What is a cataract?

The lens is the second transparent lens of the eye, located behind the pupil and iris. It is essential for ocular refraction and plays a key role in the eye’s ability to focus. When the lens becomes cloudy and loses its transparency, this condition is called a cataract.

What are the most common causes?

Loss of lens transparency in childhood is usually due to congenital cataracts, often caused by viral diseases.

Cataracts can also occur as a result of eye trauma, the use of certain medications such as corticosteroids, metabolic disorders (particularly diabetes), or low calcium levels in the blood, among other causes.

The most frequent type is senile cataract, which is always age-related. It is essentially the aging of the lens and manifests as a gradual loss of vision.

How is the procedure performed?

Throughout history, several techniques have been developed to remove cataracts or at least move them away from the visual axis. Today, the ideal and most advanced technique is phacoemulsification (“phaco”).

This procedure removes the lens through a 3mm incision. Phacoemulsification uses an ultrasound probe or Erbium-YAG laser to fragment the lens, which is then aspirated.

An intraocular lens is implanted to replace the natural lens. In most cases, stitches are not required because the incision is small enough to seal itself.

The procedure is very safe, performed under topical anesthesia (anesthetic eye drops), and is painless. It typically lasts about 20 minutes per eye, is outpatient, and allows for a very fast visual recovery—meaning the patient usually does not need to interrupt daily activities.

Who is a good candidate for phacoemulsification?

Most people with cataracts benefit from this type of surgery. The best results are seen in patients with cataracts in the early stages. It is better not to wait until the cataract “matures” and causes severe vision loss, because a highly opaque lens becomes too hard for the phacoemulsifier to handle.

What should be done before surgery?

Before surgery, your ophthalmologist must perform a complete eye exam to ensure there are no other conditions that could complicate the procedure or affect the outcome.

It is also essential to measure the length of the eye and the curvature of the cornea to calculate the correct power of the intraocular lens to be implanted. No special preparation is needed from the patient, other than washing the eyelids and face thoroughly with soap and water.

What should be done after surgery?

It is normal to experience mild discomfort in the eye the day of surgery (similar to having an eyelash inside the eye). Vision is usually blurry during the first 2 or 3 days due to mild inflammation. It is important not to apply pressure to the eye for at least 5 days (especially avoiding rubbing).

Post-surgery, prescribed eye drops must be applied as indicated. About 15 days after surgery, patients can generally return to all normal activities.

What results can be expected?

More than 90% of patients achieve vision better than 20/40. In some cases, vision does not improve to this level if there is another retinal condition present. This highlights the importance of a thorough pre-surgical exam. The use of eyeglasses is usually necessary after surgery, though in most people who develop cataracts this was already required due to age-related vision changes.

Can a second procedure be necessary?

In some cases, over time, the lens capsule may become cloudy again, reducing vision. In this situation, a YAG laser capsulotomy is required. This is an outpatient procedure that does not require hospitalization, incisions, or anesthesia, and it is completely painless.