Sometime after age 50, most of us are likely to hear our eye doctor say, “You have cataracts.”

A cataract is a clouding of the lens inside the eye, causing vision loss that cannot be corrected with glasses, contact lenses or corneal refractive surgery like LASIK.

As frightening as cataracts might sound, modern cataract surgery usually can restore vision lost to cataracts — and often can reduce your dependence on eyeglasses as well.

Best Candidates

blurred vision, clouded vision, light sensitivity, dim colors

  • Procedure time: about 15 minutes
  • Typical results: long-lasting clear vision (at all distances with presbyopia-correcting IOLs)
  • Recovery time: about a month

Most cataracts are associated with the aging process and are common among older Americans. In fact, according to the National Eye Institute (NEI), 68.3 percent of Americans 80 and older had cataracts in 2010.

And the prevalence of cataracts in the U.S. is expected to grow significantly in the years ahead, due in part to the aging of the population. In 2010, roughly 24.4 million Americans had cataracts, and that number is projected to grow to 50.2 million by the year 2050, according to NEI.

Thankfully, modern cataract surgery is one of the safest and most effective surgical procedures performed today.

More than 3 million cataract surgeries are performed in the United States every year, with the vast majority of these procedures produce excellent visual outcomes.

Cataract Surgery Basics

In cataract surgery, the lens inside your eye that has become cloudy is removed and replaced with an artificial lens (called an intraocular lens, or IOL) to restore clear vision.

The procedure typically is performed on an outpatient basis and does not require an overnight stay in a hospital or other care facility.

Most modern cataract procedures involve the use of a high-frequency ultrasound device that breaks up the cloudy lens into small pieces, which are then gently removed from the eye with suction.

This procedure, called phacoemulsification or “phaco,” can be performed with smaller incisions than previous surgical techniques for cataract removal, promoting faster healing and reducing the risk of cataract surgery complications, such as a retinal detachment.

After all remnants of the cloudy lens have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied. (In special cases, an IOL might be placed in front of the iris and pupil, but this is less common.)
The surgeon then completes the cataract removal and IOL implantation procedure by closing the incision in your eye (a stitch may or may not be needed), and a protective shield is placed over the eye to keep it safe in the early stages of your cataract surgery recovery.

Preparing For Cataract Surgery And Choosing An IOL

Prior to cataract surgery, your optometrist and/or ophthalmologist will perform a comprehensive eye exam to check the overall health of your eyes, evaluate whether there are reasons why you should not have surgery and identify any risk factors you might have.

Cataract Prevalence After Age 50 (U.S.)

A refraction also will be performed to accurately determine the amount of nearsightedness, farsightedness and/or astigmatism you have prior to surgery. Additional measurements of your eyes will be taken to determine the curvature of your cornea and the length of your eye.

These measurements are essential to help your cataract surgeon select the proper power of the intraocular lens and give you the best vision possible after surgery.

Today you have many types of IOLs to choose from for your cataract surgery, depending on your specific needs. In addition to IOLs that correct nearsightedness and farsightedness, there are now toric.

IOLs that correct astigmatism as well.

If you don’t mind wearing glasses after cataract surgery, a monofocal lens implant usually is used. Often, only part-time use of reading glasses is needed after cataract surgery with monofocal IOLs. But if prescription eyeglasses are needed (which often is the case if you only need cataract surgery in one eye), your eye doctor typically will prescribe new glasses for you approximately one month after surgery.If you like the idea of being less dependent on glasses after cataract surgery, one way to correct presbyopia and reduce your need for reading glasses is to have your cataract surgeon adjust the power of one of your monofocal IOLs (assuming you have cataract surgery performed in both eyes) to give you a monovision correction, similar to monovision with contact lenses.

Another option is to choose one of a variety of advanced presbyopia-correcting IOLs to improve your reading vision without sacrificing your distance vision. Presbyopia-correcting IOLs include accommodating IOLs and multifocal IOLs; both types are designed to provide a greater range of vision after cataract surgery than conventional monofocal IOLs.

Be aware that not everyone is a good candidate for these premium IOLs, and choosing a presbyopia-correcting IOL will increase the out-of-pocket cost of your cataract surgery, since the added cost of these advanced lens implants is not covered by Medicare or other insurance plans.

Prior to cataract surgery, in addition to discussing the different types of IOLs, you will be advised about what to expect before, during and after your procedure. This information — which may be presented orally, in writing, via a video presentation or a combination of all three — is meant to help you make an informed decision about whether to proceed with surgery.

If you have any questions or concerns about cataract surgery, be sure to discuss them with your eye doctor and cataract surgeon prior to signing “informed consent” documents authorizing surgery.

Also, discuss with your eye doctor all medications you are taking, including non-prescription (“over-the-counter”) formulations and nutritional supplements. Some medications and supplements can increase your risk of cataract surgery complications and might need to be discontinued prior to surgery. Ask your doctor for details.

Cataract Surgery Recovery

An uncomplicated cataract surgery typically lasts only about 15 minutes. But expect to be at the surgical center for 90 minutes or longer, because extra time is needed to prepare you for surgery (dilating your pupil; administering preoperative medication) and for a brief post-operative evaluation and instructions about your cataract surgery recovery before you leave.

You must have someone drive you home after cataract surgery; do not attempt to drive until you have visited your eye doctor the day after surgery and he or she tests your vision and confirms that you are safe to drive.

You will be prescribed medicated eye drops to use several times each day for a few weeks after cataract surgery. You also must wear your protective eye shield while sleeping or napping for about a week after surgery. To protect your eyes from sunlight and other bright light as your eye recovers, you will be given a special pair of post-operative sunglasses.

Also, many centers require someone to be with you after cataract surgery if you received anesthesia. Be sure to ask about this requirement prior to your cataract procedure so you are prepared for surgery day.

While your eye heals, you might experience some eye redness and blurred vision during the first few days or even weeks following the procedure.

During at least the first week of your recovery, it is essential that you avoid:

  • Strenuous activity and heavy lifting (nothing over 25 pounds).
  • Bending, exercising and similar activities that might stress your eye while it is healing.
  • Water that might splash into your eye and cause infection. Keep your eye closed while showering or bathing. Also, avoid swimming or hot tubs for at least two weeks.
  • Any activity that would expose your healing eye to dust, grime or other infection-causing contaminants.

Your cataract surgeon may give you other instructions and recommendations for your cataract surgery recovery, depending on your specific needs and the outcome of your procedure. If you have any questions at any time after cataract surgery, call your eye doctor for advice.

If you need cataract surgery in both eyes, your surgeon typically will prefer that you wait one to three weeks between procedures, so your first eye has healed sufficiently and you have good vision in that eye before the second surgery is performed.

Eyeglasses After Cataract Surgery

Unless you choose presbyopia-correcting IOLs, it’s likely you will need reading glasses after cataract surgery to see near objects clearly. Even people who choose these premium IOLs often find reading glasses are helpful for certain near tasks and seeing very small print.

In the event you have some mild refractive errors present after surgery (this is common), you may want to wear eyeglasses with progressive lenses full-time after your surgery to attain the best possible vision at all distances.

Even people who have an excellent visual outcome and can see well without glasses after cataract surgery often choose to wear eyeglasses full-time after their procedure to protect their eyes and because they feel more like themselves wearing eyeglasses after surgery if they have worn glasses most of their life.If you choose to wear glasses after cataract surgery, lenses with anti-reflective coating and photochromic lenses are highly recommended for the best vision, comfort and appearance. Ask your eye care professional for details and to demonstrate these lenses.


Our Team

Dr. Shailesh Agrawal
M.S (Ophthalmology) , Gold Medalist , Phaco & Refractive Surgeon Fellow in Medical Retina & Oculoplasty (L.V. Prasad Eye Institute)

FAQS

What is a cataract?

Cataracts occur when there is a buildup of protein in the lens that makes it cloudy. This prevents light from passing clearly through the lens, causing some loss of vision. As the cataract advances the cloudiness in the eye also increases until it is treated.

Why does a cataract develop?

A cataract is a part of ageing process. It is the most common cause of vision loss in people over age of 50. The amount and pattern of cloudiness can vary within the lens.Moreover cataract can develop cause of eye injury, presence of diabetes and usage of some medications or any other eye diseases. It is not necessary for cataract to develop only in old age only but it does develop in infants.

What are the symptoms of a developing cataract?

Cataracts usually form slowly and cause few symptoms until they noticeably block light. Symptoms may vary from individual to individual, some people may have problem with vision that is cloudy, blurry, foggy. Some may experience progressive nearsightedness in older people often called “second sight” because they may no longer need reading glasses. There might be changes in the way you see color because the discolored lens acts as a filter. You may face problems driving at night such as glare from oncoming headlights, problems with glare during the day, double vision (like a superimposed image).

What is Made for you Cataract Surgery?

With ‘Made For You’ Cataract surgeries, REH offers a unique solution that’s crafted just for you. Here, after rigorous pre-operative diagnosis and one to one lifestyle analysis sessions, REH suggests the perfect surgical technique and an IOL lens that not only fits your lifestyle, but also enhances it!

Can cataract be prevented or treated with medication?

As cataract is a part of ageing process it cannot be prevented. Using your eyes and your involvement in your daily activities has nothing to do with cataract formation. There are no current medicines as per the ongoing researches that have been proven to be helpful in the treatment of cataracts. The only known treatment for cataract is surgery.

When can one undergo Cataract Surgery?

When the cataract advances to a level which causes blurred vision, interfere with activities of daily living, or prevent them from leading active and productive lives, in such cases, these individuals should not wait to undergo surgery to remove their cataracts

Can all patients having a cataract undergo Phaco surgery?

The ophthalmic surgeon decides whether the patient can undergo phaco or not.The medical team will do a detailed eye examination to check the type of cataract, eye pressures, retina etc. to rule out any other eye problem. A Scan or Intraocular lens power calculation test will be done to know what power lens should be implanted after cataract removal.On the finding of the test it is been decided whether the patient is eligible for it or not and if not then which treatment he is eligible and suitable for.

What are the various types of Intraocular Lenses (IOLs) which can be implanted in the eye?

The lens choice is customized to suit the patient and depends on their overall eye condition including their optical system and considering the visual needs of the patient. Modern lenses are able to increase range of focus to include both distance and near vision.

We offers Aspheric monofocal (IQ), multi-focal (RESTOR), cylindrical (TORIC) and multi-focal combined cylindrical (RESTOR-TORIC)

IQ – is a Monofocal foldable IOL with thinner aspheric design for improved image quality , blue light filtration for uncompromised colour perception and single – piece acrylic design for superior biocompatibility and stability.

ReSTOR Aspheric – is a Multifocal acrylic foldable IOL which is the most frequently implanted Presbyopia correcting IOL with more than a quarter million implantations worldwide , has patented Apodised technology to minimize visual disturbances and has an aspheric optic to improve image quality and functional vision.

Toric IOL – is an astigmatism correcting Monofocal acrylic foldable IOL which is rotationally stable in the eye. The power of IOL is calculated using the AcrySofToric Calculator which ensures precise astigmatic correction.

RestorToric IOL– This IOL incorporates a promising new technology where the same IOL corrects astigmatism and also corrects presbyopia.It combines the benefits of a multifocal and Toric IOL.

Our team of doctors and counselors would be pleased to educate you for the best suitable option.

How is the IOL power calculated prior to cataract surgery?

IOL power calculations are done by trained professionals and every effort is made so as to get very minimal post-operative power in the distance glasses. This is done using immersion ultrasound biometry for measuring the eye accurately prior the surgery. A new device called the IOLMaster is available at the centre which is capable of extremely accurate measurement of the eye and calculation of the IOL power.

What is the life of an Intraocular Lens?

Once the IOL is implanted in the eye, it remains in place for the remainder of one’s lifetime.

Are there any problems with an Intraocular Lens?

Complications are rare and similar ones can occur with conventional surgery without an IOL implantation. Today, the technological advances in IOL manufacture and surgery have made it very much safe. All patients irrespective of other general illnesses like diabetes, hypertension etc. can have IOL surgery.

Is clear vision guaranteed after surgery?

Cataract surgery is a highly successful procedure (95-98% success rate) technically. However, the final visual outcome also depends on the condition of the eye i.e. cornea, retina, optic nerve, any pre-existing disease, amblyopia (lazy eye) etc. Sometimes it may be difficult to diagnose these abnormalities before the surgery due to cataract and we can know about it only after the operation. No surgeon in the world can perform a surgery with guaranteed results. However, almost all the patients regain good vision following a cataract surgery.

What are the possible complications that can occur with Cataract & IOL surgery?

In spite of the best care and precautions, like any other surgical procedure in the human body, there is a possibility of minor to major complication.

Some minor complications like slight drooping of the eyelid, swelling around the eye, corneal haze, reflection or slight distortion from lens implant, delayed healing, corneal edema are temporary and recover with time and medication. The chances of a serious complication like infection, severe inflammation, retinal detachment, nucleus drop, hemorrhage are negligible.

In a majority of cases these complications can be treated successfully or may resolve on their own with a good final restoration of vision. Since all the complications cannot be listed, the above list is not exhaustive.

What is Posterior Capsular Opaciation (PCO) or “After Cataract”?

In case of few patients undergoing cataract surgery, the back part of the lens capsule may thicken over a period of time causing blurred vision. This is known as Posterior Capsular Opacification (PCO), secondary cataract or “After Cataract”. This is not a complication. The condition is treated with a “YAG Laser Capsulotomy” with full restoration of vision.