Cataract surgery

Overview

Cataract surgery involves replacing the cloudy lens inside your eye with an artificial one.

It has a high success rate in improving your eyesight.

It can take 2 to 6 weeks to fully recover from cataract surgery.

What are cataracts?

Cataracts are when the lens of your eye, a small transparent disc, develops cloudy patches.

When we're young, our lenses are usually like clear glass, allowing us to see through them.

As we get older they start to become frosted, like bathroom glass, and begin to limit our vision.

Cataracts most commonly affect adults as a result of ageing.

Find out more about age-related cataracts

Do you need surgery?

If you have cataracts, it's your decision whether or not to go ahead with cataract surgery.

Cataracts usually get slowly worse over time. Whilst spectacles and brighter reading lights may help for a while, surgery to replace the cloudy lens is the only way to improve your eyesight.

Surgery is usually offered on the NHS if your cataracts are affecting your eyesight and quality of life.

The decision to have surgery should not be based solely on your eye examination (visual acuity) results.

You may have other personal reasons for deciding to have surgery, such as your daily activities, hobbies and interests.

You can choose to put off surgery for a while and have regular check-ups to monitor the situation.

There are no medicines or eye drops that have been proven to improve cataracts or stop them getting worse.

Before the operation

Before surgery, you'll be referred to a specialist eye doctor for an assessment.

During an assessment different measurements will be taken of your eyes and your eyesight.

The assessment is an opportunity to discuss anything to do with the operation, including:

your lens preference, such as near sight or long sight
the risks and benefits of having surgery
if you'll need glasses after surgery
how long you'll take to fully recover

If you're used to using 1 eye for distance and 1 for reading, which is called monovision, you can ask to stay that way.

This usually means you'll get a near-sight lens fitted in 1 eye and a long-sighted lens fitted in the other eye.

The operation

Cataract surgery is a straightforward procedure that usually takes 30 to 45 minutes.

It's often carried out as day surgery under local anaesthetic and you should be able to go home on the same day.

During the operation, the surgeeon will make a tiny cut in your eye to remove the cloudy lens and replace it with a clear plastic one.

With the NHS, you will usually be offered mono-focal lenses, which have a single point of focus. This means the lens will be fixed for either near or distance vision, but not both.

If you go private, you may be able to choose either multifocal or an accomodating lens, which allow the eye to focus on both near and distance objects.

Most people will need to wear glasses for some tasks, like reading, after surgery regardless of the type of lens they have fitted.

If you have cataracts in both eyes it may be recommended that both eyes are treated on the same day. This procedure is known as immediate sequential bilateral cataract surgery (ISBCS). ISBCS is usually only recommended for people thought to have a low risk of complications. The surgeon will discuss this with you if this is an option.

Otherwise, surgery is done 6 to 12 weeks apart to allow the recovery of 1 eye at a time.

Find out more about recovering from cataract surgery.

Benefits of surgery

After cataract surgery you should be able to:

see things in focus
look into bright lights and not see as much glare
tell the difference between colours

If you have another condition affecting your eyes, such as diabetes, macula degeneration or glaucoma, you may still have limited vision, even after successful surgery.

Risks of surgery

The risk of serious complications developing as a result of cataract surgery is estimated at around 1 in 50 cases.

These can include:

blurred vision
some loss of vision
detached retina - where the thin layer at the back of your eye (retina) becomes loose

Most of these serious complications can be treated with medicines or further surgery.

There's a very small risk – around 1 in 1,000 – of permanent sight loss in the treated eye as a direct result of the operation.

Recovery

You should be able to go home on the same day as your cataract surgery.

You may have a pad and plastic shied over your eye when you leave hospital, which can usually be removed the day after surgery.

Feeling should start to return to your eye within a few hours of surgery, but it may take a few days for your vision to fully return.

It's normal to have:

grittiness
watering
blurred vision
double vision
a red or bloodshot eye

These side effects usually improve within a few days but it can take 4 to 6 weeks to recover fully.

If you need new glasses, you will not be able to order them until your eye has completely healed, usually after 6 weeks.

Cataract surgery has a high success rate in improving your eyesight and should allow you to return to your normal activities, like driving.

When to seek help

Contact your eye surgery department as soon as possible if you experience:

increased pain and/or redness
decreased vision

Do's and don'ts

For the first few weeks after surgery:

Do:

use your eye drops as instructed
take it easy for the first 2 to 3 days
use your eye shield at night for at least a week
take painkillers if you need to
bathe and shower yourself as usual
wear your eye shield when washing your hair
read, watch TV and use a computer
use your shield, old glasses or sunglasses outdoors
avoid swimming for 4 to 6 weeks

Don't:

do not rub your eye
do not allow soap or shampoo to get into your eye
do not drive until you get the all-clear from your doctor
do not do any strenuous exercise or housework
do not wear eye make-up for at least 4 weeks
do not fly without seeking advice from your doctor

You could arrange for someone to help take care of you until your vision returns, particularly if the vision in your other eye is poor.

If you work, how soon you can return will largely depend on your type of job and if you need new glasses.

Using your eye drops

Before you leave hospital, you'll be given some eye drops to help your eye heal and prevent infection.

It's important to use your eye drops as instructed by your doctor.

Unless told otherwise, you should:

start your eye drops the morning after the operation
only use them on the operated eye
wash your hands before using your drops
don't stop your eye drops without advice from your doctor
don't let anyone else use your eye drops

.You'll be advised further about the use of eye drops at your follow-up appointment, usually 1 to 4 weeks after your operation.

At this appointment, you may be given advice on when to stop using your eye drops and when to apply for new glasses.

How to apply eye drops

1. Wash your hands.
2. Tilt your head back.
3. Look up at the ceiling.
4. Gently pull down the lower lid.
5. Squeeze the bottle until a drop goes into your eye.
6. Close your eye and wipe away excess liquid.
7. Do not let the bottle touch the eye.
8. Safely dispose of the drops once you have finished your course of treatment.

How to clean your eye

boil some water and allow it to cool
wash your hands
dip cotton wool or clean gauze in the cool boiled water
gently wipe from the inside (near your nose) to the outside corner of your eye
do not wipe inside your eye
do not wash your eye out with water
do not press on your eye

During the first 2 weeks, you may need to clean your eye twice a day because the drops and the healing process can cause slight stickiness.

Find out more about cataracts on the RNIB website.

The information on this page has been adapted by NHS Wales from original content supplied by

NHS website nhs.uk