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Cataract surgery

Key points

  • Cataract surgery is an operation to remove the cloudy lens in your eye and replace it with a clear artificial lens.
  • Cataract surgery is usually done as a day-case procedure, so you will be able to go home the same day.
  • It’s done with a local anaesthesia, so you will stay awake during the procedure. You may see some light and movement, but won’t feel any pain.
  • The operation usually takes around 30 minutes.
  • After the operation, your sight should start to improve within a few days, though may take a few weeks to fully heal.

Video: How cataract surgery is carried out 

Cataract surgery involves removing the cloudy natural lens inside your eye and replacing it with an artificial lens made of clear plastic.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About cataract surgery

As you get older, the lens in your eye can gradually become less transparent and your vision may start to look misty. If the lens in your eye becomes cloudy like this then you’re said to have a cataract.

Cataracts usually develop over a long period of time, causing your eyesight to gradually get worse. If a cataract is left untreated, the lens will eventually become so clouded that it’s impossible for you to see any detail at all, and your vision will become severely affected. You may also find that bright lights glare or dazzle you more than they used to.

Cataract surgery is an operation to remove the cloudy lens and replace it with a clear artificial lens. This will mean you can see more clearly. You can have cataracts removed at any stage; you don’t need to wait until your eyesight is badly affected.

You can develop cataracts in one or both eyes. If you have cataracts in both eyes, your surgeon will usually suggest you have them removed one at a time, starting with the eye that is most severely affected.

Animation - How cataract surgery is carried out

What are the alternatives?

Removing the cloudy lens and putting a new lens inside your eye is the only way to restore your vision.

Glasses or other visual aids may help you to see better in the short-term. However, they can’t be used to treat a cataract and if your vision becomes poor they may not help.

Preparing for cataract surgery

Your surgeon will explain how to prepare for your operation. He or she will also discuss your options for the type of artificial lens you will have fitted.

You may have a pre-operative assessment. An ophthalmologist (a doctor who specialises in eye health, including eye surgery) will measure your eye and vision. These tests help to decide which artificial lens will be best for you, so your vision is as good as possible after the surgery.

Cataract surgery is usually done as a day case. This means you have the procedure and go home the same day.

The operation is usually done under local anaesthesia. This completely blocks pain from the area around your eye and you will stay awake during the procedure. You may be given the local anaesthetic as eye drops or an injection.

You can also have cataract surgery done under general anaesthesia, although this is less common. If you have a general anaesthetic, you will be asleep during the operation.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during cataract surgery

The operation usually takes around 30 minutes.

You will have eye drops put in to widen your pupil and relax the muscles in your eye. This makes it easier for your surgeon to examine your eye and remove the lens. He or she will also put local anaesthetic eye drops into your eye and place a clean drape over your face. The drape will make a small tent over your face so you can still breathe and speak easily.

Once the anaesthetic has taken effect, your surgeon will make tiny cuts on the surface of your eye. Although your eye is open and you will be awake, you won’t be able to see the instruments being used, however you may see light and some movement. You won’t feel any pain.

Your surgeon will use a special instrument to break up the cloudy lens. You may hear a soft buzzing sound when it’s being used. He or she will remove the broken lens from your eye leaving behind the capsule it sits in. The new artificial lens is then put in, where it will stay permanently.

Your surgeon will usually leave your eye to heal naturally without stitches.

What to expect afterwards

After a local anaesthetic, it may take several hours before the feeling comes back into your treated eye. Your eye is likely to be covered with a protective pad, which you will need to wear overnight.

You may need pain relief to help with any discomfort as the anaesthetic wears off. You may be given antibiotic eye drops to use at home to help prevent an infection. You may also be given steroid eye drops to help control inflammation in your eye.

You will usually be able to go home when you feel ready. However, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.

Recovering from cataract surgery

If you have been prescribed antibiotic eye drops, it’s important to complete the whole course.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You should start to get feeling back in your eye after a few hours. Your vision should start to improve within a few days, however it may take a few weeks to heal completely.

There are some important instructions to follow for the first 10 days after cataract surgery. The main ones are listed below.

  • Don’t touch or rub your eye. If you’re a restless sleeper you can wear an eye patch at night to protect your eye.
  • Keep soap and shampoo out of your eyes.
  • Don’t do any heavy lifting or strenuous exercise for the first few weeks after the operation, as this can increase the pressure in your eye and could put strain on your healing scar.
  • Don’t wear eye make-up, drive or go swimming until your surgeon tells you it’s safe to do so.
  • If you go out when it’s windy, protect your eye from grit and dust.

See your GP if you have any symptoms, including:

  • severe pain
  • loss of vision
  • redness in your eye that continues to get worse

It usually takes about two to six weeks to make a full recovery from cataract surgery, but this varies between individuals, so it’s important to follow your surgeon’s advice.

Once your eye has healed, you may need to have an eye test and new prescription glasses.

What are the risks?

As with every procedure, there are some risks associated with cataract surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of cataract surgery include:

  • an itchy or sticky eye and blurred vision
  • mild pain, discomfort and bruising of your eyelid or eye
  • sensitivity to bright light
  • reduced central vision that usually returns to normal after treatment

Complications

Complications are when problems occur during or after the operation.

The most common complication of cataract surgery is called posterior capsule opacification (PCO). This is when cells from the removed lens are left behind after surgery and begin to grow back. This causes problems with your vision similar to having a cataract. You can have laser treatment to correct the problem.

Other complications of cataract surgery are rare but can include:

  • an eye infection
  • a tear in your lens capsule
  • problems with the new lens, such as the wrong type of lens used or problems with its position in your eye
  • a detached retina

If any of these complications occur, you may need to have another operation.

 

Produced by Dylan Merkett, Bupa Health Information Team, January 2013.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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