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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 rest of the surgery is much like phacoemulsification. 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 to restore the focusing power of the lens (cataract). 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 older adults. 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 can still be 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. Usually, the doctor will try to choose an IOL that can allow you to see without glasses or contact lenses after surgery. Be sure you understand what your vision will be like after the IOL is implanted.

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 people 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 Preferred Practice Patterns Cataract and Anterior Segment Panel, Hoskins Center for Quality Eye Care. Cataract/anterior segment summary benchmark - 2016. Updated October 2016. www.aao.org/summary-benchmark-detail/cataract-anterior-segment-summary-benchmark-2016. Accessed November 17, 2016.

Moorman C. Cataract surgery. In: Spaeth GL. Danensh-Meyer HV, Goldberg I, Kampik A, eds. Ophthalmic Surgery: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier; 2012:chap 4.

Tipperman R. Cataracts. In: Gault JA, Vender JF. Ophthalmology Secrets in Color. 4th ed. Philadelphia, PA: Elsevier; 2015:chap 21.

Wevill M. Epidemiology, pathophysiology, causes, morphology, and visual effects of cataract. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 5.17.

 
  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

  • Slit-lamp exam

    Slit-lamp exam - illustration

    A slit-lamp, which is a specialized magnifying microscope, is used to examine the structures of the eye (including the cornea, iris, vitreous, and retina). The slit-lamp is used to examine, treat (with a laser), and photograph (with a camera) the eye.

    Slit-lamp exam

    illustration

  • Cataract - close-up of the eye

    Cataract - close-up of the eye - illustration

    This photograph shows a cloudy white lens (cataract) as seen through the pupil. Cataracts are a leading cause of decreased vision in older adults, but children may have congenital cataracts. With surgery, the cataract can be removed, a new lens implanted, and the person can usually return home the same day.

    Cataract - close-up of the eye

    illustration

  • Cataract

    Cataract - illustration

    The lens of an eye is normally clear. If the lens becomes cloudy (opacified) it is called a cataract.

    Cataract

    illustration

  • Cataract surgery  - series

    Cataract surgery - series

    Presentation

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration

    • Slit-lamp exam

      Slit-lamp exam - illustration

      A slit-lamp, which is a specialized magnifying microscope, is used to examine the structures of the eye (including the cornea, iris, vitreous, and retina). The slit-lamp is used to examine, treat (with a laser), and photograph (with a camera) the eye.

      Slit-lamp exam

      illustration

    • Cataract - close-up of the eye

      Cataract - close-up of the eye - illustration

      This photograph shows a cloudy white lens (cataract) as seen through the pupil. Cataracts are a leading cause of decreased vision in older adults, but children may have congenital cataracts. With surgery, the cataract can be removed, a new lens implanted, and the person can usually return home the same day.

      Cataract - close-up of the eye

      illustration

    • Cataract

      Cataract - illustration

      The lens of an eye is normally clear. If the lens becomes cloudy (opacified) it is called a cataract.

      Cataract

      illustration

    • Cataract surgery - series

      Presentation

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Cataract removal

           

             

            Review Date: 8/11/2015

            Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 11/17/2016.

            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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