Drexel University College of Medicine

Surgeries

Cataract removal

Definition

Cataract removal is a procedure to remove a clouded lens (cataract) from the eye to help improve vision. The procedure almost always includes replacing the lens of the eye with an artificial lens.

Alternative Names

Description

PREPARATION:

An ophthalmologist will take several measurements of the eye to determine the type of surgery needed and the power of the artificial lens. An eye ultrasound is done to measure length and the curvature (shape) of the eye's front surface.

Routine testing before surgery is often done to determine your overall general health prior to cataract removal. Because cataract surgery is usually done with local anesthesia (numbing medicine), most patients are able to undergo cataract extraction regardless of other illnesses they may have.

PROCEDURE:

The surgery is performed in a hospital or in an outpatient setting. Children are typically given general anesthesia to keep them in a deep sleep and pain-free; adults usually are awake but sedated and pain-free with local anesthesia.

With the help of a microscope, a small incision is made at the junction of the clear and white outer parts of the eye. The lens can be removed in several ways, depending upon the type of cataract:

• With surgical instruments and suction
• With an instrument and machine that uses high frequency sound waves (ultrasonic energy) to break up the lens and suction it out (phacoemulsification)

An artificial intraocular lens (IOL) is usually inserted to help the eye focus in the absence of the removed lens. The incision may be closed with fine stitches (sutures) or may be self sealing (sutureless). If sutures are placed, they may need to be removed at a later date.

The surgery typically lasts less than an hour.

Indications

This procedure is usually recommended for people who have loss of vision or visual abnormalities caused by cataracts.

Risks

Complications of cataract surgery are not common, and serious complications are rare. Most patients have better vision after cataract surgery.

In about 3% - 4% of cases, the entire lens cannot be removed and another procedure is required at a later date to remove all of the lens fragments. Most of these patients still do very well. In other very rare cases, infection can occur after cataract surgery, which can lead to permanent vision problems.

FREQUENTLY ASKED QUESTIONS:

Q: Will a laser be used to remove my cataract?

A: No. Lasers are not used to remove cataracts, though they likely will be in the future. Several months after the surgery, a laser can be used to break apart remaining old lens fragments sitting behind the new artificial lens, if necessary.

Q: Will it harm my eye to wait to remove the cataract?

A: No. Cataracts do not harm the eye. You should have your cataract removed when it is convenient for you and only if you are unhappy with your vision.

Q: If I have a cataract in each eye, can I have them both done at the same time?

A: No. Usually one eye is allowed to heal before the operation is repeated on the other eye. Most surgeons recommend waiting 1 to 2 months between procedures.

Expectations after surgery

The outcome of cataract surgery is usually excellent. The operation has low risk, the pain is minimal and recovery time is short. Improvement in sight occurs in most cases. Ninety-five percent or more of all cataract surgeries result in improved vision.

Convalescence

Generally the patient returns home the same day as the procedure and then returns the following day for examination. A patch is placed over the operated eye and worn until the follow-up examination the next day. Antibiotic and anti-inflammatory eye drops will be prescribed for use for several weeks to assist the healing process.

Expect complete healing in about 10 weeks. Glasses or contact lenses may then be fitted if the clarity of your vision needs to be refined. Close follow-up with the surgeon is essential.

References

American Academy of Ophthalmology. Cataract in the Adult Eye, Preferred Practice Pattern. San Francisco: American Academy of Ophthalmology, 2006. Accessed July 1, 2008.

Allen D. Cataract. BMJ Clinical Evidence. Web publication date: 01 April 2007 (based on October 2006 search). Accessed July 1, 2008.

Physician Reference

Current Procedural Terminology (CPT)

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