Having Cataract surgery

You have a natural lens inside your eye that helps you to see. The lens should be transparent like glass but a cataract makes the lens cloudy.

Not all cataracts need an operation and sometimes glasses will improve the vision. Having cataracts is a problem that can only be completely cured by surgery. No other medical treatment is currently available. During cataract surgery the surgeon removes the cloudy lens from your eye and may replace it with a man-made lens.

In older people cataract surgery is a common and quick operation that is almost always successful. But cataract surgery can be a little more complicated when you’re young because your eyes are more delicate.

What next?

To sort out your cataract the ophthalmologist (eye doctor) will first have to decide what type of surgery is right for you. Adults have a local anaesthetic, where the eye goes numb but they are awake. Children have a general anaesthetic, where you are asleep for the operation. Before the day of the operation some measurements will be taken of the eye using a scanner machine in the clinic.

During the operation, which takes between 30 to 60 minutes to do, the doctor will remove the lens with the cataract in it from your eye. Then they might fit an artificial lens (called an intra-ocular lens or IOL) inside the eye. After surgery a pad might be placed over the treated eye for a while.

If you have cataracts in both eyes, each eye will require a separate operation, usually within a short time of each other. The two operations are not usually done at once because that could increase the risk of infection.

From left to right - A severe cataract, a mild cataract and an artificial lens (IOL)

 
 

Before the surgery and on the day
See: General anaesthetic factsheet

After the surgery

Following your operation you will need eye drops to prevent inflammation (redness and soreness) and infection. The doctor will need to see you regularly but the clinic visits will be less often over time. If no artificial lens was placed in the eye, a contact lens will be fitted about two weeks after the surgery or sometimes strong glasses are used. You might need patching treatment to improve the eye with weaker vision.

 
 
 
  • Surgery is the only treatment to completely cure cataract
  • An artificial lens or a contact lens will replace the natural lens removed during surgery
  • Glasses may need to be worn after surgery
 

Trouble Spots
A child’s eyes are very delicate and, as with all surgery, there are possible side effects. Most side effects are mild and recover, such as soreness, redness and bruising. Listed below are some more serious possible complications. As long as you are regularly checked by the ophthalmologist, it should be possible to quickly identify any problem.

Infection:
Infection inside the eye (called endophthalmitis) is very rare but can cause severe damage to the eye. Keeping the eye clean and using antibiotic eye drops help to prevent it. If you do get an infection it will be treated with antibiotics.

Loose stitches:
Stitches may be used to close the opening in your eye through which the lens was removed. These may become loose and cause your eye to become sore and red. Some stitches may need removing.

Different eye appearance
Surgery can cause the shape of your pupil to look a bit different afterwards. It may become oval or appear off-centre, but this will usually not affect your vision.

Glaucoma
Glaucoma is where pressure inside the eye is increased which can gradually damage the nerve of sight and cause loss of vision. It may require treatment with drops, medicine or even surgery.

Amblyopia (lazy eye)
This occurs where visual development in one or both eyes has been temporarily held back. The usual way to treat amblyopia is to wear a patch over the stronger eye to encourage the weaker eye.

Strabismus (squint)
A squint or eye turn may develop and sometimes needs treatment with glasses or surgery.

Capsule thickening
The membrane behind the lens implant inside the eye can cloud over, which often happens in young people. It may need treatment by laser or more surgery.

The outcome
Not all children with cataract need surgery. When young people do require surgery it is not easy to predict its success.  Factors that affect the success of surgery include how bad the cataract is and whether any complications happen after surgery. For most who need an operation, surgery will improve the vision but there will be some children who continue to have poor vision afterwards.

Moorfields Eye Hospital NHS Foundation Trust
City Road, London EC1V 2PD
Phone: 020 7253 3411 
www.moorfields.nhs.uk

Moorfields Direct Telephone Helpline
Phone
: 020 7566 2345
Monday to Friday 09.00 to 16.30 for further information and advice. 

 

Article reviewed by Moorfields Children’s Information Group

Last Reviewed

Date: September 2010 Date for review: September 2012