Surgery for a cataract involves removing the natural lens of the eye that contains the cataract. The lens can be replaced with an artificial lens called an intraocular lens implant (IOL), or it can be left out and contact lenses, or rarely eyeglasses, can compensate for its absence. The most common replacement is an IOL; contact lenses or eyeglasses are needed after surgery if an intraocular lens cannot be used. Before surgery, review with your doctor the advantages and disadvantages of each type of replacement lens.

• Intraocular lens (IOL). A variety of IOL types are available. Your doctor will choose the type of IOL that may work best for you.
• Contact lens. A contact lens is placed on the surface of the eye. A contact lens may not be a good choice for young children or older adults who have a hard time properly placing the lens in the eye.
• Cataract glasses. Cataract glasses were used for decades when there were no other options for lens replacement. Because they are thick and heavy, they are rarely used now.

For most adults, surgery is only needed when vision loss caused by a cataract affects your quality of life. The goals of surgery in adults with cataracts include:

• Improving vision.
• Helping you return to work, leisure, and other daily activities.

Should I have cataract surgery?

The choices for treating cataracts in children depend on how likely the cataracts are to interfere with development of normal vision. Surgery for cataracts in children may be necessary.

Second surgery

For adults who have cataracts in both eyes, surgery is not done on both eyes at the same time. The first eye needs to heal, and your doctor will determine how much eyesight has improved before surgery is done on the second eye.

If you have both glaucoma and cataracts, you may have surgery for both conditions at the same time. After a cataract is removed, you may have decreased pressure in the eye in which the cataract was removed.⁵ Depending on which condition caused the vision loss, vision may improve after surgery.

Surgery Choices

Extracapsular surgery is used to remove cataracts. There are two types of extracapsular surgery. The decision about which one to use depends on what kind of cataract you have and how much experience the surgeon has with each type of surgery.

• Extracapsular surgery using phacoemulsification. In this type of surgery, the incision is small, and sound waves (ultrasound) are used to break up the lens into small pieces. Currently, this is the most common method of doing cataract surgery.
• Extracapsular surgery. This is also called extracapsular cataract extraction (ECCE). In this type of surgery, the lens and the front portion of the plastic-like membrane (anterior capsule) wrapped around the lens is opened. The lens is then carefully removed in one piece.