FAQs

The modern concept is patient specific. When the patient feels the cataract is interfering too much in their day to day activities or work, they may go in for surgery. This may vary from profession to profession and from one type of cataract to another.

Most cataract surgeries these days are performed under topical anaesthesia (by the use of local anaesthetic eye drops) which means that no injection is required at all. After surgery there is usually no pain at all. The patient may feel some mild discomfort which usually subsides after some time or with medication.

Cataract surgery is performed mostly under local or topical anaesthesia, but also under general anaesthesia in some cases.

By topical anaesthesia is meant that the eye is made numb by instilling local anaesthetic eyedrops. This is the most preferred form of anaesthesia these days. It allows speedy recovery from the anaesthetic effect after surgery thereby eliminating the need for bandaging the eye. The patient’s cooperation is required during surgery.

Under local anaesthesia, an injection of local anaesthetic solution in injected around the eyeball to block the nerves to the eye and allow painless surgery with an immobile eye. It is required for longer surgeries or if the cataract is of very hard consistency, and also in cases when patient is unable to keep the eye still during surgery.

General anaesthesia is rarely required in adults- only in case the person is allergic to local anaesthetics or is mentally or physically challenged and not able to cooperate during surgery. General anaesthesia is also required for surgery on children.

A cataract is a cloudiness of the eye’s natural lens, which lies between the front and back areas of the eye, directly behind the pupil.

Most cataracts develop slowly over time and affect people over age 50. About half of the population has a cataract by age 65, and nearly everyone over 75 has one. But in rare cases, infants can have congenital cataracts. These usually are related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited. Cataracts may also develop due to certain diseases, medications or after trauma to the eye.

All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery world over. Many cataract surgeons have several thousand procedures under their belts. Choosing a surgeon with this much experience will reduce the risk of something going wrong.

A small incision is made on the front surface of the eye with a keratome (knife) or a laser. A circular hole is then cut in the front of the thin membrane (anterior capsule) that encloses the eye’s natural lens. Typically the lens is then broken into smaller pieces with a laser or an ultrasonic device (phacoemulsification) so it can be more easily removed from the eye.

Once the entire lens material is removed, it is replaced with a clear implant called an intraocular lens (IOL) to restore vision. In most cases, the eye heals quickly after surgery without stitches.

In a minority of cases (perhaps 20 to 30 percent), months or years after cataract surgery, the posterior portion of the lens capsule that is left inside the eye during surgery for safety reasons, becomes hazy, causing vision to again become blurred.

This “aftercataract” (also called posterior capsular opacification) usually can be easily treated with a less invasive follow-up procedure called a YAG laser capsulotomy. In most cases, this 15-minute procedure effectively restores clear vision.

Rarely does anyone have to wear thick, heavy eyeglasses after cataract surgery these days. Most modern cataract procedures involve the use of advanced technology and IOLs that often can correct your vision to 20/20 without glasses or contact lenses.

In fact, premium multifocal IOLs can even eliminate your need for reading glasses after cataract surgery. During your pre-op exam, ask your cataract surgeon for more details about this exciting technology.

The cost of cataract surgery varies from one doctor to the next; it also depends on the type of procedure and intraocular lens you and your cataract surgeon decide is best for your needs.

Medicare and most health insurance plans will cover cataract surgery and ordinary intraocular lenses, but not the cost of premium IOLs, such as presbyopia-correcting IOLs that simultaneously correct vision at near, intermediate and distant ranges

As with any surgery, pain, infection, swelling and bleeding are possible, but very few people experience serious cataract surgery complications. In most cases, complications or side effects from the procedure can be successfully managed with medication or a follow-up procedure.

To reduce your risk for problems after cataract surgery, be sure to follow the instructions your surgeon gives you and report any unusual symptoms immediately.

Yes, in most cases, cataract surgeries are performed under local or topical (eyedrops) anaesthesia and the patient remains awake throughout. But the procedure lasts a very short time (5-10 min) during which time the patient will be asked to look straight up at the ceiling.

Yes, astigmatism may be corrected by the use of toric lens implants. The toric lens is customized for the correction required by each patient and eliminates this refractive error after surgery.

Cataracts can cause both temporary and permanent blindness.

If cataractous changes to the natural lens are allowed to progress till full opacity, it will lead to blindness. But this blindness can be reversed with surgery when the cloudy lens matter is removed and in most cases replaced by a lens implant.

But if a cataract is not treated or monitored, it may progress to the point of becoming swollen, leading to cataract induced glaucoma. This may lead to damage to the nerve of sight (optic nerve) leading to permanent vision loss. At times, the lens material itself can cause damage to the eye leading to vision loss. An overly mature cataract may fall back into the vitreous chamber (behind the lens) onto the retina, leading to many difficulties and much more complicated surgery. Here also vision may be permanently hampered.

So cataract should not be left to mature unmonitored and should be removed at the right time.

No, the only cure to cataracts is surgery. The progress of the clouding of the lens varies greatly from individual to individual. These changes are totally normal aging processes, much akin to graying of hair, some people grey faster, some slower. No medication is known to slow or stop this progression.

Yes, since LASIK has been around for so many years now, patients who have had it done are now reaching the age of cataracts. Special calculations are required for the lens implants in patients who have had LASIK. The pre-operative assessment and preparation may be a bit more complex.

Patients of glaucoma can undergo cataract surgery. At times surgery  for both conditions is performed at the same sitting. If the surgeries are to be performed at separate sittings, glaucoma surgery is performed first, then cataract surgery at a later date.

In some patients, the progression of cataract is so slow that even if left untreated, no major issue arises. They do however need to be regularly monitored for certain complications which may arise due to untreated cataract. Those complications are glaucoma induced due the swelling of the lens, glaucoma due to toxicity of the lens matter, dislocation (subluxation) of the lens due to weakening of some of the zonules (the thin threads that hold the lens in place) or even falling to the lens into the vitreous due to breakage of zonules.

In the past, with the use of monofocal lens implants, patients would inevitably requires glasses for reading after surgery.

With the advent of premium lens implants like toric lenses, multifocal lenses  and multifocal toric lenses, the necessity of glasses after cataract surgery has decreased significantly. To fine tune near vision, they may however still be required.

A secondary lens implant refers to the implantation of a lens in a patient who has had their natural lens removed in a previous surgery. This may be a surgery for trauma or an infection of the eye.

This may be a technically more difficult surgery depending on the circumstances of the first surgery.