Cataract extraction with intraocular lens (IOL) implant is a common surgical procedure to restore vision affected by cataracts. A cataract causes the eye’s natural lens to become cloudy, leading to impaired sight. This surgery involves removing the clouded lens and replacing it with a clear, artificial IOL, aiming to improve visual clarity.
What Are Cataracts and Why Surgery is Needed?
Cataracts develop when proteins within the eye’s lens break down and clump together, forming opaque areas. This process often occurs gradually with aging, but can also result from eye injury, certain medical conditions like diabetes, prolonged steroid use, or genetic factors. As these cloudy patches enlarge, they scatter or block light from reaching the retina, declining vision.
Common symptoms include blurred, dim, or misty vision, making it feel as though one is looking through a dirty window. Patients may also experience increased light sensitivity, halos or streaks around bright lights, difficulty seeing in low light or at night, and colors appearing faded or yellowish. While initial eyeglass prescription changes might offer temporary improvement, glasses or contact lenses eventually cannot correct vision adequately. When cataracts significantly interfere with daily activities like driving, reading, or recognizing faces, surgery becomes the only effective treatment.
The Surgical Procedure
Cataract extraction, most commonly performed using phacoemulsification, begins with eye preparation. Measurements are taken to determine the correct IOL power. The surgery is typically done under local anesthesia, often with medication to help the patient relax.
The surgeon creates a small incision (1.8-2.8 mm) at the edge of the cornea. Through this opening, a circular tear, known as a capsulorhexis, is made in the front of the lens capsule. This provides access to the clouded lens material while leaving the capsule intact to support the new IOL.
Next, a small ultrasonic probe is inserted. This instrument emits high-frequency sound waves to break the cataract into fragments. These fragments are then suctioned out. After removing the lens material, a foldable IOL is inserted through the incision into the capsular bag. The IOL unfolds and is positioned, focusing light onto the retina. The incision is self-sealing and usually does not require stitches, closing naturally.
Choosing Your Intraocular Lens
IOL selection is personalized, with different types offering varied visual outcomes based on lifestyle and needs. Monofocal IOLs are the most common, providing clear vision at a single, fixed distance, usually set for far vision. Patients with monofocal lenses often require glasses for near tasks like reading.
Multifocal IOLs are designed with multiple focal points to provide clear vision at various distances. These lenses aim to reduce or eliminate the need for glasses for many daily activities, although some individuals may experience visual disturbances like halos or glare around lights, especially at night. Extended Depth of Focus (EDOF) IOLs offer a continuous range of clear vision, excelling at intermediate and far distances. They provide a smoother transition and lower incidence of halos or glare than multifocal lenses, though reading glasses may still be needed for fine print.
Toric IOLs are designed to correct astigmatism, a common refractive error from an irregularly shaped cornea. They compensate for corneal curvature, providing clearer vision and often reducing the need for astigmatism-correcting glasses. The choice depends on individual vision goals, astigmatism, and willingness to accept trade-offs between spectacle independence and visual side effects.
What to Expect After Surgery
After surgery, patients may experience temporary blurry vision, mild discomfort, and light sensitivity. These normal symptoms usually improve within days. To aid healing and prevent complications, patients are prescribed antibiotic and anti-inflammatory eye drops, to be used as directed for several weeks.
A protective eye shield is usually recommended during sleep for about a week to prevent rubbing or pressure. Avoid strenuous activities like heavy lifting or vigorous exercise for at least two weeks to prevent eye strain. Swimming and hot tubs should also be avoided for about two weeks to minimize infection risk. Light activities like reading or walking can be resumed within days. Vision usually stabilizes within one to three days, though full recovery can take one to two months. Follow-up appointments monitor recovery and address concerns.