Everything You Need to Know About Cataract Surgery
What is cataract surgery?
The purpose of cataract surgery is to treat cataracts. The clouding of your eye lens is caused by clumps of proteins. Over time, your vision may deteriorate. They are the world's leading cause of blindness.
Behind your pupil and iris is your eye's lens, which allows you to focus on objects that are far away. An artificial lens is usually replaced with a cloudy lens during cataract surgery.
In the United States, cataract surgery is one of the most common and safest operations. Approximately 95 percent of people who undergo the procedure report improved vision.
Find out everything you need to know about cataract surgery by reading on.
Cataract surgery signs and symptoms
As you age, you are more likely to develop cataracts, and they tend to worsen over time.
In the early stages of lens changes, there is no significant visual impairment and surgery is not required. Usually, your doctor will recommend surgery when cataracts begin affecting your vision. It is a sign that you may need cataract surgery if you have trouble with everyday activities such as driving, reading, or seeing in bright light.
Cataracts can affect your vision in a number of specific ways, including:
- blurry vision
- impaired night vision
- colors appearing faded
- sensitivity to glare and bright lights
- halos around lights
- double vision
There are also congenital cataracts, which are present from birth. Children who suffer from congenital cataracts are among the most likely to become blind. A child tends to have a better outcome if surgery is performed before 6 weeks of ageTrusted Source.
There are several types of cataract surgery
Most modern types of cataract surgery involve replacing your lens with a transplant called an intraocular lens (IOL). Some of the most common cataract surgery techniquesTrusted Source include:
Phacoemulsification
During phacoemulsification, a surgeon will make a 2- to 3-millimeter-long incision in the front of your eye for an ultrasonic probe. The probe breaks up the cataract with vibration and removes the fragments with suction. A foldable lens is then inserted through the incision.
This technique leaves behind a small wound that doesn’t usually need sutures to heal.
Manual extracapsular cataract surgery (MECS)
During MECS, a surgeon makes a relatively large incision, between 9 to 13 millimeters long, and removes your lens and inserts the replacement IOL.
This technique has a higher risk of complications compared to phacoemulsification due to the larger incision. However, because of the low cost, it’s still performed in many parts of the world.
Manual small incision cataract surgery (MSICS)
MSICS is a variation of the MECS technique. It involves a smaller V-shaped incision that’s narrower on the outside of your eye and wider on the inside. The outer incision is about 6.5 mm to 7 mm and the internal incision is up to 11 mm.
A 2013 studyTrusted Source found that phacoemulsification and MSICS have similar long-term outcomes and comparable complication risks. However, phacoemulsification may have better short-term results in the 3 months following surgery while MSIC is cheaper to perform.
FLACS is a femtosecond laser-assisted cataract surgery.
FLACS uses a laser instead of a manual incision to make an incision in your eye. The laser can also divide and soften the cataract, requiring less phacoemulsification energy to remove it. The healing process can be accelerated as a result.
Lastly, the laser can create an arcuate incision, which can correct astigmatism. Astigmatism is the result of an irregular shape at the front of the eye that can cause blurry vision. You might not even need glasses if you have this condition. However, this method is more expensive. Marginal benefits and costs are still debated.
Intracapsular cataract surgery
In intracapsular cataract surgery, the entire lens and lens capsule are removed from the eye through a large incision. Because of the high risk of complications, it is rarely performed today.
Options for post-cataract surgery lenses
As a replacement for your natural lens, you can choose from several options. Choosing the right lens depends on your lifestyle and budget.
Lenses with monofocals
Insurance usually covers monofocal lenses, which are the most common type of lens replacement. The insurance provider may consider other lenses a premium and not cover them.
The best vision with monofocal lenses is at a particular distance. Many people choose to use distance glasses and reading glasses for near vision.
A toric lens
Toric lenses help correct astigmatism.
Extended depth-of-focus
Distance and intermediate vision are improved with extended depth-of-focus lenses. This is helpful when using a computer or performing many kinds of work.
Monofocal lenses can be accommodated
As opposed to traditional monofocal lenses, accommodating monofocal lenses can be adjusted according to eye muscle activity.
A multifocal lens
By splitting the light that enters your eye, these lenses allow you to see far and near objects clearly. However, splitting the light can cause halos and starbursts in some people's vision. Some people can adapt, but others cannot. Your doctor may be able to help.
Preparing for cataract surgery
About a week before the procedure, an eye doctor will likely perform an ultrasound and take measurements. Using this information, they can determine the size and shape of your eye and decide what surgery is best.
You will also be asked if you take any medications. Before your surgery, you may be given eye drops to use.
You will not have to stay overnight in an outpatient surgery center or hospital for cataract surgery. As soon as the procedure is complete, you will need to arrange for a ride home.
Depending on your provider, you may not be able to eat solid food six hours before your surgery. Avoid alcohol at least 24 hours before your surgery.
The cataract surgery procedure
According to the surgical technique your surgeon uses, your surgeon will perform a specific procedure. Both cataract surgeries will likely be scheduled weeks apart if you have cataracts in both eyes.
This is what you can expect during phacoemulsification:
- Local anaesthesia will be administered through an injection or eye drops to numb your eye. During the surgery, you will remain awake, but you will not be able to see what your surgeon is doing. To help you relax, you may be given a sedative.
- As your surgeon makes a small incision to the front of your eye, they will observe through a microscope. Once the incision has been made, they will use an ultrasonic probe to remove your cataract and break up your lens. Pieces will be suctioned out with the probe.
- The foldable lens implant will be inserted through the incision and positioned where your original lens was. This technique usually does not require stitches.
- After your surgery, you'll rest in a recovery area for about 30 minutes before going home.
How long does cataract surgery take?
Surgery for cataracts is usually very quick. From start to finish, the process takes just 20 to 30 minutes.
How painful is cataract surgery?
Even though you'll probably be awake during the procedure, you'll be given a local anesthesia, so you won't feel any pain. The procedure will probably be relatively painless.
Cataract surgery aftercare
It usually takes several days for you to notice significant improvement, though it may take up to a month for you to fully recover. For pain relief and to prevent infection, your healthcare provider may prescribe special eye drops. You may also be required to wear a protective mask when you sleep.
During your recovery, you should wear sunglasses to protect your eyes from the sun. You should also avoid touching your eyes or getting anything into them.
After cataract surgery, can you drive?
After surgery, you won't be able to drive, so you should arrange a ride home in advance. Driving may be possible several days after the surgery. A timeline specific to you should be discussed with your eye doctor.
How much time will you miss from work?
After surgery, most people feel better within a few days and can return to work within 1 to 2 days if there are no complications. However, you might have to refrain from lifting heavy objects or bending over for a few weeks.
Sleeping position after cataract surgery
In general, it's recommended that you sleep on your back or on the opposite side of your healing eye to avoid direct pressure that could dislodge your lens.
When can you exercise after cataract surgery?
Strenuous activities should be avoided immediately after surgery. The provider will be able to give you a specific timeframe for avoiding exercise. It is likely that they will recommend taking at least one week off from strenuous activities.
Other restrictions after cataract surgery
You should also avoid the following things after surgery to protect your eyes:
- getting water and soap in your eyes
- touching your eyes
- swimming
- wearing mascara for a week or two
- using face cream or lotion
- coloring or perming your hair for 1 to 2 weeks
- using hot tubs and saunas
- dusting and gardening
Possible cataract surgery complications and risks
Although cataract surgery is generally safe, like all surgeries, it comes with risks. These may include:
Cloudiness in the eye after cataract surgery
A cloudy layer known as posterior capsule opacification can develop behind your implant in 5 to 50 percent of cases. An office-based procedure called a YAG laser capsulotomy can be performed in about five minutes.
Blurred vision after cataract surgery
It is normal to experience blurriness shortly after cataract surgery. In most cases, it clears up within a few days but may take longer in some cases.
Floaters after cataract surgery
Floaters appear as specks of dust that follow your line of vision. Floaters may not require any specific treatment, but they are a sign of retinal tears in some cases.
Dry eyes after cataract surgery
It is common to experience dry or gritty eyes after your procedure. Eye drops can usually alleviate this.
Eye pain after cataract surgery
Infections and other complications can cause severe pain. Talk to your surgeon about how to treat it.
Double vision after cataract surgery
Many causes of double vision exist, but it is often caused by your brain getting used to its new visual acuity. Within a few days, it should resolve.
Infection
EndophthalmitisTrusted Source is an infection of the fluid that surrounds your inner eye. Only 0.05 to 0.30 percent of cataract surgeries result in this problem.
Anesthesia allergy
Any time you receive anesthesia, you might experience an allergic reaction. A severe reaction is rare.
Cataract surgery cost
If your surgery is deemed medically necessary, your insurance may cover the cost. Cataract surgery prices vary depending on location and type of surgery.
Anesthesia fees, hospital fees, postoperative care, and surgeon fees could cost approximately $2,500 for this procedure out of pocket, according to an article published by the American Academy of Ophthalmology in 2014. It may now be more expensive. For a more precise figure, you can speak with an ophthalmologist in your area.
Does Medicare cover cataract surgery?
The cost of cataract surgery is covered by Medicare if the procedure is performed with traditional surgical techniques or lasers.
A pair of corrective lenses or contacts required after eye surgery is covered by Medicare part B for 80 percent of the cost.
Cataract surgery recovery and prognosis
According to the National Eye Institute, about 9 out of 10Trusted Source people can see better after cataract surgery. The procedure is considered safe and has the potential to return your vision to its pre-cataract sharpness.
About 5 to 50 percentTrusted Source of people will develop posterior capsule opacification and require a second surgery to treat it.
How long can cataract surgery be postponed?
Cataracts are not considered a medical emergencyTrusted Source and tend to develop slowly. How long you can safely delay your surgery depends on how fast your cataracts are progressing.
It’s generally best to have the surgery as soon as possible, but if you need to wait, you should talk with a doctor to determine a safe timeframe.
If left untreated, cataracts will continue to progress and may lead to complete blindness.
It’s important for children with congenital cataracts to have them identified and treated as early as possible
Takeaway
In the United States, cataract surgery is one of the most common and safest types of surgery. It is a quick procedure that does not require an overnight stay in the hospital. Medicare and many insurance companies cover the cost.
If cataracts are impairing your vision, you might want to consult a doctor to see if you're a good candidate for surgery.
