Cataract surgery

Cataracts usually occur in people who are over 60 years old, although they can occur in younger people, including congenital cataracts in newborns. Cataracts occur when the natural lens of the eye, known as the crystalline lens, becomes cloudy.

The symptoms include deterioration of far and near vision, light sensitivity, intolerance to glare and the dulling of colours. If you notice any such symptoms, you should visit your optometrist or GP.

Success rate of cataract surgery

Cataract surgery is now regarded as a very straight forward procedure. Providing the eye is otherwise healthy, 99% of patients will have a good result. This, together with constant technical advances, has ensured that recovery is now much faster and complications are far less likely.

The procedure

Cataract surgery involves intricate microsurgery. Performed in a day surgery or hospital, the patient will be given a local anaesthetic. The anaesthetist will also ensure that a patient is relaxed before entering surgery (many patients will actually doze off during the procedure).

Once in surgery, there are several steps involved in the procedure.

First, the surgeon will create a tiny incision in the in the cornea no more than 3mm long. (This wound is small enough not to require a stitch as a rule and heals within days.) Fluid (viscoelastic) is then injected in the incision, allowing separation of space between the cataract and the underside of the cornea.

Next, what is called a ‘capsulorhexis’ is performed. This is the term for the round cutting of the anterior capsule of the lens in a uniform manner. The capsule is irrigated, and ultrasound is then used to soften and break up the hard, cloudy lens – this is called phacoemulsification. 

Once this is finished, the lens fragments are vacuumed out and the lens capsule is irrigated. Now, it is empty and clean. 

Then, an intraocular lens (IOL) is injected into the empty capsule. The flexible lens is rolled up in a soft tube, and inserted via the corneal incision into the lens capsule, unfolding rather like a ship in a bottle. The new lens is then held in place by the natural lens capsule and remains there permanently. Once in place the lens is not likely to ever move or require replacement. It cannot be felt once inside the eye.

Day of surgery

You will have been given instructions on fasting (no food or drink for 6 hours prior to the surgery is the usual requirement). You’ll also be asked not to apply any make-up, lotions or nail polish, and wear comfortable clothes.

If you have any underlying medical conditions, such as diabetes, your doctor will give you specific instructions. As a rule you may continue all regular medications including anticoagulants such as Warfarin and aspirin.

The actual operation itself takes less than 30 minutes, with much of the time taken by preparing the eye with drops to enlarge the pupil and to numb the eye prior to the operation. Time is also required to recover if any anaesthetic drugs have been used.  

After the operation, you’ll need to rest for a while. You’ll also be offered something to eat and drink.

You’ll most likely be in and out of the day clinic or hospital in around 2 hours.It’s important to remember that you won’t be able to drive, so you will be required to have someone accompany you home.

More information

For more information on cataract surgery, visit the FAQs page.