Cataract surgery: What to expect before, during and after

Cataract surgery is one of the most common surgeries in the U.S. It's also one of the oldest procedures still being performed today.

Ancient Egyptians used a surgical technique known as "couching," in which a sharp needle was used to slide the cloudy lens out of the field of vision and into the vitreous cavity in the back of the eye. Later, the Romans used a method called "needling" to slice up the cataract into pieces small enough to be reabsorbed. While both procedures improved vision, they couldn't provide completely clear sight because they didn't replace the lens.

That breakthrough didn't come until the 1940s, when English ophthalmologist Harold Ridley invented the intraocular lens.

Today's cataract surgery

Unlike the surgeries of antiquity, today's cataract surgery uses small incisions and suction to remove the cloudy lens, and then replace it with an artificial plastic lens.

Lens extraction is done using one of two procedures: phacoemulsification or extracapsular surgery. After your cloudy lens is removed, it will be replaced with an implanted clear artificial lens called an intraocular lens (IOL). Your eye doctor will select a lens with appropriate focusing power based on measurements of the eye that were made before surgery, as well as discussion of your lifestyle needs.

What to expect on cataract surgery day

Cataract surgery is typically performed as an outpatient procedure. You'll most likely spend two to three hours at the surgical facility. The procedure itself usually lasts less than half an hour.

You will be awake, but you may receive a sedative intravenously to relax you. You'll get local anesthesia to prevent block pain. Operating room staff will apply various drops to the eye before and after the surgery, according to the doctor's orders.

Afterward, the surgeon may cover the eye with a bandage or shield, which you can remove later that day or on the following day. You will rest in the recovery area for about 30 minutes, and then will receive instructions on how to care for your eye. Once you're ready to go home, someone will need to drive you.

Recovery at home after cataract surgery

You will see your ophthalmologist for several postoperative visits—typically one day, one week, one month, two months, and six months after surgery. At each appointment, the doctor will examine your eye, test your visual acuity, and measure your eye pressure.

After your surgery, you will apply prescription antibiotic and anti-inflammatory eyedrops several times a day to prevent infection and reduce inflammation. For about a week after surgery, you'll wear an eye shield to protect your eye while you sleep. Wear sunglasses outside per your doctor's recommendation.

To learn more about cataracts and surgery options, read Clearing the fog of cataracts, a Special Health Report from Harvard Medical School.

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