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Cataract Surgery - Treatment, Procedure And Side Effects

Last Updated: Jun 27, 2023

What is cataract surgery?

Cataract surgery is the process of the removal of the natural lens of the human eye, also termed the crystalline lens. This process is performed when one or both eyes have developed an opacification, commonly known as a cataract. The metabolic changes in the crystalline lens lead to the development of cataracts with the passage of time.

As a result, the eyes lose their transparency which in turn causes impairment and even complete loss of vision. Most patients experience the first symptoms of cataracts as a strong glare from light sources in the morning and small light sources in darkness.

It is also marked by reduced acuity when there is low light. During the surgery, the affected natural lens is taken out and replaced with a high-quality synthetic lens for restoring the transparency of the lens. There are two types of procedures for cataract surgery used all over the world.

The first process involves phacoemulsification while the second one is extracapsular cataract extraction. In most surgeries, the intraocular lens is inserted. Cataract extraction with the aid of intracapsular cataract extraction is suspended by the Phaco and therefore, it is rarely performed all over the world.

What are the 3 types of cataract surgery?

The types of cataract surgery are:

  • Phacoemulsification: It is also known as 'Phaco,' which is the most prevalent method for cataract removal these days. Phacoemulsification takes less than half an hour to remove a cataract, and it only requires minor sedation, such as local anaesthesia (injecting anaesthetic around the eye) or topical anaesthesia (administering numbing drops into the eye).

    Ophthalmologists utilize a hollowed-out tube to introduce the IOL through a small corneal incision.

  • Extracapsular cataract surgery: An artificial lens (IOL) is implanted inside the capsular bag in the same way that phacoemulsification is done.

    The significantly larger wound necessitates a number of stitches to heal it, resulting in a slower wound and vision recovery. The numbing medicine is given through an injection around the eye to begin the cataract removal procedure.

  • Intracapsular cataract surgery: This cataract removal technique is rarely utilized nowadays. It necessitates a wider incision than extracapsular surgery, which removes the entire lens along with the surrounding capsule.

    Furthermore, in this surgical operation, the IOL (intraocular lens) is inserted in a different location, in front of the iris.

Summary: There are mainly three kinds of cataract surgery which include phacoemulsification, extracapsular cataract surgery and intracapsular cataract surgery.

How cataract surgery is performed?

cataract surgery takes about an hour, and it doesn’t cause much discomfort among patients. During the process, the eye surgeon first numbs the eye with the aid of an anesthetic. This suggests that you will remain awake during the process.

If you are very anxious, the doctor would also give you medicine for relaxing. Then the surgeon would make a small incision in the front part of the eye. Then specialized equipment would be used for breaking the cataract and then, suck it out. The new lens is then inserted which can be made of silicone, acrylic, or plastic.

In most cases, the intraocular lens is used after the removal of the natural lens. The implanted lens is then inserted through the incision within the capsular bag present in the posterior chamber. Sometimes, it may be required to opt for sulcus implantation owing to the presence of posterior capsular tears or zonulolysis.

Then the incision is closed, and the doctor would then sews the incision with stitches. Cataract surgery is a simple process, and it is widely performed all over the world to improve the power of vision among patients who have difficulty in viewing.

How painful is cataract surgery?

People are frightened by the prospect of having their eyes operated on. They are concerned that the treatment will be uncomfortable. Cataract surgery is a painless procedure. Before the procedure, a light anaesthetic is given to relax the nerves, and eye drops are used to numb the eye.

There might be some little discomfort following surgery, but it won't last long, and over-the-counter pain relievers should be sufficient. Patients are usually asked to wait in the office for an hour after surgery so that their ocular pressure can be monitored.

After a few days, your vision will begin to improve. The vast majority of cataract procedures result in visual restoration.

Summary: Cataract surgery is not painful due to the use of numbing eye drops. You won’t feel the pain for a few hours after the use of these drops.

Are you sitting or lying down during cataract surgery?

Phacoemulsification was performed on all patients in a face-to-face upright seated position. The patient is seated upright or semi-recumbent, while the surgeon is seated or standing in front of them. The microscope is moved forward, and surgery is performed using topical intracameral anaesthetic through an incision in the lower portion of the cornea.

A prospective study was conducted on all 240 face-to-face cases done by the same surgeon. Reasons for positioning problems adopted positions, and post-operative issues were all recorded in the database.

Data on 34 patients' comprehensive systematic monitoring and 90 patients' satisfaction were also collected.

Summary: Cataract surgeries are performed in face-to-face seating positions, especially for people who have difficulty lying down.

Which eye is done first in cataract surgery?

If you have cataracts in both eyes, surgery on one is usually performed first. This method permits the first eye to heal and your vision in that eye to settle before the second eye is operated on.

However, current cataract surgery is extremely safe and effective, with a very low percentage of cataract complications. As a result, some surgeons have begun to offer simultaneous (or sequential) bilateral cataract surgery (SBCS), which involves performing cataract surgery on both eyes on the same day.

Summary: Cataract surgery is done in one eye at a time. If the patient has a cataract in both the eyes, the doctor first operates on one eye and then after healing the procedure is further performed on the second eye.

Do you still need glasses after cataract surgery?

To see properly following cataract surgery, people needed to wear very thick spectacles or special contact lenses. Intraocular lenses are a type of substitute for the eye's native lenses (IOLs).

There are a variety of lens implants that can help you lessen or eliminate your reliance on glasses.

Many factors influence whether you will continue to use full-time spectacles, part-time glasses, such as reading glasses, or no glasses at all.

Summary: Mostly, after the cataract surgery people do not need to wear glasses. But some people prefer wearing glasses to avoid dust and dirt getting into their eyes.

How far apart should cataract surgeries be?

You'll require two operations if you have cataracts in both eyes. The operations are usually scheduled two to six weeks apart. The first eye will have more time to heal this way. Before the second surgery, your vision in the first eye may improve.

Summary: It requires a minimum of two to six weeks for the surgery of the second eye. It is done only after the recovery of the first eye.

Who needs cataract surgery?

Cataract surgery can be performed on any individual who is suffering from difficulties seeing with both eyes. In most of these instances, the patients are recommended to consider monovision.

This process involves inserting the intraocular lens in one eye providing near vision while the intraocular lens in the other eye offers a distant vision. Some people face tremendous difficulties in seeing objects at the night. It is imperative to perform the surgery in all these cases since the growth of cataracts can lead to loss of vision as well.

Who is not eligible for the treatment?

Even though you may have a cataract, it is not always necessary to undergo the cataract surgery. You may not notice any changes in your vision even though the cataract may have started to develop. Some people with this condition are absolutely fine with their prescription glasses or using magnifying glasses or using bright lights for reading. Also, people with high blood pressure and diabetes are not considered an ideal candidate for the treatment.

What activities should be avoided after cataract surgery?

However, it is critical to use caution while recovering from surgery. Following are seven things you should avoid during cataract surgery:

  • Avoid Driving:You should not drive for at least 24 hours after the surgery. You might wish to wait a little longer because many people experience light sensitivity for a few days following surgery.
  • Do not use Makeup:Makeup is teeming with microorganisms. It is safe as long as you don't share your cosmetics, but it makes your eyes more susceptible to infection while they heal. Wait until your surgeon advises you to resume wearing makeup. If you are wearing outdated makeup, these can easily carry bacteria into your eyes.
  • Don’t participate in any strenuous activity:Until your surgeon recommends otherwise, limit yourself to light exercise. Heavy lifting, exercise, and other intense activities should be avoided. While you're recuperating, exercise can bring difficulties.
  • Avoid going near a dusty area:To avoid dust you can wear protective eyewear when you're around it. To prevent anything from getting in between the lenses, goggles are preferred over glasses.
  • Avoid Swimming:You shouldn't even get water in your eye while showering, so make sure the showerhead isn't pointed towards your face. You should also avoid going to the pool or hot tub for the next two weeks.
  • Wear sunglasses while going outside:You should use sunglasses after cataract surgery, it's much more necessary. Don't go out without a nice pair of sunglasses to protect your eyes from UV harm.
  • Don’t rub your eyes:It may be itchy or inflamed, but touching it will aggravate the situation. Rubbing your eyes might lead to significant problems. If the pain persists, medications or eye drops might be used to alleviate it. Call your doctor if your discomfort persists after a few days.
Summary: You should avoid doing strenuous activities, swimming and dusting for at least 2 weeks after the surgery.

What are the side effects of cataract surgery?

Cataract surgery is among the safest surgical interventions in the history of medical science. Also, it can rarely lead to any kind of side effects. A significantly low percentage of patients experience occurrences like bleeding from the eyes, drooping eyelid, build-up of fluid within the eye, swelling, eye infection, detachment of the retina, feeling of pressure under or within the eye and loosening of the implanted lens. If you feel any discomfort following your surgery, it must be reported to the doctor with no further delay. Also, you must ensure following the guidelines of your doctor to ensure that you experience no unwanted side effects.

What to expect after cataract surgery?

There is no reason to worry about your eyes feel sore for a few days of completion of the cataract surgery. You may find that there is fluid discharge from your eyes and it has become impossible to see anything in the bright light. Your eye surgeon would prescribe eye drops which would prevent infection, and you must take this for 2 to 3 weeks post operation. You should not drive for at least 2 weeks, pick up heavy objects or do anything that would exert pressure on your eyes. Your doctor may also advise you to sleep in an eye shield for protecting the operated surgery and allow it to heal.

How long does it take to recover from cataract surgery?

Healing after the cataract surgery generally doesn’t take much time. Just follow the post cataract operation guidelines suggested by your eye surgeon to reduce cataract surgery recovery time. It would take about 2 months for your eyes to heal completely with proper medications and application of the eye drops.

Do you wear an eyepatch after cataract surgery?

It is necessary to take precautions after the cataract surgery. Wearing eyepatch or eyeglasses protects your eyes from direct light and anti inflammatory eye drops can be used to protect your eyes.

How much does cataract surgery cost in India?

Cataract surgery is one of the most affordable treatment options all over the world. In India, the cost of Cataract surgery can range from Rs. 25,000 to Rs. 1,40,000 depending on the methods and equipment used. Your eye surgeon would be able to guide you better about the cost you are likely to incur for the surgery.

Can Cataracts be cured?

In about 90 per cent of the cases, the cataract surgery is successful with no infections and complications. Regardless of whether you choose to undergo manual or laser-assisted surgery, it can improve the vision to a considerable extent. But it is important to have realistic expectations as you may have to wear glasses or lens for excellent vision after the surgery.

What are the alternatives to the treatment?

The most common alternative to cataract surgery is wearing lens and glasses that can help an affected individual to see most clearly. There are also eye drops available which can assist in dissolving the clumped proteins causing cataracts in the eyes. People who cannot undergo surgery due to health reasons should consider getting the eye drops containing lanosterol as an effective treatment. But it is crucial to consult with an eye surgeon before deciding.

Key Highlights:

  • Safety: High
  • Effectiveness: High
  • Timeliness: High
  • Relative Risk: Low
  • Side Effects: Low
  • Recovery Time: High
  • Price Range: RS. 20,000 - Rs. 60,000


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Written ByDr. Anurag Agarwal MS - Ophthalmology,MBBSOphthalmology
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