Cataract surgery

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Cataracts occur because the lens in your eye becomes cloudy, making it difficult for you to see well enough to carry out your usual daily activities. If the cataract is not removed, your vision may stay the same, or it may get worse. Waiting for a longer period of time will not make a cataract operation more difficult.

Removing a cataract is the most common operation performed by eye surgeons and happens thousands of times each year at Yorkshire Eye Hospital. Modern techniques have made the operation extremely reliable.

Cataract operations can be performed under local anaesthetic (drops / injection to 'numb' the eye). The operation usually takes under 20 minutes. During the cataract treatment a small incision is made at the upper edge of the cornea, underneath the upper eyelid. The cataract is removed and a synthetic lens put in place of it. This helps the eye to focus after the operation and stays in the eye for life.

This artificial lens cannot change shape so glasses will be needed after the operation to achieve the change of focus at various distances (e.g. distance to reading). The eyes are tested for glasses after a few weeks. Eye drops are required after the operation to help control any inflammation from the surgery.

Contact a patient consultant on 01274 612 566 for more information on this eye condition and the surgical process. You can also book an initial consultation with one of our expert eye consultants.

Cataract information

Select the topic you are interested in for a more comprehensive look at cataract surgery:

• The likelihood of better vision.
• Benefits of cataract surgery.
• Diagnosis of cataracts.
• The cataract procedure.
• Frequently asked questions about cataract surgery.
• Pre-assessment for cataract surgery.
• The day of your cataract surgery.
• When you can go home after cataract surgery?
• What happens the morning after cataract surgery?
• Will my eye hurt after cataract surgery?
• Special considerations regarding cataract surgery and uveitis

The likelihood of better vision

After your cataract operation you may read or watch TV almost straight away, but your vision may be blurred. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract.
The majority of patients have improved eyesight following cataract surgery.

Please note that if you have another condition such as diabetes, glaucoma or age related macular degeneration your quality of vision may still be limited even after successful cataract surgery.
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Benefits of cataract surgery

The most obvious benefits of cataract surgery are greater clarity of vision and improved colour vision. As lens implants are selected to compensate for existing focusing problems, most people find their eyesight improves considerably after surgery, but will need to replace their glasses.
As with any surgical procedure there is a small risk of complications either during or after the operation and these should be discussed with you by your consultant prior to your operation.
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Diagnosis of cataracts

To enable the consultant to diagnose a cataract, you will be seen within our Out Patients Department on the ground floor of Yorkshire Eye Hospital. You will have a full eye examination, which may require drops to be administered to enable a full view of the eye structures. From this diagnosis we will require measurements to be taken of your eyes. A nurse will carry out this procedure and the measurements allow the surgeon to select the appropriate lens for your eye and the cataract removal procedure will be explained to you before it is carried out.
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The cataract removal procedure

At Yorkshire Eye Hospital your cataract operation will be performed on a day case basis. This means that you will be discharged home the same day as your operation.
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Frequently asked questions about cataract surgery

Q. Do I need a letter of referral?
A. Yes, we need to know your medical history. Either your GP or optometrist can directly refer you.

Q. Will I need glasses after my cataract surgery?
A. Once the cataract (the cloudy lens of your eye) is removed, an artificial lens is implanted. Using a standard artificial lens, which has a fixed distance of focus, almost all people will need glasses especially for intermediate and near vision. With the use of special artificial lenses the need is much less. Scientific studies have shown that over 90% of patients with a multi-focal lens are completely free of glasses for distance, intermediate and near vision with the rest needing them only occasionally.

Q. Does a cataract need to be 'ripe' before surgery is done?
A. No, modern cataract surgery in skilled hands is very successful. This means that the threshold for recommending cataract surgery has changed over the years. The chance of making your vision permanently worse following uncomplicated surgery is under 1%. If you are in poor health it is advisable to have your cataract operation at an early date.

Q. Can I be too old for cataract surgery?
A. No, there is no age limit for cataract surgery. Not too long ago surgery was performed on a lady who was 102 years old. She was delighted with the outcome and wished that she had had the operation years ago.

Q. Is it true that a cataract operation can be performed under just eye drops rather than an anaesthetic?
A. Yes, cataract surgery is usually performed under local anaesthetic eye drops.

Q. What may happen if I don't have the cataract treatment?
A. The natural history is for the cataract to get worse with time. This will make your vision more and more misty over the months and years ahead.

Q. I have macular degeneration (ARMD). Does this stop me from having cataract surgery?
A. No, many patients with macular degeneration will benefit from removing the cloudy cataract lens. Vision, especially peripheral vision, will be much brighter. The IOL-VIP is a new lens specially designed for people with macular degeneration and can further improve vision due to the effect of magnification and deflection of the light onto a healthy part of the retina.

Q. Who will perform my cataract operation?
A. In the NHS, the cataract waiting list is shared. A different team who initially saw you may operate on you and the surgeon could be a consultant or supervised training eye doctor. Although listed under a particular named consultant team, this does not mean that the consultant is the person doing your operation. With a private operation you can specifically choose your surgeon.

Q. How long does the artificial lens last for?
A. We use artificial lenses (intraocular lens implants) in children now as well, so these lenses are designed to last for life.

Q. How long will the cataract operation take?
A. This essentially depends on who performs the surgery. Under a consultant ophthalmologist at Yorkshire Eye Hospital it will take approximately 20 minutes.

Q. Will I stay in overnight?
A. No, the majority of cataract surgeries are undertaken as day case procedures. You will be in the hospital for approximately 2 hours.

Q. Do I have stitches in my eye after cataract surgery?
A. The cataract operation takes place through a small wound of under 3mm in size, so often no stitches are required but some patients do. The consultant will decide whether stitches are required.

Q. Will I have a shield over my eye after?
A. The operation is performed using eye drops only so all needles are avoided. This means that a shield is only sometimes required after the operation.

Q. When will the cataract operation date be and how long will I need to wait for the second eye to be done?
A. For the NHS, the current recommendation in Leeds is for the first eye to be done within three months and an additional six month wait for the second eye. Only one eye is done at a time. By going privately, not only can you choose your surgeon but also the time and date of your surgery as well as the comfort of free and easy parking. Privately, the second eye can be done one week after the first eye.

Q. How soon can I drive?
A. It is sensible to have a few days off from driving. Legally, if you can see the number plate at 67 feet and your visual field is fine, you can drive a normal vehicle.

Q. How soon can I go back to work?
A. Be sensible and don't exhaust yourself. The exact answer to this really depends on the type of work you do, but usually a few days off is all that is needed.

Q. What must I not do after cataract surgery? 
A. After a week most normal activities can be undertaken including hair washing. It is advised to avoid swimming for a month and please do not rub your eye.

Q. I have had previous refractive laser surgery, can I still have cataract surgery?
A. Yes, unfortunately the calculations for a precise result are less predictable following laser surgery to the cornea. Knowing what your corneal measurements were before and after the laser surgery helps to get better accuracy.

Q. Can you correct my short-sightedness or long-sightedness at the same time?
A. Yes, this is because accurate measurements before the operation allow us to precisely calculate the power of the artificial lens needed to focus the image on the retina. By choosing a multifocal lens, this allows unaided distance, intermediate and near vision in over 90% of people.

Q. I have astigmatism. Can this be corrected at the same time as well?
A. Yes, astigmatism is an irregularity of the window of the eye (cornea), which blurs the image on the retina by producing two points of focus. By using a Toric artificial lens, this special lens will correct the astigmatism and so produce a clear image.

Q. I have already had cataract surgery but am frustrated at still needing glasses for reading. Can anything be done for this?
A. Yes, rather like the advantages of the multifocal lens which produces no need for glasses for distance, intermediate and near vision in over 90% of people, so a similar lens can be put on top of your cataract operation lens and give you the benefits of unaided intermediate and near vision as well.

Q. Can cataracts come back following the surgery?
A. No, however the bag the artificial lens sits in can become cloudy months or years later. You will realise this, as vision will not be as sharp as it was before. It appears as if the cataract has come back. A laser capsulotomy can easily restore the good vision. It is done on an outpatient basis and takes only a few minutes to do in the clinic.

Should you require any more information or you wish to make an appointment, please contact us on 0845 456 2021.
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Pre-assessment for cataract surgery

A nurse in the Out Patient Department will carry this out, or if it is your second eye, it can be completed over the telephone by prior arrangement.
The assessment consists of a series of questions relating to your general health, eye history and personal history. The nurse will also take details of any medication you are currently taking. It also may be necessary to take a sample of blood and perform a tracing of your heart. Both can be performed in the hospital.
These questions are necessary in order for us to plan your care and discharge you safely from the Day Care Unit.
At the assessment the nurse will discuss the anaesthetic procedure and the cataract operation with you. The nurse will also discuss the aftercare that you will receive following surgery.
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The day of your cataract surgery

On the day of your cataract operation you will be asked to attend the hospital at a designated time. You will be directed to the Day Care Unit where your named nurse will greet you.
The nurse will make some checks to ensure we have your correct information and will instil eye drops, which will dilate your eye, ready for surgery. At the allotted time the nurse will escort you into the cubicle area in theatre where your local anaesthetic will be administered. The nurse will stay with you until your operation is complete and hand hold if requested. It is at this stage that monitoring equipment will be used. A clip will be attached to your finger, heart and inner arms. Your blood pressure will also be taken. All these measures are routine and nothing to worry about.

Once the anaesthetic is working, you will be taken into the theatre, where the nurse assisting the consultant will greet you. Your details will be checked again and the monitoring equipment will continue.
Your nurse will sit beside you and hold your hand throughout the cataract treatment. If at any time you feel uncomfortable, squeeze the nurse's hand and they will alert the surgeon who will (at a safe time) stop and ask what the matter is. It is very important that there are no sudden movements during surgery.
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When you can go home after cataract surgery?

You will be offered tea or coffee and biscuits following your cataract treatment.
The nurse will check that there are no specific instructions from the surgeon, and will then explain what to do with your drops and the need for a follow up appointment. When you are happy, you will be able to go home.
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What happens the morning after your cataract surgery?

The morning after your operation you will either be returning to the hospital or be receiving a telephone call at home. If you are returning to the hospital a nurse in the Out Patients Department will remove your eye dressing when you arrive.

If you have experienced any problems then you can telephone the Hospital before 10am and ask to speak to a nurse who will be able to assist you' If you are coming back in to the Hospital, we ask patients to remove their bandage before they come back for their post operative check up
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Will my eye hurt after cataract surgery?

If you have any discomfort you make take your usual analgesia e.g. paracetamol, which should be effective. If your pain is not relieved, or becomes worse, then you should contact the hospital on the number given for advice. Your eye may feel prickly and may be watery, but don't worry, this is normal.
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Special considerations regarding cataract surgery and uveitis

The lens inside the human eye is transparent and, due to its ability to change shape, allows fine focusing to take place. When it turns cloudy, this is called a cataract. Cataracts are common in the elderly although they can occur at any age.

Uveitis is a name given to a large group of disorders causing inflammation inside the eye. This inflammation can cause a cataract to form that may produce blurred vision. When this becomes a problem an operation to remove the cataract can be considered as a laser will not be able to remove the cataract.

Cataract surgery in patients with uveitis

If your cataract has arisen as a complication of uveitis, an operation to remove it is less straightforward. This will vary from patient to patient and the issues will be discussed with you in the clinic before any decision is made.

The operation:The cataract surgery can take slightly longer due to the scarring inside the eye from the uveitis.

The lens implant:The best way to get good vision following a cataract operation is to put a synthetic lens into the eye.

After the operation:Frequent outpatient attendance is required in the first few weeks after the operation to keep a close watch on the eye. A combination of frequent drops will be prescribed and it is very important that you take them as directed.

Reading glasses:It is normal, usually sometime after the age of forty, to need reading glasses as the lens inside the eye loses its ability to alter focal distance. As many people with cataracts due to uveitis are under the age of forty, they will experience a need for glasses in order to acquire the best vision possible in their eye following cataract surgery.

Contact us today for any further information you may require on undergoing cataract surgery at Yorkshire Eye Hospital.