Cataract Surgery Procedure: Cost, & Complications

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What is cataract? 

It has become almost normal for people to be diagnosed with cataract after the age of 50 years.  In this condition, clouding occurs in the natural lenses of the eyes, which lie behind the iris and the pupil. 

Cataract may occur as a result of a past eye surgery such as ICL, or due to aging, genetic disorder, diabetes, exposure to ultraviolet rays or radiation, or eye trauma or any eye injury which changes the tissue of the eye lens. 

When cataract occurs, the natural lens of the eyes become hazy due to protein denaturation. This prevents light from passing through the lens, clouding the vision. 

Cataract surgery is an outpatient procedure and takes around 30 to 45 minutes. 

Please Note: Cataract surgery is done on one eye at a time. The surgery on the next eye is performed only after the complete recovery of the first eye.

To know more about cataracts, how do cataracts form, who is prone, and the symptoms of cataracts please see: Cataracts: Causes, Symptoms, and Treatment

Am I an ideal candidate or eligible for cataract surgery?

You are an ideal candidate for cataract surgery if you are :

  • experiencing cloudy vision
  • seeing bright colors as faded
  • experiencing double vision
  • experiencing light sensitivity
  • experiencing poor night vision
  • not pregnant and nursing
  • cataracts are impeding your daily activities such as driving, reading, cooking, or your outdoor activities
  • not experiencing dry eyes 

How is the cataract surgery done? 

Cataract surgery involves the following steps: 

  • At the outset, the doctor applies drops to your eye which dilate your pupil.
  • The area around your eye is then washed and cleansed.
  • Thereafter, the doctor injects anesthesia into the tissue of your eye. Alternatively, anesthesia can also be administered as drops.
  • To prevent you from blinking, eyelid holders are used to keep your eyelids open and hold them in place.

There are two different methods for removing cataract from your eyes - 

  • Phacoemulsification
  • Extracapsular

Phacoemulsification

In the phacoemulsification procedure:

  • Using a fine scalpel or laser, the doctor makes three-minute incisions, less than 1 - 4 mm on the side of the cornea.
  • He creates an opening through the capsule of the lens, through which he inserts a small probe emitting ultrasound waves. The ultrasound waves break the cloudy lens into fragments.
  • The doctors suctions out the fragments through the incisions.
  • He then injects a small artificial intraocular lens made of plastic, silicone, or acrylic compounds through an incision.
  • Once inside, the artificial lens unfolds automatically and takes up the position of the natural lens.
  • Once the artificial lens is in position inside the eye the procedure is complete.
  • No sutures are required as the incisions made are very minute.

This artificial lens almost always lasts for the remainder of a person’s life. 

Extracapsular

In the extracapsular method of cataract surgery:


  • The doctor makes a rather large incision (10-12 mm) on the side of the cornea.
  • Through the incision, the doctor removes the entire cloudy lens as one single piece.
  • He then inserts an artificial lens through the opening to replace the natural lens.
  • After inserting the artificial lens the doctor sutures the incision. In this procedure, since the incision is large sutures are required. These sutures do not need to be removed.

The recovery period from the extracapsular cataract surgery is longer compared to the phacoemulsification cataract surgery due to the large size of the incision. 

Are there any side effects of cataract surgery? 

After the cataract surgery you will:

  • be sensitive to bright light
  • feel as if there is a foreign body in your eye
  • experience blurred vision
  • mild itchiness
  • stickiness
  • pain in the eye
  • dry eyes after the surgery which is a common side-effect and gradually resolves as the eye heals (You can also use lubricating eye drops after consulting with the doctor till such time that the dry eye syndrome subsides).

These side effects are completely normal and usually heal in a couple of days as the eye begins to heal. 


More serious complications which can occur are:

  • infections such as endophthalmitis
  • decreasing vision
  • increasing pain
  • swelling around the eyes
  • inflammation
  • seeing floaters
  • swelling of the retina due to fluid build up between the layers of the retina which affects the eyesight
  • retention of a piece of cataract within the eye
  • swelling of the cornea due to fluid build up
  • retinal detachment when the retina detaches from the inner wall of the eye


These complications, however, are extremely rare. If they do occur, you will need to contact the doctor immediately. 

Very rarely, a complication called posterior lens capsule opacification (PCO) occurs after cataract surgery.  This occurs when the capsule holding the lens may become cloudy, sometime after the cataract surgery or even in the months following the surgery. This occurs when the epithelial cells which remain after the cataract surgery grow on the capsule. 

PCO can be easily treated with a laser procedure which removes the hazy part of the capsule.  

Are there any pre-surgery and post-surgery guidelines? 

The first step of cataract surgery is the eye evaluation done by the cataract surgeon. Your eye will be examined and the doctor will ask you questions about your lifestyle to understand your expectations from the surgery, the kind of vision you seek to have after the surgery. This evaluation will also help your surgeon to find out what type and power of lenses you require.  

The doctor may also advise you to undergo additional health checkup before the surgery. 

Before the surgery, you will be prescribed a preoperative eye drop, which you need to apply on the eye which is to be operated, as directed before the surgery.

On the day of the surgery:

  • make sure to wear comfortable clothes
  • do not apply any makeup, cream or lotion on your face and especially avoid any eye makeup
  • you will need to make arrangements for someone to drive you to and fro on the day of the surgery
  • make sure to eat your regular meals before the operation


After the surgery :

  • your vision will be blurred for the first few days
  • it is advisable not to go out for a few days after the surgery to avoid any kind of sudden injury, and direct sunlight
  • you need to wear the sunglasses continuously even inside the house, it will help your eyes feel less sensitive to light
  • it is very normal to experience a little eye irritation after the surgery, or even eye discharge
  • you should refrain from rubbing your eyes or splashing water on your eyes for at least two weeks after the surgery
  • do not use any face wash, or soap on your face for two weeks after the surgery, instead, you can use baby wipes, or makeup wipes to clean your face
  • do not shampoo your hair during the first week after the surgery. If you do wish to shampoo the next week, make sure that the shampoo does not get into your eyes
  • avoid the shower and hot tubs
  • while sleeping you can use eye shields which will protect your eyes if you inadvertently try to rub them in your sleep
  • you will be advised to avoid any form of strenuous activity or exercise such as gardening, weight-lifting, jogging, swimming, yoga, or aerobics.
  • you will also be advised by the doctor to not bend over for any purpose for a couple of days to avoid putting any extra strain on your eye
  • you should refrain from driving till you are absolutely confident that your vision is clear and stable.

How long will it take to recover from cataract surgery?

It will take around 6 - 10 weeks to completely heal from cataract surgery. 

What is the cost of cataract surgery in India? 

The cost of cataract surgery in India varies from Rs. 30,000 - Rs. 65,000 for each eye.

Are the results of cataract surgery permanent?

Cataract surgery results are considered to be permanent. 

More Topics on Opthalmology Procedures

People interested in this topic  also read: 

References

1. D Allen, Clinical Review Cataract, and surgery for cataract [Internet]. https://www.bmj.com. 2018 [cited 13 April 2018]. Available from: https://www.bmj.com/content/333/7559/128

2. Sonron E, Tripathi V, Bridgemohan P, Sharma S, Clinical Review Cataract and surgery for cataract [Internet]. https://www.bmj.com. 2018 [cited 13 April 2018]. Available from: https://www.bmj.com/content/333/7559/128 

3. CASE 19: Treating cataracts in India [Internet]. Center For Global Development. 2018 [cited 13 April 2018]. Available from: https://www.cgdev.org/page/case-19-treating-cataracts-india

Would you like to consult a doctor for Cataract Surgery Procedure ?

Questions answered by trusted doctors

Verified User
My father has cataract in his right eye, we consult the clinic, they told need to do surgery. So I'm in doubt whether should we go with the laser cataract surgery or traditional cataract with the blade. Please could guide us doctor. Thanks
Dr. A K Goel
Ophthalmologist/ Eye Surgeon, Moradabad
Choose the surgeon instead of procedure. Let the surgeon decide the procedure as per his/her proficiency. After laser even the surgery will be performed by phacoemulcification.
And a finer blade will be needed  for phaco tip entry.
Dr. Smriti Jain
Ophthalmologist/ Eye Surgeon, Gurgaon
Laser cataract surgery provides a little safety over the one with the blade, but the technology doesnt let laser alone take care of cataract surgery and the current gold standard is still Phacoemulsification . Its the surgeon who matters ... with or without laser !
Verified User
Please tell me about different types of lenses used for a cataract surgery different doctor are charged different charges for lenses.tell me which is better for cataract surgery
Dr. Mohammed Haris
Ophthalmologist/ Eye Surgeon, Varanasi
Basically there is differences in prices of intraocular lenses owing to its different properties.Premium lenses cost more because they are similar in color perception and contrast sensitivity to normal human crystalline lenses.Multifocal lenses gives almost freedom from spectacle use,as patients are able to read also without the aid of glass.
Verified User
My mother is having cataract surgery tomorrow and the surgeon has asked her to put eye drops named VIGADEXA. But he did not say in which eye(as only her right eye is going to have cataract surgery) and how many drops? Please advise me with the same.
Dr. A K Goel
Ophthalmologist/ Eye Surgeon, Moradabad
put it in eye to be operated.
Dr. Vaibhev Mittal
Ophthalmologist/ Eye Surgeon, Sangrur
Hello
Use that eyedrop in eye to be operated tomorrow
One drop 6 times will be enough
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Did you know?

Cataract statistics in India in 90’s

In India in the early 1990s, it was estimated that more than 80 percent of blind people, or more than 10 million individuals, suffered from bilateral cataract, and another 10 million individuals had cataract in one eye.

Cataract Blindness Control Program

In 1994, recognizing both the tremendous problem of adult blindness in India and the shortcomings in the existing cataract treatment program, the Cataract Blindness Control Program was begun in seven states in India where the need was most concentrated.

Impact Of the Cataract Blindness Control Program

A cumulative total of 15.35 million cataract operations were performed within the seven years of the program, which was successful in improving the quality of care.

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