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Eye health centre

How it is performed

NHS ChoicesMedical Reference

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Cataracts are removed using surgery. If you have cataracts in both eyes, you will have surgery on them on separate occasions. This gives the first eye time to heal and your vision time to return.

Most cataract operations are performed as day surgery under local anaesthetic, which means you can go home afterwards. Nearly all of your vision will return within two days of surgery but you will need someone to look after you for the first 24 hours after surgery. Read more about recovering from cataract surgery.

Pre-operative assessment

Before your operation, you will be referred to a specialist eye doctor (an ophthalmologist or ophthalmic surgeon). They will assess your eyes and general health.

During the assessment, your eyes are measured to prepare for the artificial lens that will replace your natural lens.

Surgery

Cataract surgery is very common and can often be completed within 45 minutes.

Phacoemulsification is the most common cataract procedure and usually takes 15-30 minutes.

During phacoemulsification, your surgeon will put drops in your eye to dilate (widen) your pupil (the black circle at the centre of your eye). You will also be given a local anaesthetic (painkilling medication), which can be applied as eye drops or given as an injection into the tissue around the eye.

The surgeon makes a tiny incision (cut) in your cornea (the transparent outer layer on the front of your eye). A small probe that releases ultrasound waves (high-frequency sound waves) is inserted into your cornea to break the cataract up into tiny pieces. After the ultrasound probe has been removed, a new probe is inserted which sucks out the pieces of the cataract.

When the entire cataract has been removed, the surgeon inserts a small plastic lens through the incision in your cornea. The lens sits in the lens capsule, behind the pupil. The replacement lens is folded in half when it's inserted so it can fit through the incision in the cornea. When it is in place, it unfolds itself and adopts the natural position of the old lens.

Replacement lenses

When the cloudy lens is removed it is replaced with an artificial, clear plastic lens. This is called an intraocular implant, or intraocular lens (IOL).

Three types of IOL are available. Your ophthalmologist will help you to decide which type of lens will be best for you. The three types of lens are:

  • fixed strength lenses (monofocal), which are set for one level of vision, usually distance vision
  • multifocal lenses, which allow two or more different strengths, such as near and distance vision
  • accommodating lenses, which allow the eye to focus on both near and distant objects, in a similar way to the natural human lens

Multifocal and accommodating lenses are not usually available through the NHS. Glasses will always be required.

NHS funding for these types of lens will depend on your local primary care trust (PCT). Ask your GP or ophthalmologist about the type of lenses available in your area. If NHS funding is not available for these types of lenses, you may be able to pay to have them fitted privately.

Medical Review: April 24, 2012

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