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Cataract Surgery

What You Need to Know About Cataract Surgery

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Updated July 30, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Cataract surgery is a procedure designed to treat cataracts. A cataract is a clouding of the eye's lens. Cataracts are a normal part part of aging, and the leading cause of blindness among people older than 55. As cataracts become worse, your vision becomes less and less clear.

What causes cataracts?

Most of us will develop cataracts at some point in our lives. Cataracts are like gray hair - some of us will go gray in our thirties, but some of us will not see any silver until decades later. Cataracts may develop early in some people, but don't tend to become significant and visually debilitating for most people until their early 70s.

Risk factors for developing cataracts:

  • Diabetes
  • Eye trauma
  • Eye surgery
  • Family history of cataracts
  • Smoking
  • Certain medications
  • UV exposure
  • Congenital development

Who needs cataract surgery?

Cataract surgery is needed when the quality of your vision is affecting your lifestyle and daily activities. If you think that your vision might be improved by having cataract surgery, schedule an appointment for an eye exam. During your comprehensive eye examination, your eye doctor will perform several diagnostic tests in order to determine the severity of your cataracts.

When considering cataract surgery, ask yourself the following questions:

  • Have you had to have your eyeglass prescription changed more frequently?
  • Are you not seeing as well as you thought you would with your new glasses?
  • Do colors seem dull?
  • Does your vision seem dim?
  • Is your vision worse at night?
  • Do you experience glare or halos around lights while driving at night?
  • Do you require more light to see clearly?
If you answered "yes" to any of the questions above, cataracts may be affecting your vision. Cataract surgery may be recommended if removing the cloudy lenses is the most effective treatment.

How will my doctor determine if I need cataract surgery?

A comprehensive eye examination by an optometrist or ophthalmologist will be performed to evaluate the severity of your cataracts. Your doctor will start by conducting a review of your medical history, including your family history. Make sure you inform your doctor of any allergies to medications or other substances that you may have. Your doctor will then perform a series of diagnostic tests that may include the following:
  • Visual Acuity - Visual acuity is a measure of how well you can see. Refraction will be performed to determine how much improvement a new prescription could bring to your vision.

  • PAM Test - A PAM test, or potential acuity meter test, will tell your doctor the approximate level of vision gained if cataract surgery is performed.

  • Slit Lamp Exam - A microscopic examination of the lens of the eye will be performed using a slit lamp to grade the severity of the cataract. Dilating your eyes will give your doctor a detailed view.

How should I prepare for cataract surgery?

Your doctor will consider your lifestyle, hobbies and daily activities to determine which type of cataract surgery is best for you. Talk to your primary care physician or specialist if you have any significant medical problems before scheduling the surgery. Your eye surgeon may need to receive clearance from your family doctor if you have cardiac or respiratory problems.

Be sure to keep all pre-surgical appointments with your eye doctor. Before cataract surgery, your doctor will need to measure your eyes to determine the proper power and design of the intraocular lens implant that will be inserted into your eye.

Call your insurance company to determine costs. Although most cataract surgeon’s offices are very good at determining the out-of-pocket costs associated with having cataract surgery, it is a good idea to have a basic idea of possible deductibles or co-insurances that may be due at the time of service. You may have unexpected costs, such as payment to the surgery center where the surgery will be performed. Make sure all your physicians are in-network unless it is an emergency.

Plan your day of surgery appropriately. Don't wear eye makeup to your surgical appointment. Continue with eye treatments or eye drops prescribed by your cataract surgeon. Make sure you have a friend or family member lined up to drive you home after the surgery. The surgery itself may only last 15 minutes but you may be at the surgery center or hospital for 1-2 hours including prep and recovery time.

What happens during cataract surgery?

Cataract surgery is usually an out-patient procedure, which means you will go home the same day of the surgery. On the day of your surgery, you may be given a mild sedative and eye drops will be instilled so that your pupil becomes dilated. The skin around your eye and eyelid will be cleaned and sterilized. A sterile drape will be placed over your head and around your eye. Cataract surgery is performed with minimal anesthesia. In fact, only anesthetic eye drops are required in 98% of cases.

To begin the surgery, tiny incisions will be made in the peripheral part of your cornea, the clear dome-like structure on the front part of your eye. Next, the capsule or lens bag will be opened. A small ultrasonic probe will be inserted into your eye. This probe will dissolve the cataract at a very high rate of speed and the remaining material will be suctioned out. A new, clear lens implant will then be inserted into your eye through the same small incision and positioned into place. The incision will be self-sealing and require no stitches in 99% of cases.

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