Removal of the clouded eye lens — caused by aging, trauma or systemic disease — by breaking it up with sound waves and aspirating it, then placing an artificial intraocular lens (IOL).
Indication
- Progressive blurred vision and difficulty with daily activities due to age-related cataract
- Glare and dazzling from oncoming headlights while driving
- Faded color perception and a marked decrease in contrast sensitivity
- Cataract developing after diabetes, long-term corticosteroid use or trauma
- Congenital or childhood-onset cataract that interferes with visual development
- Lens opacity that prevents the diagnosis or treatment of posterior segment disease (e.g., retinal disorders)
- Vision loss not correctable with glasses or contact lenses and assessed as suitable for surgery by the physician
Preparation
- A comprehensive eye examination, biometry and intraocular lens (IOL) power calculation are performed before surgery
- Systemic conditions such as diabetes, hypertension and use of blood thinners are evaluated; medications are continued or adjusted with physician approval
- When local (drop) anesthesia is used there is no requirement for prolonged fasting; if sedation is planned the physician will inform you of the fasting period
- Come without makeup on the day of surgery; perfumes, creams and lotions on the face are not recommended
- It is appropriate to have a companion to take you home, and not to drive on the same day
How it's performed
- Local anesthesia is usually applied as drops; light sedation may be added when needed
- A millimetric incision (about 2-3 mm) is made in the cornea to access the inside of the eye
- The clouded lens is fragmented and aspirated using ultrasound (phacoemulsification)
- An appropriate artificial intraocular lens (monofocal, toric or multifocal IOL) is placed within the lens capsule
- Sutures are usually not required; the incisions seal themselves and a protective shield is placed over the eye
- The procedure is generally outpatient; you are discharged the same day
Post-procedure
- First check-up the same day or the next day; eye pressure, cornea and lens position are evaluated
- Antibiotic and anti-inflammatory eye drops prescribed by the physician are used regularly for the indicated period
- During the first week, avoid rubbing the eye, getting water in it, and protect it from dust and impact
- Heavy lifting, swimming and saunas should be avoided for the period your physician advises
- Visual acuity usually improves noticeably within a few days; final clarity stabilizes within 4-6 weeks
Risks
- Intraocular infection (endophthalmitis) — rare but serious complication
- Transient elevation of eye pressure, corneal edema or inflammatory reaction
- Posterior capsule opacification over time (secondary cataract); treated with a brief laser procedure (YAG capsulotomy)
- Risk of retinal detachment, particularly increased in highly myopic patients
- Displacement of the intraocular lens or the refractive target not being fully achieved
FAQ
Is a multifocal or toric intraocular lens suitable for me?
Monofocal lenses provide clear vision at a single distance (usually far), while multifocal lenses aim to provide both near and distance vision; toric lenses are designed to correct existing astigmatism. Each patient is assessed according to the eye, lifestyle and any accompanying conditions; not every lens is suitable for everyone. Discussing the advantages and limitations in detail with your surgeon is recommended.
Will I feel pain during the surgery?
With drop local anesthesia the procedure is generally painless; you may feel mild pressure, watering and a sensation of light. You remain awake throughout and can hear the physician's instructions; sedation is provided to keep you comfortable when needed.
When can I read or drive after surgery?
After the next-day check-up most patients can return to reading and daily activities; however driving requires your physician to measure your visual acuity and give approval. Driving is usually appropriate within a few days.
Are both eyes operated on the same day?
Standard practice is to operate on one eye first and the second eye after follow-up. Same-session surgery on both eyes is considered only in selected situations, and your physician will advise you of the most appropriate timing.
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