Cataract Surgery
What is a cataract?
A cataract is a clouding of the eye's naturally clear lens. The lens
focuses light rays on the retina — the layer of light-sensing
cells lining the back of the eye — to produce a sharp image
of what we see. When the lens becomes cloudy, light rays cannot pass
through it easily, and vision is blurred.
Light
rays entering an eye with a normal lens.
Light
rays entering an eye with a cataract. When a cataract forms, the lens
of your eye is cloudy. Light cannot pass through it easily, and your
vision is blurred.
What
causes cataracts?
Cataract
development is a normal process of aging, but cataracts also develop
from eye injuries, certain diseases or medications. Your genes may
also play a role in cataract development.
How
can a cataract be treated?
A cataract
may not need to be treated if your vision is only slightly blurry.
Simply changing your eyeglass prescription may help to improve your
vision for a while.
There
are no medications, eyedrops, exercises or glasses that will cause
cataracts to disappear once they have formed. Surgery is the only
way to remove a cataract. When you are no longer able to see well
enough to do the things you like to do, cataract surgery should be
considered.
In cataract
surgery, the cloudy lens is removed from the eye through a surgical
incision. In most cases, the natural lens is replaced with a permanent
intraocular lens (IOL) implant.
What
can I expect if I decide to have cataract surgery?
Before
Surgery
To determine if your cataract should be removed, your ophthalmologist
(Eye M.D.) will perform a thorough eye examination. Before surgery,
your eye will be measured to determine the proper power of the intraocular
lens that will be placed in your eye. Ask your ophthalmologist if
you should continue taking your usual medications before surgery.
You should
make arrangements to have someone drive you home after surgery.
The
Day of Surgery
Surgery is usually done on an outpatient basis, either in a hospital,
an outpatient surgical center, or an ambulatory surgery center. You
may be asked to skip breakfast, depending on the time of your surgery.
When
you arrive for surgery, you will be given eyedrops and perhaps a mild
sedative to help you relax. A local anesthetic will numb your eye.
The skin around your eye will be thoroughly cleansed, and sterile
coverings will be placed around your head. Your eye will be kept open
by an eyelid speculum. You may see light and movement, but you will
not be able to see the surgery while it is happening.
Under
an operating microscope, a small incision is made in the eye. In most
cataract surgeries, tiny surgical instruments are used to break apart
and remove the cloudy lens from the eye. The back membrane of the
lens (called the posterior capsule) is left in place.
During
cataract surgery, tiny instruments are used to break apart and remove
the cloudy lens from the eye.
A plastic, acrylic, or silicone intraocular lens is implanted in the
eye to replace the natural lens that was removed.
An intraocular
lens (iol) implant
In cataract
surgery, the intraocular lens replaces the eye's natural lens.
After
surgery is completed, your doctor may place a shield over your eye.
After a short stay in the outpatient recovery area, you will be ready
to go home.
Following
Surgery
You will need to:
- Use
the eyedrops as prescribed
- Be
careful not to rub or press on your eye
- Avoid
strenuous activities until your ophthalmologist tells you to resume
them
- Ask
your doctor when you can begin driving
Wear
eyeglasses or an eye shield, as advised by your doctor
You
can continue most normal daily activities. Over-the-counter pain medicine
may be used, if necessary.
Is a laser used during cataract surgery?
Laser
surgery is not used in cataract removal surgery. However, the lens
capsule (the part of the eye that holds the lens in place) sometimes
becomes cloudy several months or years after the original cataract
operation. If the cloudy capsule blurs your vision, your ophthalmologist
can perform a second surgery using a laser. During the second procedure,
called a posterior capsulotomy, a laser is used to make an opening
in the cloudy lens capsule, restoring normal vision.
Posterior
capsulotomy: a laser is used to make an opening in the cloudy lens capsule.
Will cataract surgery improve my vision?
The success
rate of cataract surgery is excellent. Improved vision is achieved
in the majority of patients. Only a small number of patients continue
to have problems following cataract surgery.
Complications
After Cataract Surgery
Though
they rarely occur, serious complications of cataract surgery are:
- Infection
- Bleeding
- Swelling
- Detachment
of the retina
Call your ophthalmologist immediately if you have any of the following
symptoms after surgery:
- Pain
not relieved by nonprescription pain medication
- Loss
of vision
- Nausea,
vomiting or excessive coughing
- Injury
to the eye
Even if cataract surgery is successful, some patients may not see
as well as they would like to. Other eye problems such as macular
degeneration (aging of the retina), glaucoma or diabetic retinopathy
may limit vision after surgery. Even with these problems, cataract
surgery may still be worthwhile.
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Copyright
© 2003 American Academy of Ophthalmology®
