Cataract is any opacity in the natural lens of the eye. This is a natural change which progresses through life but can be brought on more quickly in other situations, for example after an injury to the eye or in people with diabetes.
Surgery is usually considered when the cataract impairs your eyesight to the extent that it interferes with your daily activities enough to limit what you can do. This is a very individual choice and can be a difficult decision to make, so take your time!
Sometimes cataract surgery is recommended to reduce the risk of sudden high pressure in the eye, or to allow accurate examination of the back of the eye, or to reduce imbalance between the two eyes.
Modern cataract surgery is low-risk but not risk-free. The serious complications include bleeding at the back of the eye or infection within the eye but these are very rare (fewer than 1 in 1000 cases). Other complications include rupture of the capsule which supports the lens, swelling of the retina, inflammation inside the eye or raised pressure within the eye. These are also uncommon.
If any of these occur your consultant ophthalmologist will take great care to look after you and treat any problem appropriately. This may require more eye drops or a second procedure.
Eye drops (anaesthetic and antiseptic) are given to make the eye numb and clean. Using a microscope, an incision 2.5mm long is made at the edge of the cornea. The cataract is broken up into tiny fragments using ultrasound and removed through this incision and then a plastic lens is inserted through the same incision.
No stitches are used routinely as the incision is self-sealing. A clear shield is placed over the eye at the end of the surgery for protection.
No - surgery should be pain-free and most people are surprised at how little sensation they notice during the procedure. The main sensation is that of slight tingling as local anaesthetic is given, and gentle pressure at various stages.
If surgery is uncomfortable it is possible to give extra anaesthetic during the procedure - please ask!
Steroid eye drops taken for 3 weeks after the procedure help the eye to recover and reduce any inflammation. Sometimes extra drops are given to reduce the risk of swelling of the retina.
Antibiotic drops are not routinely needed as a dose of antibiotic is given inside the eye at the end of the procedure to reduce the risk of infection. Occasionally however a short course of antibiotic drops may be given as an extra precaution.
Please arrange to see your optometrist around 4 weeks after surgery. By this time the eye will have settled and measurements for new spectacles are accurate.
In order to drive, your eyesight will have to meet the legal criteria specified by the DVLA (click here for more details) and the operated eye must be comfortable and not distracting. This may be as soon as a few days after surgery if the procedure is uneventful and the unoperated eye sees well.
Your surgeon may be able to give you more of an idea about this at your consultation.
We prefer patients to stay locally for the immediate post-op period just in case there are any issues which need reviewing or treatment adjusting. After 2 weeks if all is well it should be safe to travel although swimming should be avoided for 4 weeks after surgery.
The lens implant is intended to last life-long.
Occasionally in the past some lens materials could become slightly cloudy over time but these lens models are no longer used.
No - once the cataract is removed it cannot come back.
Sometimes the membrane bag ('capsule') which supports the lens implant can gradually become cloudy over the following few years but this can be easily treated with laser and does not need any further surgery. This clouding does not recur after laser treatment.
Not usually as there are a few advantages to delaying the second eye's surgery by a week or so. Any early complications can be managed before embarking on the treatment for the second eye, and experience from the first eye's surgery can sometimes help the second eye's operation to be safer and more accurate.
If you have a particular reason for wanting to having both cataracts removed on the same day please discuss this with your surgeon at your assessment.