If
you have a cataract,
there are several treatments available to you.
A
cataract is a clouding of the lens in the eye that typically will affect
your vision. Most cataracts are related to aging. People who have cataracts
often have other vision problems in one or both eyes that accompany
the cataract, such as Nearsightedness
(Myopia), Farsightedness
(Hyperopia), Astigmatism
(blurred vision), and/or Presbyopia
(reading problems).
Both
surgical and non-surgical treatments are available to treat patients
with cataract. In addition, there are several ways to treat vision after
a cataract is removed. This discussion of cataract surgery provides
information about the cataract surgery procedure, including how the
cataract lens is removed, as well as the available surgical and non-surgical
options to treat your vision.
We
hope you find our discussion helpful. Please scroll down to learn more
about cataract surgery discussion or you can access a particular section
by clicking on a link below:
Table
of Contents for Cataract Eye Surgery
How
Is a Cataract Treated?
Treatments
to Correct Vision Problems Accompanying Cataracts
Non-Surgical
Treatments
Surgical
Options
How
Is a Cataract Treated?
Early
Treatment of Cataracts. The symptoms
of an early cataract may be improved with new eyeglasses, brighter lighting,
anti-glare sunglasses, or magnifying lenses. If these measures do not
help, cataract eye surgery is currently the only effective treatment.
At present, there is no medical treatment for cataracts, only surgery.
For example, there are no drops that will dissolve a cataract.
What
Does Cataract Surgery Involve? Cataract
surgery involves removing the cloudy lens in your eye and replacing
it with an artificial lens known as an Intraocular Lens Implant or IOL.
Cataract surgery involves removing the cloudy lens in your eye and replacing
it with an artificial lens known as an Intraocular Lens Implant or IOL.
When
Should I have Cataract Surgery? A Cataract
needs to be removed only when vision loss interferes with your everyday
activities, such as driving, reading, participating in sports, or watching
TV. You and your eye care professional can make this decision together.
Once you understand the benefits and risks of cataract surgery, you
can make an informed decision about whether cataract surgery is right
for you. In most cases, delaying cataract surgery will not cause long-term
damage to your eye or make the surgery more difficult, which is why
many people decide to have the surgery only when it significantly interferes
with their vision.
In
other words, if you have a cataract and are a candidate for this procedure,
you do not have to rush into surgery. We recommend taking the time to
find a cataract surgeon with proven experience and expertise. You can
find many highly qualified cataract surgery experts in our Trusted
LASIK Surgeons Directory.
In
some cases, a cataract should be removed from your eye even if it does
not cause significant problems with your vision. For example, a cataract
should be removed if it prevents examination or treatment of another
eye problem, such as age-related macular degeneration or diabetic retinopathy.
If
your eye care professional finds a cataract, you may not need cataract
surgery for several years. In fact, you might never need cataract surgery.
By having your vision tested regularly, you and your eye13When_Will
care professional can discuss if and when you might need treatment.
If you are found to have cataracts during a refractive surgery consultation,
your eye care professional may refer you to a vision correction surgeon
with experience in cataract surgery to remove the cataract and treat
any vision problems that accompany your cataract.
People who need cataract surgery may also have other eye conditions,
such as age-related macular degeneration or glaucoma. If you have other
eye conditions in addition to a cataract, please talk with your eye
doctor to learn about the risks, benefits, alternatives, and expected
results of cataract surgery in your particular case.
What
Are the Different Types of Cataract Surgery?
There
are two types of cataract surgery to remove your cataract and replace
with an intraocular lens (IOL) implant to help improve your vision.
Your doctor can explain the differences and help determine which is
better for you:
1.
Phacoemulsification, or phaco. Almost all cataract surgery today
is done by phacoemulsification, also called "small incision cataract
surgery." The Phaco procedure is by far the most common way to
remove a cataract and is the procedure of choice for most cataracts.
A small incision is made on the side of the cornea, the clear, dome-shaped
surface that covers the front of the eye. Your doctor inserts a tiny
probe into the eye. This device emits ultrasound waves that soften and
break up the lens so that it can be removed by suction. After the cataract
is removed, an Intraocular Lens Implant (IOL) is placed inside the eye
to refocus the light rays. An IOL is a clear, plastic lens that requires
no care and becomes a permanent part of your eye. The IOL not only replaces
the cloudy cataract but can also correct nearsightedness (myopia), farsightedness
(hyperopia) and astigmatism (blurred vision). In most cases a suture
is not required since the incision is generally very small (less than
3 mm). This is referred to as “No Stitch” Cataract Surgery.
For more details on Intraocular
Lens Implants and how they can correct and improve your vision please
visit.
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2.
Extracapsular Surgery. In Extracapsular Surgery, your eye surgeon
makes a longer incision on the side of the cornea and removes the cloudy
central core of the lens (nucleus) in one piece. The rest of the cataract
lens is removed by suction. After the natural lens has been removed,
it is replaced by an intraocular lens implant (IOL) just as in the phaco
procedure.
Patients
who have another eye disease or have significant problems during cataract
surgery cannot always have an IOL. For these rare complications, a soft
contact lens or glasses that provide high magnification may be the best
vision correction treatment available.
Complications: What Are the Risks of Cataract Surgery?
As
with any surgery, cataract surgery poses general risks, such as infection
and bleeding. If you are properly diagnosed and informed of those risks
specific to you, your eye surgeon should recommend taking appropriate
precautions. For example, before cataract surgery, your eye doctor may
ask you to temporarily stop taking certain medications that increase
the risk of bleeding during surgery or make the surgery more complicated.
In men, the use of drugs such as Flomax to aid in urination, can make
the surgery more complicated and special techniques are necessary to
control the size of the pupil. As long as the surgeon is aware that
you are taking the drug, the results are usually satisfactory. After
any cataract surgery, you must keep your eye clean, wash your hands
before touching your eye, and use the prescribed medications to help
minimize the risk of infection to your eyes. A serious infection can
result in loss of vision.
Cataract
eye surgery slightly increases your risk of retinal detachment. Other
eye disorders, such as high myopia (nearsightedness), can further increase
your risk of retinal detachment after cataract surgery. One sign of
a retinal detachment is a sudden increase in flashes or floaters or
a shadow in the peripheral vision. Floaters are little "cobwebs"
or specks that seem to float about in your field of vision. If you notice
a sudden increase in floaters or flashes, please see an eye care professional
immediately, preferably an experienced refractive surgeon. A retinal
detachment is a medical emergency. If necessary, go to an emergency
service or hospital. Your eye must be examined by an eye surgeon as
soon as possible. While a retinal detachment causes no pain, obtaining
early treatment for retinal detachment often can prevent permanent loss
of vision. The sooner you get treatment for a detached retina, the more
likely you will regain good vision. Even if you are treated promptly,
some vision may be lost. Symptoms which might indicate a possible retinal
detachment include floaters and/or flashes. This is caused by a separation
of the vitreous which is a normal part of the aging process. If you
also notice a shadow, or curtain, covering a portion of your peripheral
vision, you should be evaluated immediately for a possible retinal detachment.
Please
discuss these and any risks of cataract eye surgery with an experienced
refractive surgeon to make sure Cataract Surgery is right for you.
Is
Cataract Surgery Effective?
Cataract
removal is one of the most common eye surgery operations performed in
the United States. With an experienced refractive surgeon, cataract
surgery is also one of the safest and most effective types of surgery.
In over 90% of cases of people with cataracts, those patients who have
cataract eye surgery have better vision afterward since vision problems
can be treated simultaneously with lens implants as further discussed
in the section
What Tests Are Generally Performed Before Cataract Surgery?
A
week or two before cataract surgery, your doctor will do some tests
on your eyes. These tests may include measuring the curve of the cornea
and the size and shape of each eye. The information from these tests
and measurements helps your eye surgeon recommend the type of Intraocular
Lens Implant that can best improve your vision problems. In the past,
the IOL implant was designed to either correct your distance vision
or it could be targeted to correct your reading vision (Monovision).
In the past few years, other types of implants have been approved by
the FDA including lenses to correct for astigmatism (Toric Implants)
and presbyopia correcting implants lenses-- like multifocal implants
or accommodating implants—that can help correct your vision for
both near and far vision.
What
To Expect Just Before Cataract Surgery
You
will have a medical check-up by your regular doctor to make sure it
is safe to have cataract surgery. This check up will usually include
blood tests and an EKG.
You
will be asked not to eat or drink anything 12 hours before your cataract
surgery.
You
may also be asked to apply eye drops on the day before surgery.
What
Happens During Cataract Surgery?
To
prepare your eye for cataract surgery, drops will be put into your eye
to dilate the pupil and the area around your eye will be washed and
cleansed.
Cataract
surgery usually lasts less than one hour and is almost painless. Many
patients choose to stay awake during surgery. Others may need to be
put to sleep for a short period of time.
If
you are awake, you will have an anesthetic to numb the nerves in and
around your eye.
After
cataract surgery, a patch may be placed over your eye. You will rest
for a while. Your medical team will monitor your eye for any problems,
such asbleeding. Most patients who have cataract surgery can go home
within an hour of the procedure. You should always arrange for someone
to drive you home.
What Happens After Cataract Surgery?
Itching
and mild discomfort are normal after cataract surgery. Some fluid discharge
is also common. Your eye may be sensitive to light and touch. After
one or two days, moderate discomfort should disappear. If you have any
discomfort that continues, contact your eye doctor to get this treated.
For
a few days after surgery, your doctor may ask you to use eyedrops to
help healing and decrease the risk of infection. Ask your doctor about
how to use your eyedrops, how often to use them, and what effects they
can have. You will need to wear an eye shield or eyeglasses to help
protect your eye. Avoid rubbing or pressing on your eye.
When
you are home, try not to bend from the waist to pick up objects on the
floor. Do not lift any heavy objects. You can walk, climb stairs, and
do light household chores.
In
most cases, healing will be complete within eight weeks. Your doctor
will schedule exams to check on how you are progressing.
What Problems Can Develop After Cataract Surgery?
Significant
problems after cataract surgery are rare, but they can occur. Thesecomplications
can include infection, bleeding, inflammation (pain, redness, swelling),
loss of vision, double vision, and high or low eye pressure. If any
of this occurs, please seek prompt medical attention since these problems
can usually be treated successfully.
In
some cases, the eye tissue that is behind the IOL may become cloudy
and blur your vision. This condition is called an after-cataract. An
after-cataract may develop anywhere from a few months to years after
you have your cataract surgery.
An
after-cataract may be treated with a laser. An experience eye doctor
uses a laser to make a tiny hole in the eye tissue behind the lens to
let light pass through. This outpatient procedure is called a YAG laser
capsulotomy. It is painless. In rare cases, this procedure will result
in increased eye pressure or other eye problems. As a precaution, your
eye doctor may give you eye drops to lower your eye pressure before
or after the procedure.
When Will My Vision Return To Normal?
You
can return quickly to many everyday activities, but your vision may
be blurry. The healing eye needs time to adjust so that it can focus
properly with your other eye, especially if your other eye has a cataract.
Be sure to ask your eye doctor when it is safe for you to resume driving.
If
you received an IOL (lens implant), you may notice that colors have
become brighter than before. This is because IOL is clear, unlike your
natural lens which may have had a yellowish or brownish tint. Typically,
you will become accustomed to the improved vision within a few months
after receiving an IOL. Also, when your eye heals, you may need new
glasses or contact lenses depending on the type of lens you had implanted
and what vision correction was achieved.
What Can I Do If I Already Have Lost Some Vision From a Cataract?
If
you have lost some sight from cataract or cataract surgery, ask your
eye care professional about low vision services and devices that may
help you make the most of your remaining vision. Ask for a referral
to a specialist in low vision. Many community organizations and agencies
offer information about low vision counseling, training, and other special
services for people with visual impairments. A nearby school of medicine
or optometry may provide low vision services.
Treatments
to Correct Vision Problems Accompanying Cataracts
Summary
If
you have Cataract, you will likely have other vision problems in one
or both eyes that accompany the Cataract, which can include Nearsightedness
(Myopia), Farsightedness (Hyperopia), Astigmatism (blurred vision),
and/or Presbyopia (reading problems).
Depending
on your vision correction needs as well as the health and condition
of your eyes, there are various vision correction surgical procedures
that can be performed during the cataract surgery as well as some non-surgical
treatments that may be available after your cataract surgery procedure.
For example, different IOLs can be implanted during your cataract surgery
to correct nearsightedness, farsightedness, astigmatism, and/or presbyopia.
In addition, treatments that do not involve refractive eye surgery consist
of glasses and contact lenses.
Monovision
Correction. Monovision is where one eye is focused for distance vision
and the other eye is focused for near vision. Some people have monovision
naturally and others may have been corrected for monovision through
glasses, contact lenses, or a refractive surgery procedure such as LASIK.
For many cataract patients, monovision may be a viable course of treatment
to improve your vision in conjunction with your cataract surgery.
Please
consult an experienced cataract surgeon to help you determine what options
and treatments are best for you when considering cataract surgery and
correcting your vision.
Correcting
Nearsightedness with Cataracts
If
your cataract eye is nearsighted, the following treatments may help
improve your vision:
- Non-Surgical
Treatments
- Refractive
Surgery Options
- Accommodating
Lens Implants
- Monofocal
Lens Implants for Monovision Correction
- Toric
Lens Implants
To
learn more about the available treatments for nearsightedness that accompany
your cataract, please click on specific vision correction treatments
listed above.
Correcting
Farsightedness with Cataracts
If
your Cataract eye is Farsighted, the following treatments may help improve
your vision:
- Non-Surgical
Treatments
- Refractive
Surgery Options
- Monofocal
Lens Implants
- Accommodating
Lens Implants
- Monofocal
Lens Implants (including for Monovision Correction)
To
learn more about the available treatments for farsightedness that accompany
your cataract, please click on specific vision correction treatments
listed above.
Correcting
Astigmatism with Cataracts
If
you have significant Astigmatism, you may be able to improve your vision
through the following treatments:
- Non-Surgical
Treatments
- Refractive
Surgery Options
- Toric
Lens Implants
- Limbal
Relaxing Incisions
To
learn more about the available treatments for Astigmatism that accompany
your cataract, please click on specific vision correction treatments
listed above.
Correcting
Presbyopia with Cataracts
If
you have reading problems known as Presbyopia, the following options
to improve your vision may be available:
- Non-Surgical
Treatments
- Refractive
Surgery Options
- Toric
Lens Implants
- Multifocal
lens implants
- Accommodating
lens implants
- Limbal
Relaxing Incisions
To
learn more about the available treatments for Presbyopia that accompany
your cataract, please click on specific vision correction treatments
listed above.
Non-Surgical
Treatments
Below
are treatments that do not involve eye surgery than can correct the
following vision problems that can accompany cataracts:
Glasses.
If your vision cannot be corrected with an IOL (lens implant) or is
not completely corrected with an IOL at the time of your cataract surgery,
you typically can be fitted with glasses as you were before the surgery.
You may also be corrected for Monovision, which may be an option where
one eye is corrected for distance and the other eye is corrected for
nearer or closer vision.
Contact
Lenses. If you were comfortable with wearing contact lenses before
you had your cataract removed, this is often an available option to
improve and correct your vision. For some patients an available option
may be Monovision, where one eye is corrected for distance and the other
eye is corrected for closer vision.
Surgical
Options
With
the exception of Limbal Relaxing Incisions, the available vision correction
surgical procedures involve various types of Intraocular Lens Implants
(IOL), which are inserted into the eye to replace the cataract lens
during cataract eye surgery. If you have a Cataract, IOLs can be inserted
during your Cataract Surgery procedures. If you do not have a Cataract
in your eye but have vision problems, lens implants are at times a better
option than laser vision surgery. Please discuss your options with an
experienced refractive surgeon to determine the best course of treatment
for your vision. Below are refractive lens implant procedures that can
help improve your vision:
Lens
Implant Procedures (IOLs)
-
Toric
Implants
-
Multifocal
Implants
-
Accommodating
Implants
-
Monofocal
Lens Implants
Other
Refractive Surgery Procedures:
- Limbal
Relaxing Incisions
- Arcuate
Incisions
As
you can see, several vision problems can often accompany a cataract
in one or both of your eyes- nearsightedness, farsightedness, astigmatism
(blurred vision), and reading problems (presbyopia) in addition to several
unique conditions that may affect your eyes. Various and sometimes different
vision correction treatments are available to treat problems for how
you see. As each eye can have different conditions and may be better
suited to different treatments, we recommend finding cataract eye surgeon
with proven experience when it comes to selecting the best treatment
for your cataract and vision needs
How
to Find a Highly Qualified and Experienced Surgeon for Cataract Surgery