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What you can expect

By Mayo Clinic staff

During cataract surgery
Cataract surgery, usually an outpatient procedure, takes an hour or less to perform. Eyedrops placed in your eye dilate your pupil. You'll receive local anesthetics to numb the area, and you may be given a sedative to help you relax. If you're given a sedative, you may remain awake, but groggy, during surgery.

Typically, two things happen during cataract surgery — the clouded lens is removed, and a clear artificial lens is implanted. In some cases, however, a cataract may be removed without implanting an artificial lens.

Surgical methods used to remove cataracts include:

• Using an ultrasound probe to break up the lens for removal. During a procedure called phacoemulsification (fak-o-e-mul-sih-fih-KA-shun), your surgeon makes a tiny incision in the front of your eye and inserts a needle-thin probe. Your surgeon then uses the probe, which transmits ultrasound waves, to break up (emulsify) the cataract and suction out the fragments. The very back of your lens is left in place to serve as a place for the artificial lens to rest. In this procedure stitches may or may not be used to close the tiny incision.
• Making an incision in the eye and removing the lens. A less frequently used procedure called extracapsular cataract extraction requires a larger incision than is made during phacoemulsification. Through this incision your surgeon uses surgical tools to remove the cloudy portion of your lens and suctioning tools to remove additional portions of the lens. The very back of your lens is left in place to serve as a place for the artificial lens to rest. This procedure usually requires stitches to close the incision.

Once the cataract has been removed by either phacoemulsification or extracapsular extraction, a clear artificial lens is implanted into the empty lens capsule. This implant, known as an intraocular lens (IOL), is made of plastic, acrylic or silicone. You won't be able to see or feel the lens. It requires no care and becomes a permanent part of your eye.

A variety of IOLs with different features are available. Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close. However, many IOLs are flexible, allowing a smaller incision that requires no stitches. The surgeon folds this type of lens and inserts it into the empty capsule where the natural lens used to be. Once inside the eye, the folded IOL unfolds, filling the empty capsule.

Some types of IOLs block ultraviolet light and other types of IOLs work like bifocals to provide multifocal vision — both near and distant vision. Discuss the benefits and risks of the different types of IOLs with your eye surgeon to determine what's best for you.

After cataract surgery
After cataract surgery, expect your vision to begin improving within a few days. Your vision may be blurry at first as your eye heals and adjusts.

You'll typically see your eye doctor a day or two after your surgery, the following week and then again after a month to monitor healing.

It's normal to feel itching and mild discomfort for a couple of days after surgery. Avoid rubbing or pressing on your eye. Your doctor may ask you to wear an eye patch or protective shield the day of surgery. Your doctor may prescribe eyedrops or other medication to prevent infection, reduce inflammation and control eye pressure. After a couple of days, all discomfort should disappear. Often, complete healing occurs within eight weeks.

Contact your doctor immediately if you experience any of the following:

• Vision loss
• Pain that persists despite the use of over-the-counter pain medications
• Increased eye redness
• Light flashes or multiple spots (floaters) in front of your eye
• Nausea, vomiting or excessive coughing

Most people rely on glasses, at least some of the time, after cataract surgery. Your doctor will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses.

If you have cataracts in both eyes, your doctor typically schedules a second surgery a month or two later to remove the cataract in your other eye. This allows time for the first eye to heal before the second eye surgery takes place.

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