A Complete Guide To Cataract Surgery


Many of us are likely to hear our eye doctor say, "You have cataracts" anytime after age 50.

A cataract is a clouding of the lens inside the eye that causes vision loss and can not be fixed with glasses, contact lenses, or corneal refractive surgery such as LASIK.

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

Many cataracts are related to the cycle of aging and are widespread among older Americans. In fact, 68.3 percent of Americans 80 and older had cataracts in 2010, according to the National Eye Institute (NEI).

Cataracts occur as proteins begin to break down in the eye's lens so that vision can become distorted, doubled, or turn yellow in tint. You may lose vision in color, peripheral vision, or you may have a spot or two in the center of your vision. It can cause vision loss, which will make it more difficult for you to enjoy your life. This can become dangerous in some instances.

cataract surgery

This means that you can qualify for cataract surgery, a procedure that removes the eye's diseased lens and substitutes it with an artificial lens. There are two forms of cataract surgery and you can choose from many different lenses, but some of them might not be covered by insurance.

And cataract prevalence in the U.S. is projected to increase dramatically in the years ahead, due in part to population aging. Roughly 24.4 million Americans had cataracts in 2010, and according to NEI
this number is projected to grow to 50.2 million by the year 2050.

Fortunately, modern cataract surgery is one of today's safest and most effective surgical procedures.

More than 3 million cataract surgeries are conducted each year in the United States, with the vast majority of these operations yielding outstanding visual results.

What are Cataracts?

Cataracts are the world's leading cause of blindness, and the leading cause of vision loss in the U.S. In reality, in one or both eyes, 20.5 million Americans aged 40 and older have a cataract representing around 17 percent of the middle-aged and older population.

This disorder involves clouding the lens of the eye and can occur at any age, although it is associated with older adults more often than young people.

Cataract treatment and removal are widely available, though some barriers may exist, including cost, insurance coverage, access to vision care, and understanding of the seriousness of the condition, which may affect when and how cataracts are treated.
About 6.1 million people with cataracts had their clouded eyes removed during surgery. Although this is one solution to cataract care, the only alternative is far from being that. The symptoms of cataracts are important to understand, so they can be diagnosed early. Then, it may take various strategies to handle and eliminate them.

Cataract Symptoms & Causes

When cataracts form in your eye lens, you may experience changes in your vision which may decrease how well you see them. Cloudiness can appear in a tiny region of your lens and will barely affect your vision if it does something, or the spot may be prominent and grow quickly. As the cataract grows larger, you will experience an increased loss of vision, including blurriness, color changes, and low light trouble because the cataract will change how your lens refracts light in your eye.

If you have cataracts, you can experience the symptoms below:

  • Cloudiness in your vision, like looking through a foggy or dusty windshield
  • Blurry or hazy vision
  • Double vision (diplopia)
  • Less colorful vision, particularly a yellow tint to the world
  • Increased light sensitivity
  • Trouble seeing well at night
  • Needing more light to read
  • Seeing halos around lights

The most common cause of cataracts is normal eye changes, which for many people start at around age 40. Proteins begin to break down in the lens, either due to genetic or pre-existing conditions or with age; this breakdown of proteins leads to the clouding of the lens. People over 60 typically begin experiencing some clouding in their lenses. Although clouding may begin with protein breakdown, actual degradation or loss of vision may not begin until years later.

There are different causes you might start developing cataracts.

  • Family history of cataracts, or of similar family members
  • Diabetes, high blood pressure or other ailments
  • Previous eye injury, ophthalmology or treatment with upper body radiation
  • Spending a lot of time in the sun, particularly without ultraviolet ( UV) radiation protective sunglasses
  • Medicines such as Corticosteroids
  • Consuming too much alcohol
  • Smoking
  • Obesity
  • Previous eye inflammation

Different types of Cataracts

  • Nuclear cataracts: This affects the lens center. They may begin with causing more nearsightedness or an unusual temporary improvement in vision reading. The lens will gradually turn yellow and cloudy though, so the loss of vision begins. When nuclear cataracts are left untreated, the lens can also turn gray.
  • Cortical cataracts: They start as wedge-shaped, whitish opaque areas or streaks along the lens' outer edge. This type of cataract progression means that the streaks or opaque areas extend towards the center of the lens to interfere with light passing through the organ.
  • Posterior subcapsular cataracts: This type of cataract forms a thin, opaque region in the back of the lens, often directly in the path of sight. Your perception of reading can change, you'll have difficulty in bright light with dim light and poor vision, and at night you can see glares or halos around the lights. This form appears to evolve faster than other cataract forms.
  • Congenital cataracts: These are formed in utero, so in childhood, a baby will be born with them, or develop them quickly. They may be genetic, or due to head trauma or intrauterine infection that affects eye growth. Other diseases in young children can cause certain cataracts. These are often removed soon after detection to avoid impact on vision.
  • Traumatic cataract: These may develop following an eye injury that damages the lens. Often, years after the original injury, this form of cataract can develop.
  • Secondary cataract: It can develop to treat a problem of the vision such as glaucoma after particular eye surgery. This is sometimes called posterior capsular opacification, and the procedure is basically scar tissue.
  • Cataract radiation: Exposure to certain forms of radiation can damage the lens and cause cataracts.

If cataracts are formed you can qualify for cataract surgery. While cataract surgery is based on removing the affected lens, there are two distinct types: traditional and laser-assisted. More understanding out of those approaches is important.


Cataract Surgery

Cataract surgery is a technique for removing the eye's lens and replacing it with an artificial lens, in most cases. The lens in your eye is usually transparent. A cataract causes the eye to get blurry, which then affects the vision.

Cataract surgery is done outpatient by an eye specialist (ophthalmologist), meaning you don't need to stay in the hospital after the surgery. Cataract surgery is very common and is a safe procedure in general.

  • Traditional cataract surgery: This approach to treating cataracts also known as phacoemulsification starts with your eye surgeon making a tiny incision on the surface of your cornea using a scalpel. Instead, a precision tool is placed behind the pupil, where the eye lens rests, through the opening. Another device produces a circular hole in the lens and then the sound waves are used by a probe to crack the glass, which is then suctioned out. In substitute for the natural lens, an artificial lens is installed. The cornea is typically filled with self-sealing liquid, instead of using stitches to seal the opening.
  • Laser-assisted cataract procedure: The laser-assisted procedure maps the whole eye with an ultrasound system similar to conventional cataract surgery. Guided lasers create the holes in the cornea and lens instead of a scalpel, and they are often used to crack the lens in place of the probe.

Although many people benefit from conventional cataract surgery, if you have astigmatism along with cataracts, your ophthalmologist can explicitly prescribe laser-assisted surgery because the lasers will also fix this refractive error by reshaping the cornea with lasers.

Alternatively, you can qualify for laser-assisted cataract surgery if you have a premium lens implanted, like one that corrects astigmatism, or is a multifocal IOL.

Any type of surgery needs different names for different incision sizes as well.

  • Small-incision cataract surgery: This is the most common type of cataract surgery and involves removing the lens with the smallest incision possible.
  • Extracapsular surgery: This technique requires a slightly wider incision, which enables removal of the lens center in one piece.

All conventional and laser-assisted cataract procedures have similar recovery times, and existing Medicare guidelines specify that the laser-assisted treatment can not be performed by a surgeon unless one of the two requirements listed above is met. The laser-assisted surgery has a great additional cost, so there is currently no reason to pursue it unless you have to correct astigmatism, too.

Research has not demonstrated any potential value to those with cataracts who have no astigmatism to try laser-assisted surgery. The skill of your surgeon has more effect on healing and improving vision than the technology used in the procedure.

Usually, for complete recovery, each treatment takes about three months. Some people will suddenly experience vision improvements and others may start noticing vision improvements after a few weeks. As the eye heals, vision progressively improves.

Risk Factors

Complications following cataract surgery are rare, and most can be successfully treated.

Risks of cataract surgery include:

  • Inflammation
  • Infection
  • Bleeding
  • Swelling
  • Drooping eyelid
  • Dislocation of artificial lens
  • Retinal detachment
  • Glaucoma
  • Secondary cataract
  • Loss of vision

If you have another eye disorder or a severe medical problem the chance of complications is greater. Occasionally, cataract surgery due to underlying eye damage from other conditions, such as glaucoma or macular degeneration, does not improve the vision. If necessary, evaluating and treating other eye conditions before making the decision to undergo cataract surgery can be helpful.

Approximately 1 % of people undergoing cataract surgery typically experience temporary vision loss due to macular edema or swelling in the eye; less than 1% develop an eye infection. Around 10 percent of older adults undergoing this procedure experience drooping eyelids, but after around six months this usually returns to normal on its own.

The Procedure of the Cataract Surgery

After the cataract operation has been decided by you and your eye doctor as the correct move for your eyes, there are several ways to plan for the operation. It is an outpatient procedure, and you won't be staying in the hospital for the night; instead, your treatment will be at home. You should talk to your eye doctor about the amount of time you need to take work off to recover from the procedure.

Second, you'll be asked after you've been diagnosed with cataracts that are likely to require surgery:

  • Undergo certain tests to measure your eye size and shape.
  • Stop taking certain medicines, especially those that increase the risk of bleeding.
  • To raise the risk of infection using medicated eye drops.
  • Fast for 12 hours (no eating or drinking) before surgery.
  • Set up your first recovery days, including getting a ride home with someone you trust and securing assistance around the house.

Sometimes, you should discuss with your doctor what sort of IOL you want. Possibilities include:

  • Monofocal fixed-focus which has a single focus intensity to enhance the vision of distance. It means that you might need to wear glasses after surgery.
  • Monofocal accommodation-focus, which also has a single arm. With muscle twitches in your eye which normally focus your natural lens, they can shift from close to far vision.
  • Multifocal lens, which is like wearing bifocal or progressive lens lenses, allowing for near, medium, and distant vision.
  • Removal of astigmatism, or toric lenses, that can help to reshape the eye while also enhancing vision.

Like some other vision procedures, cataract surgery is fast and takes an average of around 30 minutes. You will obtain a sedative to relax the eye during the operation, although it is extremely unlikely you will be put under general anesthesia.

Your doctor will prescribe medicated eye drops for you to use after the surgery and will give you a list of things to avoid for the first few days and weeks.

These can include wearing a protective eye mask during the daytime while you sleep and wearing glasses to stop you from scratching your eye. You may also need to avoid exercise, driving, and work for a couple of days leading to eye strain. Your ophthalmologist will tell you when those things are safe to do again.

The first days after the procedure you may experience itching, mild discomfort, or a small amount of discharge.

How much a Cataract Surgery Costs?

Average cataract surgery costs are likely to be covered at least in part by insurance, especially if you undergo conventional cataract surgery and obtain mono-focal lenses. Toric lenses will start at about $1,500 each and can cost up to $3,000 each for even more specialized lenses. These may not be covered by insurance, so talk to your doctor before making a decision on those lenses.

Medicare will cover this procedure when it is deemed medically necessary for older adults. The treatment will also be protected by other insurance providers, at least in part, as they will be able to see effects on health and quality of life.

You can not know how much cataracts affect your life until after getting surgery to fix the problem. About 62 percent of people undergoing cataract surgery report seeing better and enjoying life more as a result. As technology advances, recovery time shortens after cataract surgery, so you can return to activities you enjoy earlier

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Maria Brown

Graduate in biotechnology, Maria Brown has a huge appreciation for books and writing. Apart from talking about classic literature with people around (which is her favourite thing to do), she provides editorial assistance to the team. Maria always has something to talk about on any topic because of her vast knowledge on a plethora of subjects.