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Cataracts (cont.)

Medications

A small number of adults and children with cataracts may benefit for a short time from eyedrops that widen (dilate) the pupil. These eyedrops increase the amount of light getting into the eye. They are sometimes used to help prevent vision loss in very young children who need to wait for surgery to be done.

What to think about

There is currently no medicine that will cure cataracts.

Surgery

Surgery for cataractsClick here to see an illustration. involves removing the clouded lens of the eye (the cataract). The lens can be replaced with an artificial lens called an intraocular lens implant (IOL). Or, if an IOL cannot be used for any reason, it will be left out and contact lenses or, in rare cases, eyeglasses can compensate for its absence. Most people will get an IOL during surgery.

Before surgery, ask your doctor about what types of IOLs can go in your eye. Or, if you will not be getting an IOL, ask about the pros and cons of contact lenses or eyeglasses.

Options to help you see better after surgery

  • Intraocular lens (IOL). A variety of IOL types are available. Work with your doctor to choose the best one for you.
  • Contact lens. You will need to insert, remove, and clean the lenses on a regular basis. A contact lens may not be a good choice for young children or older adults who have a hard time properly placing the lens on 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 who have cataracts include:

  • Improving vision.
  • Helping you return to work, leisure, and other daily activities.
Click here to view a Decision Point.Cataracts: Should I Have Surgery?

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

Second surgery

For adults who have cataracts in both eyes, surgery is not normally done on both eyes at the same time. The first eye needs to heal. Then 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. Depending on which condition caused the vision loss, vision may improve after surgery.

Surgery choices

There are two types of cataract surgery. They are both done in an outpatient center. 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.

  • Phacoemulsification (small-incision surgery). In this type of surgery, the incisions are small, and sound waves (ultrasound) are used to break up the lens into small pieces. This is the most common method of doing cataract surgery.
  • Standard extracapsular cataract extraction (ECCE). In this type of surgery, the lens and the front portion of the lens capsule wrapped around the lens is opened. The lens is then carefully removed in one piece.

In the past, cataracts were removed by intracapsular surgery in which the entire lens and lens capsule were removed. Intracapsular surgery is rarely, if ever, used today. It is more difficult and has a higher rate of complications than extracapsular procedures.

The most common problem after cataract surgery is clouding of the posterior lens capsule (called aftercataract) within 5 years after surgery. This clouding is usually not a serious problem. And it is easy to treat with a laser surgery (Nd:YAG laser posterior capsulotomy) if it occurs.

What to think about

For adults, cataract surgery is almost always elective and can be done at your convenience. The surgeon, or someone familiar with routine surgical practices, will usually be available for any follow-up exams and treatment.

Surgery may be advisable if you want to continue to drive a car. If you live in a retirement home or assisted-living facility, you may decide to use vision aids and avoid surgery.

If you do not have another eye condition, such as glaucoma or problems with your retina, your chances of seeing better after cataract surgery are very good. But you may still need reading glasses or glasses for near vision.

Just because you have a cataract doesn't mean you need to have it removed. Only you can decide whether cataracts are affecting your vision and your life enough for you to have surgery. Learn what to ask about cataract surgery before deciding whether to have the surgery.

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