Around the world, around 10 million cataract surgery procedures are performed every year. This staggering number is due to cataract surgery being the only way to definitively treat the vision problems caused by cataracts. While there are a number of causes of cataract, increasing age is the main contributing factor, making vision problems from cataracts a common occurrence. 

Depending on your country, cataract surgery may look slightly different. The quality of the equipment, the skill and training of your cataract surgeon, and the state of the environment in which you have your operation may vary. However, what happens during cataract surgery remains largely the same, no matter where you are. 

In Australia, we’re fortunate to have access to a large number of highly skilled and experienced cataract surgeons. We also have a healthcare system that gives you the option to undergo cataract surgery for free via the public system or at a cost through the private system. Because of the accessibility of cataract surgery in Australia, advanced vision problems due to cataract are rare. 


What Happens During Pre-Operation

Before you enter the operating theatre, your cataract surgeon will have had a consultation with you at least once. The purpose of this consult is to assess your vision and cataracts and to ensure that cataract surgery is the right solution for you at that point in time. 

In addition to measuring your visual acuity and looking at the cataract through a microscope known as a slit lamp, the surgeon will also check your risk factors for complications. Knowing and controlling for any risk factors can influence what happens during cataract surgery and the final visual outcome. For example, a person with diabetic eye disease (retinopathy) is at risk of having this exacerbated through cataract surgery and damaging the retina further. In order to reduce your risk of worsening this condition and associated vision problems through a cataract operation, your cataract surgeon may recommend having the retinopathy under effective control for at least three months before considering cataract surgery

Prior to your cataract procedure, your surgeon will also have an important discussion with you about the sight you want to achieve after the operation. This is because you have a choice in what sort of artificial lens implant (intraocular lens) you would like to replace the cataract once it’s been removed. Amongst other choices, your options include having an implant that corrects your long-distance vision, a multifocal implant, or one that leaves you short-sighted for easy near vision without glasses.

So, what happens during the cataract surgery itself?


What Happens During Cataract Surgery

On the day of your cataract surgery, you’ll need to find someone to drive you to (or at least from) the hospital. Although general anaesthesia is usually avoided during cataract surgery, your sight will be blurry, and you may feel drowsy or unwell from the sedatives. 

To prepare you for surgery, you’ll have pharmaceutical eyedrops instilled. These drugs widen the pupil so the surgeon can view and access the cataract that sits behind it. You’ll also have your eye area numbed with a local anaesthetic injection or topical anaesthetic eyedrops, and the area will also be sterilised and covered with a sheet.

what exactly happens during cataract surgeryAs you lie on the operating bed, your surgeon may ask you to fixate on a target light overhead.

This is to keep your eye still. An incision is created in the cornea, the front surface of your eye.

This incision can be performed with either a manual blade or, in more recent times, a femtosecond laser tool.


If you are undergoing femtosecond laser-assisted cataract surgery, the laser is also used to tear open the capsular bag that holds the cataract.

If your cataract surgeon is not using the femtosecond laser, this step can be performed with forceps. After this, the cataract needs to be broken into smaller pieces. Femtosecond laser-assisted cataract surgery achieves this by softening the cataract with the laser before using energy from an ultrasound probe to fragment it.

If undergoing conventional cataract surgery, only the ultrasound probe is used. Conventional cataract surgery, which is performing the operation without the femtosecond laser, is commonly called phacoemulsification. 

Once the cataract has been extracted from the capsular bag, the intraocular lens can then be slipped into the space left behind. The small incision in the cornea is allowed to self-seal and heal over time. Your surgeon will place a protective shield over the eye and send you home with a few bottles of prescription eyedrops and a list of post-op recovery guidelines


What Happens Post-Op

After your cataract surgery, you’ll have a few review appointments with your surgeon. These appointments are to ensure your eye is healing as expected and your sight is moving in the right direction. Often, these follow-up consults will be a day or two after your cataract surgery, a week after, and a month after, but these can depend on your surgeon and where you live. If you need to have both cataracts removed, surgeons will often perform the second eye at least one month after the first. 

It can take 4 to 6 weeks for your eye to recover fully after cataract surgery. During the healing process, you may find the eye can feel dry and gritty, especially in the first few days after the operation. Your sight may also fluctuate over the 4 to 6 weeks as the intraocular lens settles in the capsular bag and your cornea incision heals. If at any point you’re unsure that what you’re experiencing is normal for the recovery period, contact your cataract surgeon. 


Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.



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