Cataract operation: pros and cons

By Jackie Griffiths on 21 July 2022

A cataract occurs when the lens of the eye becomes cloudy and makes it difficult to see. The lens is used to focus light on the retina at the back of the eye in order to form images. Although cataracts usually take a long time to form, if left untreated they can eventually lead to blindness. The most common kind of cataract operation in the UK is to remove the lens and implant an artificial one. This article on cataract surgery is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

The only way to repair a cataract is to have a cataract operation. While not all cataracts have to be removed immediately by means of cataract surgery, it is recommended if the condition affects your ability to read or drive. Your doctor may also advise you to have cataract surgery straight away in order to prevent other eye complications, such as diabetic retinopathy, and macular degeneration, both of which affect the blood vessels in the eye.

The medical term for a cataract removal operation is phacoemulsification and is performed under a local anaesthetic. After applying eye drops to widen the pupil and numb the eye, the surgeon makes a tiny incision about 3mm wide in the surface (or cornea) of the eye. The affected lens is then painlessly dissolved using a fine needle that emits ultrasound waves. After the soft pieces are sucked out, a folded artificial lens made from plastic or silicon is inserted through the same incision. It then unfolds naturally in the eye. A cataract operation takes around 20 minutes.

Treatment

Occasionally in cataracts treatment, an operation called a manual extracapsular extraction is needed. This cataract operation involves a larger incision and the removal of the lens in one whole piece. The cut is then closed with dissolvable stitches. You will be kept in hospital for several days after this procedure.

Benefits

Cataract surgery is generally safe, and if the more common phacoemulsification procedure is performed, you will be allowed to return home the same day. Eye drops to prevent infection and reduce inflammation must be taken, but overall this modern procedure enables a rapid recovery. For many people, the benefits of improved vision far outweigh the disadvantages of having cataract surgery.

After having a cataract operation, more than 90% of people can see well enough to legally drive again. Even if you have other eye problems, such as glaucoma (a pressure build up in the eye) or macular degeneration, the chance of being able to legally drive again is still 70-80%.

Definition of a cataract

A cataract occurs when the lens of the eye becomes cloudy and makes it difficult to see. The lens is used to focus light on the retina at the back of the eye in order to form images. Although cataracts usually take a long time to form, if left untreated they can eventually lead to blindness. The most common kind of cataract operation in the UK is to remove the lens and implant an artificial one.

Negative effects

Short-term

There are unwanted but usually temporary effects of a successful cataract operation. For instance, there is a chance you will experience halos or glare in your vision, although this is uncommon and goes away in time. The following are specific side effects of cataract surgery which usually clear up after a few days:

  • an itchy or sticky eye
  • blurry vision
  • aching of the eye
  • bruising of the eyelid or eye

Long-term

Once a cataract has been removed it cannot come back. However, in the long term there is a risk that the capsule that holds the lens in place may become cloudy, causing a gradual loss of vision. This is known as posterior capsular opacification. It can be treated with simple laser surgery which makes a clear hole in the capsule.

Furthermore, one in five patients may have difficulty reading after a cataracts operation, because there is little focusing power in the new artificial lens. A pair of reading glasses will be prescribed about a month after surgery to correct this.

Complications

On rare occasions, unexpected complications can occur during, or after, cataract surgery. In a small number of cases, these can lead to reduced vision or blindness. Specific complications of cataract surgery include:

  • bleeding during, or after, cataract surgery
  • eye infection
  • abnormal reaction to the anaesthetic
  • tearing of the lens capsule, causing reduced vision
  • failure to remove all the cataract fragments, requiring a second operation
  • dislocation of the implant, requiring a second cataract operation
  • damage to the retina leading to blindness (in very rare cases) detachment of the retina

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