Cataract surgery: what you need to know

A cataract is the progressive clouding of the crystalline lens, the eye's natural lens. It is a common age-related change that reduces vision. Treatment is surgical: a short, painless and very well-established procedure that replaces the clouded lens with an intraocular implant.

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What are the symptoms?

• Blurred or veiled vision, as if looking through frosted glass.
• Light sensitivity, halos and glare at night.
• Duller colours and a need for more light when reading.
• Frequent changes of glasses that no longer really improve vision.

How is the operation performed?

Cataract surgery is usually performed as a day case (admission and discharge the same day), under local anaesthesia with eye drops. The surgeon removes the clouded lens — most often by phacoemulsification (ultrasound) through a micro-incision — then places a clear implant that permanently takes its place. The procedure usually lasts about fifteen minutes and is performed one eye at a time.

Choosing the right implant

The implant replaces the lens and also corrects part of the refractive error. The choice depends on your eye and your lifestyle:

• Monofocal implant — provides sharp vision at one distance (usually far); glasses remain useful, particularly for reading.
• Toric implant — additionally corrects astigmatism.
• Multifocal / premium implants — aim to reduce dependence on glasses for both near and distance. They are not suitable for every eye: the indication is discussed after examination.

Recovery and aftercare

Vision generally improves within a few days. Eye drops are prescribed for a few weeks, with a follow-up appointment. You should avoid rubbing the eye and follow the postoperative instructions. Later on, the capsule holding the implant may become cloudy (so-called “secondary cataract”): a quick, painless laser treatment then restores vision.

Cataract and the cornea

A corneal assessment is useful before surgery, particularly in Fuchs dystrophy: the health of the corneal endothelium influences the procedure and sometimes the surgical strategy.

This page is for general information only and does not replace a medical consultation. The indication, technique and implant choice are individualised after a full examination. Pr Eric E. Gabison — Rothschild Foundation Hospital, Paris.