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    Cataract removal

    Cataract extraction; Cataract surgery

    Cataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better. The procedure almost always includes placing an artificial lens (IOL) in the eye.

    Description

    Cataract surgery is an outpatient procedure. This means you likely do not have to stay overnight at a hospital. The surgery is performed by an ophthalmologist. This is a medical doctor who specializes in eye diseases and eye surgery.

    Adults are usually awake for the procedure. Numbing medicine (local anesthesia) is given using eyedrops or a shot. This blocks pain. You will also get medicine to help you relax. Children usually receive general anesthesia. This makes them unconscious and unable to feel pain.

    The doctor uses a special microscope to view the eye. A small cut (incision) is made in the eye.

    The lens is removed in one of the following ways, depending on the type of cataract:

    • Phacoemulsification: With this procedure, the doctor uses a tool that produces sound waves to break up the cataract into small pieces. The pieces are then suctioned out. This procedure uses a very small incision.
    • Extracapsular extraction: The doctor uses a small tool to remove the cataract in mostly one piece. This procedure uses a larger incision.
    • Laser surgery: The doctor guides a machine that uses laser energy to make the incisions and soften the cataract. The cataract is then removed usually by suctioning. Using the laser instead of a knife (scalpel) may speed recovery and be more accurate.

    After the cataract is removed, a manmade lens, called an intraocular lens (IOL), is usually placed into the eye. It helps improve your vision.

    The doctor may close the incision with very small stitches. Usually, a self-sealing (sutureless) method is used. If you have stitches, they may need to be removed later.

    The surgery lasts less than half an hour. Most times, just one eye is done. If you have cataracts in both eyes, your doctor may suggest waiting at least 1 to 2 weeks between each surgery.

    Why the Procedure Is Performed

    The normal lens of the eye is clear (transparent). As a cataract develops, the lens becomes cloudy. This blocks light from entering your eye. Without enough light, you cannot see as clearly.

    Cataracts are painless. They are most often seen in the elderly. Sometimes children are born with them. Cataract surgery is usually done if you cannot see well enough because of cataracts. Cataracts usually do not damage your eye, so you and your eye doctor can decide when surgery is right for you.

    Risks

    In rare cases, the entire lens cannot be removed. If this happens, a procedure to remove all of the lens fragments will be done at a later time. Afterward, vision of most patients is still improved.

    Very rare complications can include infection and bleeding. This can lead to permanent vision problems.

    Before the Procedure

    Before surgery, you will have a complete eye exam and eye tests by the ophthalmologist.

    The doctor will use ultrasound or a laser scanning device to measure your eye. These tests help determine the best IOL for you.

    Your doctor may prescribe eyedrops before the surgery. Follow instructions exactly on how to use the drops.

    After the Procedure

    Before you go home, you may receive the following:

    • A patch to wear over your eye until the follow-up exam
    • Eyedrops to prevent infection, treat inflammation, and help with healing

    You will need to have someone drive you home after surgery.

    You will usually have a follow-up exam with your doctor the next day. If you had stitches, you will need to make an appointment to have them removed.

    Tips for recovering after cataract surgery:

    • Wear dark sunglasses outside after you remove the patch.
    • Wash your hands well before and after using eyedrops and touching your eye. Try not to get soap and water in your eye when you are bathing or showering for the first few days.
    • Light activities are best as you recover. Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.

    Recovery takes about 2 weeks. If you need new glasses or contact lenses, you can usually have them fitted at that time. Keep your follow-up visit with your doctor.

    Outlook (Prognosis)

    Most patients do well and recover quickly after cataract surgery.

    If a person has other eye problems, such as glaucoma or macular degeneration, the surgery may be more difficult or the outcome may not be as good.

    References

    American Academy of Ophthalmology Cataract and Anterior Segment Panel. Preferred Practice Pattern Guidelines. Cataract in the Adult Eye. San Francisco, Ca: American Academy of Ophthalmology; 2011. Accessed August 29, 2013.

    Davison JA, Kleinmann G, Greenwald Y, Apple DJ. Intraocular lenses. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on CD-ROM -2013 Edition. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013: vol 6, chap 11.

    Cionni RJ, Snyder ME, Osher RH. Cataract surgery. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM- 2013 Edition. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013: vol 6, chap 6.

    He L, Sheehy K, Culbertson W. Femtosecond laser-assisted cataract surgery. Curr Opin Ophthalmol. 2011;22:43-52.

    Howes FW. Indications for lens surgery/indications for application of different lens surgery techniques. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 5.4.

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      A Closer Look

        Talking to your MD

          Tests for Cataract removal

            Review Date: 8/24/2013

            Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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