How can a cataract be treated?
A cataract may not need to be treated if your vision is only slightly blurry. Simply changing your eyeglass prescription may help to improve your vision for a while. There are no medications, eyedrops, exercises or glasses that will cause cataracts to disappear once they have formed.
Surgery is the only way to remove a cataract. When you are no longer able to see well enough to do the things you like to do, cataract surgery should be considered.
In cataract surgery, the cloudy lens is removed from the eye through a surgical incision. In most cases, the natural lens is replaced with a permanent intraocular lens (IOL) implant.
What can I expect if I decide to have cataract surgery?
Intraocular Lens (IOL) Options - The latest Advances
When a cataract is removed, it is replaced with an artificial intraocular lens (IOL). There are a variety of IOLs that can be used in cataract surgery, and they each have their own set of advantages and disadvantages.
Modern IOLs have been used successfully for over 30 years during cataract surgery. Rest assured that the IOLs used in your surgery has undergone extensive testing for safety and efficacy, and has been approved by the FDA.
- Monofocal IOLs (fixed-focus) are used in the majority of cataract procedures. These lenses have the advantage of excellent quality distance vision under a variety of lighting conditions. Since these lenses have a fixed focal point, which is generally set for distance vision, reading glasses are typically required for good near vision. For patients willing to use reading glasses for near tasks, these IOLs are an excellent choice. Several million lenses of this variety have been used for decades with an excellent safety record.
- Multifocal IOLs are used to achieve good distance and near vision with less dependence on glasses. These lenses operate either by bringing light into focus at more than one point at the same time, or by physically moving inside the eye in response to your own focusing muscles. This allows the eye to see both near and far, usually without glasses. Multifocal IOLs have a slightly greater tendency to cause night vision complaints than other IOLs, so those who drive a great deal at night may wish to consider a different IOL. These same IOLs are also used for a refractive surgery known as refractive lens exchange, to reduce or eliminate the need for glasses or contact lenses, even before cataracts have developed.
- Toric IOLs correct astigmatism. Because patients with astigmatism are more likely to still require glasses after cataract surgery, the astigmatism is often treated during surgery in order to reduce the need for full-time glasses. Mostly, this is achieved with special incisions in the cornea called limbal relaxing incisions (LRI). But, astigmatism can also be corrected with a toric IOL. Depending on the health of your eye and the amount of astigmatism, your ophthalmologist may recommend LRI or a Toric IOL.
Before Surgery To determine if your cataract should be removed, your ophthalmologist (Eye M.D.) will perform a thorough eye examination. Before surgery, your eye will be measured to determine the proper power of the intraocular lens that will be placed in your eye. Ask your ophthalmologist if you should continue taking your usual medications before surgery.
The Day of Surgery Surgery is usually done on an outpatient basis, either in a hospital, an outpatient surgical center, or an ambulatory surgery center. You may be asked to skip breakfast, depending on the time of your surgery.
When you arrive for surgery, you will be given eyedrops and perhaps a mild sedative to help you relax. A local anesthetic will numb your eye. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. Your eye will be kept open by an eyelid speculum. You may see light and movement, but you will not be able to see the surgery while it is happening.
Under an operating microscope, a small incision is made in the eye. In most cataract surgeries, tiny surgical instruments are used to break apart and remove the cloudy lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place.
You should make arrangements to have someone drive you home after surgery.
During cataract surgery, tiny instruments are used to break apart and remove the cloudy lens from the eye.
An intraocular lens (iol) implant.
In cataract surgery, the intraocular lens replaces the eye's natural lens.
After surgery is completed, your doctor may place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home.
Following Surgery
You will need to:
- Use the eyedrops as prescribed
- Be careful not to rub or press on your eye
- Avoid strenuous activities until your ophthalmologist tells you to resume them
- Ask your doctor when you can begin driving
- Wear eyeglasses or an eye shield, as advised by your doctor
Is a laser used during cataract surgery?
Laser surgery is not used in cataract removal surgery. However, the lens capsule (the part of the eye that holds the lens in place) sometimes becomes cloudy several months or years after the original cataract operation. If the cloudy capsule blurs your vision, your ophthalmologist can perform a second surgery using a laser. During the second procedure, called a posterior capsulotomy, a laser is used to make an opening in the cloudy lens capsule, restoring normal vision.
Posterior capsulotomy: a laser is used to make an opening in the cloudy lens capsule.
Will cataract surgery improve my vision?
The success rate of cataract surgery is excellent. Improved vision is achieved in the majority of patients. Only a small number of patients continue to have problems following cataract surgery.
Complications After Cataract Surgery
Though they rarely occur, serious complications of cataract surgery are:
- Infection
- Bleeding
- Swelling
- Detachment of the retina
- Pain not relieved by nonprescription pain medication
- Loss of vision
- Nausea, vomiting, or excessive coughing
- Injury to the eye