Key takeaways

  • Surgery is the only way to remove a cataract. It involves removing the damaged lens of the eye and replacing it with an artificial lens to restore vision.
  • Cataract surgery typically takes around an hour. The surgeon will numb the eye so the procedure will be painless, although people may experience itching or discomfort afterward.
  • Recovery from cataract surgery can take around 8 weeks. Most people experience a favorable outlook with improved vision.

A cataract is a cloudy area that forms in the lens of a person’s eye. It can cause vision to become foggy or blurry.

This article discusses what to expect before, during, and after cataract surgery, as well as the potential risks and benefits of the procedure.

The most suitable type of cataract surgery may depend on factors such as the type of cataract, other health conditions a person has, and the severity of the cataract.

Here are some different types of cataract surgery:

Phacoemulsification

During this type of cataract surgery, a doctor uses an ultrasonic probe to break up the cataract and removes the pieces with a vacuum. This process, called phacoemulsification, is the gold standard procedure for removing cataracts.

Most cataract surgeries in the United States use phacoemulsification.

Manual small incision cataract surgery

During manual small incision cataract surgery (MSICS), a surgeon creates a small external incision and a large internal incision that can self-seal following the replacement of the lens.

The surgeon then manually breaks up the cataract and removes the pieces with a vacuum.

Extracapsular cataract extraction

Manual extracapsular cataract extraction creates a large incision in the cornea through which a surgeon extracts the cataract.

This type of cataract surgery may be cheaper than alternatives such as phacoemulsification, but may involve a higher risk of complications.

The National Eye Institute (NEI) provides the following guidelines for preparing for cataract surgery:

  • Visit the eye doctor: Before surgery, an ophthalmologist will assess the health of the eye by examining the cornea and retina. They will also measure the size and shape of a person’s eye to select an appropriate replacement lens, called an intraocular lens (IOL).
  • Use special eye drops: An ophthalmologist may prescribe eye drops to help prevent eye infections. They may also prescribe antibiotics, steroids, and anti-inflammatory eye drops for a person to use after surgery.
  • Discuss medications: A person should inform their ophthalmologist about any medications or supplements they take, as certain medications or supplements may cause bleeding during surgery.
  • Fast before surgery: An ophthalmologist may ask a person not to eat or drink anything for at least 6 hours before surgery.
  • Clean eyelids and eyelashes: An ophthalmologist may ask a person to wash their eyelids and eyelashes with baby shampoo the night before and the morning of the surgery. This helps remove pathogens that may otherwise cause infection.

On the day of the surgery

The American Academy of Ophthalmology (AAO) notes that cataract surgeries can occur in a hospital or an outpatient surgery center.

Before surgery, a healthcare professional will explain the procedure and aftercare instructions.

A person should arrange transportation on the day of their surgery, as they cannot drive following the procedure.

Cataract surgery typically lasts around 1 hour. However, other factors, including arrival and recovery, may mean people should plan for around 2 to 3 hours.

People typically remain awake during the procedure and receive medications to numb the area so they do not feel any pain or discomfort.

Cataract surgery typically involves the following:

  • Step 1: The surgeon numbs the eye with eye drops or an injection around it. A person may also receive medication to help them relax.
  • Step 2: Using a special microscope as a guide, the surgeon makes small incisions near the edge of the cornea to access the eye’s lens. Once inside, doctors will open the clear membrane covering the front of the lens to expose the lens contents.
  • Step 3: Depending on the type of surgery, the surgeon will use an ultrasound instrument to break up the cataractous lens into smaller fragments or create a larger corneal incision to remove the lens in one piece.
  • Step 4: The surgeon replaces the lens with an IOL.

The incisions from cataract surgery generally heal on their own. A doctor will place a shield over the person’s eye to protect it while it recovers.

After surgery, a person will rest in a recovery area for 15⁠ to 30 minutes. They will then be able to go home.

A person’s eye may feel itchy, uncomfortable, or sensitive to light for 1 to 2 days after surgery.

In the weeks following the surgery, a person may need to avoid certain activities, such as:

  • touching, rubbing, or pressing the eye
  • getting soap or water in the eye
  • bending over
  • lifting heavy objects
  • wearing eye makeup

A person should speak with a doctor immediately if they notice any of the following:

  • vision loss
  • very red eyes
  • severe pain that will not go away
  • floaters — small dark spots, threads, or wiggly lines that float across the vision

A person’s eye should be fully healed 8 weeks after cataract surgery. Speak with the doctor if you experience blurred vision that persists longer than 2 months after surgery.

Before undergoing cataract surgery, people should talk with an ophthalmologist about the risks and potential benefits. Some examples are as follows:

Risks of cataract surgery

Some risks associated with cataract surgery include:

Discuss the risks of surgery with your eye doctor, and don’t hesitate to ask for clarification on anything you are unsure about prior to having your surgery.

Benefits of cataract surgery

According to the American Optometric Association (AOA), cataract surgery improves vision in around 90% of cases.

Other potential benefits of cataract surgery include:

  • a reduced need for glasses, which may encourage some individuals to resume certain hobbies or activities
  • a reduced risk of injuries from falls
  • a reduced risk of dementia

Cataract surgery is one of the safest and most efficient surgeries in the United States. Around 90% of people who undergo cataract surgery experience improved vision, according to the American Optometric Association.

A cataract cannot grow back after cataract surgery; however, a person can develop secondary cataracts in the weeks, months, or years afterward.

This happens when cells from the previous natural lens remain in a part of the eye called the posterior lens capsule (PLC), which now contains the artificial lens.

Over time, these cells accumulate, clouding the PLC and preventing light from reaching the retina.

Surgeons can typically correct secondary cataracts with a procedure called a posterior capsulotomy, which can be done in a doctor’s office. This involves using a laser to clear an opening in the cloudy PLC, allowing light to pass through for clear vision.

According to the NEI, cataract surgery is almost painless. A person will be awake during the procedure, but the surgeon will numb the eye and may administer other medications to help them relax.

A person with cataracts in both eyes must have surgery on each eye separately. They will need to wait around a month between each procedure.

Cataract removal can help doctors see into the back of the eye. As such, cataract surgery may help doctors monitor and treat other vision issues, such as those related to diabetic retinopathy and age-related macular degeneration (AMD).

The treatment for cataracts is cataract surgery, which involves removing the cloudy natural lens and replacing it with an artificial lens implant to restore vision.

There are two types of cataract surgery: small incision and extracapsular. The former involves making a series of small incisions around the cornea and using an ultrasound device to break up and remove the cloudy lens contents.

The latter involves making a larger incision to remove the cloudy lens contents as a single piece. Generally, both types of surgery are painless, with little to no discomfort.

Most people who undergo cataract surgery report improvements in their vision. A person should discuss the potential risks and benefits with an ophthalmologist before deciding whether to undergo the procedure.