Cataracts: Should I Have Surgery?

Cataract surgery removes the lens that has the cataract , which is a painless, cloudy area in the lens of the eye. In order for you to see, the lens must be replaced. This happens in one of two ways:

• During the surgery, the doctor places an artificial lens in your eye. This is how most cataract surgery is done. Some people also need to wear glasses or contact lenses after surgery.
• In a few cases, the doctor can't replace the lens. If that happens, you'll wear thick glasses or contact lenses instead.

Because the surgery replaces the lens in your eye, it's important to talk to your doctor about your choices.

If you have an astigmatism, your surgery may cost more. Talk to your doctor about your treatment options and costs.

Cataract surgery usually works very well.

If you don't have another eye problem, such as glaucoma or problems with your retina, your chances of seeing better after cataract surgery are very good. But you may still need reading glasses or glasses for distance vision.

If you are nearsighted or farsighted, or if you have astigmatism, you may not need your glasses or contacts as much after surgery. This is because replacing the lens can improve these problems. But the surgery is not done for this reason alone.

Cataract surgery doesn't usually cause problems. Your vision may be cloudy for up to 3 months after surgery. But this is normal and will go away as your eye heals.

Cloudy vision sometimes comes back

The most common problem after surgery is a gradual return of cloudy vision several months or years after surgery. The problem happens when a part of the remaining lens cover becomes cloudy. The clouding can be fixed with laser surgery.

Serious problems aren't common

Out of 100 people who have this surgery, fewer than 10 have serious problems.¹ This means that at least 90 out of 100 people do not have serious problems.

Newer surgery techniques, such as using a laser for part of the surgery, make it less likely for problems to occur during or after surgery.

Serious problems that can happen include:

• Swelling of the retina or cornea. This may cause blurry vision that often goes away on its own. If it doesn't, more treatment may be needed.
• New or different astigmatism, which can usually be treated with glasses or contact lenses.
• Infection in the eye. A very serious infection called endophthalmitis can lead to blindness. This type of infection is rare. Other eye infections, such as uveitis, may affect your vision until you get treatment.
• Problems caused by bits of the cataract left behind. Your doctor may need to do surgery to remove these bits and improve your vision.
• Glaucoma.
• Retinal detachment. After you have had cataract surgery, your risk for retinal detachment is higher than normal.

Some of these problems can be fixed with other treatment. But you may still have poor vision or blindness in the affected eye. In some cases, the treatment itself may also cause more problems.

Usually, a cataract that isn't removed will slowly get worse and make your eyesight worse:

• You may no longer be able to do your usual daily activities.
• You may not be able to drive safely, especially at night.
• You may be more likely to fall or hurt yourself.

The cataract may make it hard for your doctor to check for other eye problems, such as damage from diabetes.

When a cataract isn't treated until after it has become severe, the surgery may be harder to do. Also, you may be more likely to have problems after surgery or have a slower recovery than someone who had surgery for a less severe cataract.

Your doctor might recommend surgery if:

• Poor eyesight is affecting your ability to do your job or take part in some leisure or social activities.
• Surgery would help your doctor keep track of another eye problem, such as a problem with your retina.
• You do not have glaucoma, diabetic retinopathy, or macular degeneration. Surgery may not improve eyesight in people who also have these eye problems.

When children have cataracts that cause vision problems, surgery is usually needed. To prevent permanent vision loss, it is very important to remove cataracts before the child is 3 months old.