2 months before having cataract surgery on the other eye.

Why the Procedure Is Performed

The purpose of cataract surgery is to remove the clouded lens and replace it with an artificial lens to restore clear vision. Your doctor may recommend cataract removal surgery if you have loss of vision or other vision problems caused by clouding of your lens.

Cataracts usually do not harm your eye, so surgery can be done when it is convenient for you.

Risks

Complications of cataract surgery are rare.

Rarely, the surgeon is not able to remove the entire lens. If this happens, a procedure to remove all of the lens fragments will be needed at a later time. Most patients who need this procedure still do very well.

In other very rare cases, infection can occur after cataract surgery. This can lead to permanent vision problems.

Before the Procedure

An ophthalmologist (a medical doctor who treats the eye) will give you a complete eye exam and eye tests. These tests will include an ultrasound or another method that allows the doctor to see the inside of your eye. These tests help your doctor choose the new lens that will be placed in your eye during surgery. Your doctor may prescribe eye drops before the surgery.

After the Procedure

You will probably return home after surgery and then have a follow-up exam with your doctor the next day. Your doctor may ask you to wear a patch over your operated eye until your exam the next day. After this, you may want to wear dark sunglasses outside.

Your doctor may prescribe antibiotic and anti-inflammatory eye drops to use for 1 or more weeks to help with healing.

Make sure your hands are clean before touching your eye. Try not to get soap and water in your eye when you are bathing or showering for the first few days.

If your doctor closed your incision with sutures, you may need to schedule a visit to have them removed.

Take it easy. Light activities are best as you recover. Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.

Expect complete healing in about 10 weeks. If you need new glasses or contact lenses, have them fitted after you have healed completely. It is important to have a follow-up visit with your doctor.

Outlook (Prognosis)

The outcome of cataract surgery is usually excellent. The operation has low risk, the pain is minimal, and recovery time is short. Sight improves for most people.