Cataract Surgery/Lens replacement surgery

A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. With modern surgical techniques, you can have surgery at any stage when the cataract is affecting your daily life.

What does cataract surgery involve?

Cataract surgery involves removing your cloudy lens and replacing it with an artificial lens. It is normally performed as day surgery under local anaesthetic, so you are awake but your eye will not feel any pain. The operation usually takes approximately 15-30 minutes. Most patients do really well with numbing eye drops only but sometimes local anaesthetic injection may be required. Some patients choose to have surgery under sedation or general anaesthesia. Please discuss it during your first consultation.

Measurements were taken before the operation to decide which lens strength is right for you. The most common choice is the standard monofocal lens, which aims to make you glasses-free for distance so that you only need glasses for reading. However, there is a chance (10-20%) you will need glasses for both distance vision and reading after surgery, particularly if you have a history of astigmatism or a high refractive error.

What are the risks of cataract surgery?

Cataract surgery is usually very successful, with over 95 % of people noticing an improvement in their vision after surgery if there are no other pre-existing eye conditions. However, it is important to realise that there is always a risk of complications associated with any operation.

Some of the complications that may occur during the operation include:

• Internal bleeding, Damage to other structures of the eye, including the capsule surrounding the lens, Incomplete removal of the cataract, Part of cataract moves in the jelly of the eye.
• Some of these complications can be dealt with at the time of the surgery or just after surgery as a second procedure but rarely (<0.5%) it involves another surgical team to manage the complication.

Potential complications occurring after the operation include:

• Severe infection, Fluid accumulating in the retina, Detachment of the retina, Incorrect strength of lens inserted, Clouding of the membrane behind the lens
• These complications can sometimes occur even if the operation itself is carried out perfectly. Many of these complications are manageable, although it may mean that other treatments may be required and that the recovery period may be longer than usual.
• This includes the need for additional surgery in approximately one in 100 cases. The most serious consequence of all the complications is the risk of loss of vision, which may be temporary or permanent.
• The chance of severe or complete permanent loss of vision in the operated eye is less than one in 1,000. In approximately one in 10 cases, the membrane behind the artificial lens can become cloudy making your vision more blurred again.
• If this happens an outpatient laser procedure may be needed some time after surgery (YAG laser capsulotomy). We would like to reassure you that these risks are not common, with over 95 of every 100 operations occurring without any complications.

Are there any alternatives?

The alternative to cataract surgery is to discuss with your optician if a change in glasses can improve vision. You can delay surgery as long as you can function normally and you are getting eye checks regularly. Sometimes, cataracts can become dense after some time, which can increase the risk of cataract surgery.