Cataract Treatment

How are cataracts treated?

It is not usually necessary to treat cataracts unless they interfere with daily life. As a first step, an ophthalmologist (a doctor who specializes in the medical and surgical treatment of the eye) conducts a thorough examination to detect cataracts. Then, the patient and the ophthalmologist decide together whether removal is necessary.

Cataract removal involves surgery to remove the clouded lens. There is no pill, eye drop, or ointment alone that can prevent or cure cataracts. Similarly, lasers cannot remove cataracts, although doctors sometimes perform laser therapy if the membrane that holds the lens becomes cloudy in the weeks following surgery.

What's involved in cataract surgery?

Learn more about laser-assisted (Femtosecond) cataract surgery available at Mass. Eye and Ear.

Surgery for cataracts is a brief and relatively simple procedure. It usually takes less than an hour to complete. In the past, most cataract surgery patients remained in the hospital following the operation. However, with improvements in techniques and equipment, doctors can perform most cataract procedures as ambulatory surgery, and the patient can return home the same day. Today, more than 95 percent of cataract surgeries are successful. It is one of the safest forms of surgery.

You will arrive at Mass. Eye and Ear about 60 minutes prior to your procedure, when you will be checked in and prepared for surgery. You will meet your anesthesiologist and your eye surgeon. Just before the operation begins, you will receive eye medicine to numb the eye and dilate the pupil. An intravenous line is placed and you will receive a sedative during the surgery, but are usually awake during the procedure. In the operating room, the area around your eye is cleaned, and a device will be placed to keep your eyelids open during the surgery.

During surgery, the surgeon makes a small incision on the surface of the eye. This incision becomes a passageway through which the surgeon removes the diseased lens in small particles using sound waves and gentle suction. A folded permanent lens replacement is then inserted, and it expands into place. The small incision is "self sealing", but occasionally requires a few stitches.

What replaces my lens?

Most cataract surgery patients receive an "intraocular lens implant" to replace the natural lens. The doctor inserts it in the front part of the eye during surgery. The implanted lens is a permanent replacement for the natural lens; except in rare cases, it will never be taken out. Premium intraocular lenses, which correct vision at multiple distances and significantly reduce or eliminate the need for glasses, are also available. 

What can I expect after surgery?

You will be discharged with a patch and shield over the eye, which will be removed by the doctor the next day in the office. Eye drops that prevent infection and help the eye heal will be prescribed after surgery. You should get plenty of rest and avoid heavy lifting or other types of strenuous activity. For a few days following surgery, you may experience some discomfort in or around the eye which can usually be relieved with acetaminophen.

How will cataract surgery improve my vision?

After cataract surgery, patients may notice some improvement as soon as the doctor removes the eye bandage. Most patients experience a gradual improvement in vision during the first few weeks after surgery. A new prescription for glasses will be given about a month after surgery, when the doctor feels that the eye has healed.

Improvement in vision and individual lifestyle determine how quickly patients can resume normal activities. For example, if you have good vision in your untreated eye and do not engage in many activities that require acute vision or excessive straining, you might resume many normal activities within a few days of the operation.

Are there after-effects I should know about?

A common occurrence following cataract surgery is a clouding of the thin membrane that holds the lens in place. A doctor can readily treat this problem with laser surgery. During laser treatment, the ophthalmologist makes tiny holes in the clouded membrane to allow light to pass. This painless procedure takes only a few minutes and has a very high rate of success.