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A cataract is a cloudy lens in the eye that causes blurry vision and gets worse over time. Cataract surgery removes cloudy lenses to help people see better. The surgery usually includes placing an artificial lens in the eye to restore vision.
Cataract removal surgery is a widely available ophthalmologic treatment in the U.S. It is surgery to remove cataracts — the painless, cloudy areas of the eye's lens that can block light from getting to the retina.
Inside the retina, nerve cells detect light as it enters and signal the brain to interpret what is seen through the eye. Cataracts obscure vision by blocking the light entering the eye.
While common in older adults, cataracts aren't always caused by aging. Sometimes, people have a family history of cataracts and may be more at risk of developing them. Anyone can get cataracts at any age; some may even be present at birth. They are the leading cause of blindness in the world and the leading cause of vision loss in the U.S.
Types of cataract surgery include:
Most adults and children who have cataract surgery receive intraocular lenses (IOLs). Your doctor will recommend the best type of IOL for you.
Depending on the type of IOL used, adults may not need glasses after surgery, but most children will need to wear glasses with their IOLs. Doctors typically wait until children are at least 6 months old before they place an IOL.
If an IOL can't be placed, which is rare, you may need contact lenses or thick glasses.
Cataract removal surgery is recommended if your cataracts interfere with daily activities, such as driving a car, reading a magazine, or watching television. If vision problems bother you or you have another vision-threatening eye disease, such as diabetic retinopathy or macular degeneration, cataract surgery might be right for you.
Most adults with cataracts in both eyes have two separate cataract surgeries. Cataract surgery usually is done on one eye at a time. You can usually have the second eye done a week or two after the first eye heals. Talk to your doctor about how long to wait between surgeries.
Some people may be able to have cataract surgery on both eyes at the same time. Ask your doctor if you are a candidate for this type of surgery.
Cataracts cause blurry vision that worsens over time. Surgery is the only way to remove a cataract.
However, surgery may not be needed right away and often can be delayed for months or years. Contacts, eyeglasses, and other vision aids let many people function fine in daily life, even with their cataracts. You may be able to make small changes to manage your cataracts.
Here are a few tips to help make life with cataracts easier until it’s time for cataract surgery:
If these changes aren't enough to improve your vision, your doctor might suggest surgery. Remember, cataracts usually don’t cause permanent eye damage, so you can decide when they affect you enough to warrant surgery.
Cataract surgery is very safe. Like every surgery, however, there are risks.
The most common complications of cataract surgery are:
Rarely, the surgeon is unable to remove the entire lens during surgery. In this case, another procedure to remove the remaining lens pieces will be done at a later time. Vision can still be improved.
Cataract surgery is usually done as an outpatient procedure, meaning you won’t need to stay overnight in the hospital. An ophthalmologist — a specialized eye doctor — performs the surgery.
Before your cataract surgery, your ophthalmologist will conduct a thorough eye exam and perform specific tests.
Here’s what you can expect:
Cataract surgery typically takes less than a half-hour for one eye.
First, a small incision (cut) is made in the cornea, the clear layer covering the eye. Then, a tiny hole is made in the front of the lens capsule so the doctor can access the cataract. A small tool called a phaco probe is inserted into the lens capsule.
Using ultrasound (sound waves), the probe breaks the cataract into small pieces. The surgeon then removes the cataract pieces from the eye using suction, leaving the lens capsule intact.
A replacement lens called an intraocular lens (IOL) is then placed inside the lens capsule to restore the eye's focusing power. The posterior capsule or back of the lens holds the IOL in place. The IOL takes the place of your eye's natural lens. The incision does not usually require stitches. Depending on the IOL’s power and type, you may not need glasses after surgery.
A number of artificial IOLs are available to replace your natural lens. Your doctor will recommend the type that may work best for you.
Adults are typically awake during cataract surgery. Local anesthesia (numbing medicine) is given through eyedrops or a shot to block pain. You’ll also receive medication to help you relax.
Children receive general anesthesia, which puts them into a deep sleep for cataract surgery.
Your doctor may close the incision with very small stitches or use a self-sealing method. If stitches are used, they may need to be removed later.
When cataract surgery is finished:
Before cataract surgery, a cloudy lens is visible to others through the pupil. After cataract surgery, the pupil will look black again because the lens is clear.
It's normal to have blurred vision right after your surgery, and you'll need to use eye drops for a few weeks.
You may also need to wear glasses or contacts after surgery. Be sure to protect your eye and watch for signs of an infection. Most people will see better in one to three days.
Here are a few more recovery tips:
Recovery typically takes about two weeks. If needed, you can have new glasses or contact lenses fitted during this time. And don’t forget your follow-up visit with your doctor!
After cataract surgery, your vision may become cloudy or blurry weeks, months, or even years later. This condition, known as posterior capsular opacification (PCO), is also known as secondary cataract or scar tissue. Unlike a skin scar, PCO occurs within the eye after healing from cataract surgery.
To understand a posterior capsule, imagine it as a transparent pocket within your eye. It holds the intraocular lens (IOL) in place. Before cataract surgery, this same capsule held your eye’s natural lens (with the cataract) in position.
Over time, the posterior capsule can become cloudy, making vision hazy again. Some people mistakenly think of this cloudiness as a scar because it occurs after surgery.
If you experience cloudy vision due to PCO, your doctor may recommend a laser procedure called a posterior capsulotomy or YAG laser capsulotomy. During this noninvasive procedure, the laser creates an opening in the cloudy capsule, allowing light to pass through and restoring clear vision.
If you have any concerning vision changes after your cataract surgery, consult with your ophthalmologist. They can guide you on the best course of action to maintain optimal eye health.
Cataract surgery is very common. An estimated 20.5 million (17.2%) Americans ages 40 years and older have cataracts in one or both eyes, and 6.1 million (5.1%) have had their cloudy lenses removed by surgery.
Cataract surgery costs in the U.S. typically range between $3,500 and $7,000 per eye for those without insurance. However, both Medicare and private insurance plans often cover all or part of these costs, significantly reducing out-of-pocket expenses by up to 80%.
Here are some key points about cataract surgery costs:
If you don’t have insurance coverage, consider discussing payment plans with your doctor’s office or exploring flexible spending accounts through your employer. Your ophthalmologist can provide more information on how to manage the cost of cataract surgery so ask about your options for affording the procedure.
According to the American Society of Cataract and Refractive Surgery (ASCRS), 95% of patients with a standard IOL placed during surgery achieve full vision restoration. In addition, the U.S. has a 99% success rate for cataract surgery.
The most important factor to consider in cataract surgery is the skill and experience of your eye surgeon.
