Literally the most common surgical procedure performed in the United States, cataract surgery has helped to eliminate the once inevitable connection between growing older and poor eyesight. Cataracts affect almost everyone that reaches the age of 75 and 50 percent of these people have significant vision loss because of it. Surgical removal of the cataract and replacement of the cloudy lens with a clear, synthetic, substitute lens is a treatment that results in highly satisfactory results. Over 90 percent of all persons undergoing the procedure regain eyesight in the 20/20 to 20/40 range.
Cataract surgery is not only common, but relatively noninvasive. It is performed on an outpatient basis, under local anesthetic, with relatively quick recovery time compared to other surgical procedures. At this time, surgery is the only cure for cataracts; once the clouding begins to develop in the lens are no pharmaceutical treatments to halt or reverse the damage. However, surgery is generally not recommended until there is sufficient vision damage to justify undergoing the procedure.
* The 2010 National Average cost of Eye Surgery procedure is $2,912.
* Cataracts are one of the greatest public health challenges of the 21st century, accounting for nearly half (47.8%) of all blindness.
* Cataract surgery is the most commonly performed major operation in the United States. The 2010 Medicare allowed charge for this procedure is $2,160.91.
If you have been told that your vision problems are due to cataracts, the following information will provide you with a solid introduction to the surgical treatment for this condition. For more detailed information about how this treatment may be used to correct your particular vision problems, we recommend that you consult an eye care physician with experience in this treatment.
- What are the most common benefits of this surgery?
- How is the procedure performed?
- How long does the surgery take?
- Where will the procedure be performed?
- How much pain is there?
- What can I expect after the procedure?
- What is the recovery period like?
- What is the long-term outcome like for most people?
- Ideal Candidate:
- Other important information
- Risks and Limitations:
What are the most common benefits of cataract surgery?
By removing the clouded lens from the eye and replacing it with a permanent intraocular lens (IOL) the vision problems caused by the cataract are eliminated. Notable cataract-induced vision symptoms that are treated include: painless blurring or dimming of vision, light sensitivity, an increase in nearsightedness, visual distortion or ghost images and difficulty with near reading and glare. If vision problems are present that are due to other conditions such as glaucoma, macular degeneration (aging of the retina), or diabetic-related eye damage, the surgery will not treat this damage. But the gain in eyesight might make it worthwhile to undergo the procedure, even though it is known that the procedure will not restore completely corrected eyesight. The elimination of the symptoms of the cataract can have major effects of the day-to-day life of the patient, with improved everyday activities such as driving, reading, working, moving around, social interaction, and ability to participate in hobbies. Patients often benefit from a significant increase in safety, self-confidence, and independence after the surgery.
How is the cataract surgery procedure performed?
The basic operation to remove a cataract is a process called phacoemulsification/extracapsular cataract extraction. This technique involves making a small incision where the cornea, the clear layer covering the lens, and the sclera, the white of the eye, meet. Through this incision, two of the three structures of the lens -- the hard nucleus and the soft cortex -- are removed. The last structure, the lens capsule, is left in the eye to support the intraocular lens implant.
A relatively recent modification of the extracapsular cataract extraction technique is phacoemulsification. An ultrasonic probe is inserted into the incision and used to break up the nucleus and cortex tissue, where it is suctioned out by the probe. The major advantage to phacoemulsification is it allows the surgeon to remove the tissue through a smaller incision.
After the clouded lens tissue has been removed, the surgeon usually places a synthetic implanted lens, known as an intraocular lens (IOL), into the eye. The same incision where the lens tissue was removed is used to place the IOL in the eye. Lenses have been developed that can fold, so small incisions such as those used in the phacoemulsification process do not necessarily need to be enlarged. Implanted lenses are often preferred over cataract glasses or contacts, two other ways to replace the function of the removed lens, as they provide superior vision results and have less maintenance concerns.
How long does cataract surgery take?
The average cataract surgery is about an hour long, but can be as short as twenty minutes. Usually only one eye is done at a time.
Where will the procedure be performed?
The procedure is performed in an outpatient center or outpatient facility of a hospital. After the procedure is over, there is a short stay to check for complications, but all patients are able to go home the same day.
How much pain is there?
Local anesthesia, often administered as eye drops at the beginning of the procedure, takes care of the any pain due to forming the incision, removing the lens, and implanting the intraocular lens (IOL). There may be minor pain during the healing process, but it should be relieved by non-prescription drugs such as acetaminophen or aspirin.
What can I expect after cataract surgery?
You will need someone to drive you home after the procedure. Post-operative care often includes the use of eye drops, wearing of glasses or shields, the use of over-the-counter pain medication to control any residual twinges, and restricted driving until your doctor gives permission to return to the road.
What is the recovery period like?
Recovery is generally short, with full healing occurring within two to six weeks of the surgery. Some people have noticeable improvement in their vision from the day of surgery onward, while others need about a week for their vision to clear. The need for drops or the use of shields in bright sunlight is most acute during the first week after surgery and can continue throughout the recovery period.
What is the long-term outcome like for most people?
Cataract surgery is a highly successful treatment, with outcome eyesight between 20/20 and 20/40 for 90 percent of the procedures. In about 50 percent of all treated patients, several months to a year after the procedure the capsule of the lens will become clouded, also know as "secondary cataracts." A recent study suggested that the type of material used in the intraocular lens may be associated with more or less development of this complication, and this is something that should be discussed with your ophthalmologist.
If the "secondary cataract" develops, it can be treated using a procedure called a YAG capsulotomy. This procedure involves using a laser to clear a hole through the damaged capsule tissue for light to enter the eye. This post-operative treatment is the only current use for a laser in cataract surgery, although research into the use of a laser to remove the lens tissue is ongoing.
The ideal candidate for this surgery is a person who has medical confirmation that their vision changes are due to the development of a cataract and these changes are severe enough to impact on their day-to-day lives. Minor blurring can often be treated with a change in eyeglass prescription, so waiting for the cataract to "mature" can be suggested. In the final analysis, the cataract should be removed at the point that the negative effects of the vision changes are severe enough to justify the low, but existent, possibility of complications with the surgical procedure.
Other important information
There are now several types of intraocular lenses (IOLs) on the market, each with its own advantages and disadvantages. One new option is a multifocal lens that may allow the patient to do without reading glasses after the surgery. Multifocal lenses differ from the traditional monofocal IOLs as they accommodate, in one lens, vision problems in seeing near and seeing far. The best candidates for this new type of lens are those who are having cataracts removed from both eyes and are free of other vision altering problems such as glaucoma or macular degeneration.
Cataract Surgery Risks and Limitations:
The following complications can result from cataract surgery: high pressure in the eye (glaucoma); blood collection inside the eye; infection inside the eye; artificial lens damage or dislocation; drooping eyelid; retinal detachment; severe bleeding inside the eye; swelling or clouding of the cornea; blindness; and loss of the eye. Note that these risks are sorted from most common to least common and most have medicinal or surgical treatments.
Cataract extraction is most successful if the damaged lens is the sole vision problem in the eye. If other damage is present, particularly if due to a continuing condition, such as diabetes, vision can remain compromised even after the cataract is removed. However, if the vision quality is improved, it may make sense to undergo the procedure despite the knowledge that the resulting vision will not be perfect.
The information on this web site is intended only as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.
*Disclaimer: Sources: American Society for Aesthetic Plastic Surgery (ASAPS), nationally in 2010, and Advanced Ocular Care (march, 2011). Most surgeons offer convenient payments plans for this procedure. Cost does not include anesthesia, operating room facility, hospital stay, and other related expenses. Costs may vary depending the extensiveness of the procedure, location, and other factors. Costs are provided solely for research purposes. For specific estimates, please contact a qualified plastic surgeon.