Atrium Health Navicent Ophthalmology Macon

Cataract Surgery

Close up of an eye with a cataract

What is a Cataract?

When the lens of your eye gets opaque or cloudy, it is called a cataract. Were it to become cloudy, then the vision of an individual would be blurred. The lenses of the eye are mostly made up of water and protein. As we age, some of the protein clumps together and cloud the lenses of the eye. Gradually, the "clouding of the lenses" grows and cause difficulty with vision. Smoking, alchohol use, diabetes and prolonged exposure to the sun can also cause cataract.

So far, it is not possible to prevent the development of cataracts. Some are part of the normal aging process thus cannot be reversed. Surgery is the only way of removing cataracts.

How Cataracts Affect Vision

Initially, you will not notice much change with early cataract. Most patients say that their vision becomes like that of seeing through the dirty car windshield. You may see more glare from a lamp or car headlights at night. You may need more changes to your eyeglasses.

When is Surgery Necessary?

As cataracts begin to develop, you might not realize changes in your vision. However, as it continues to grow, it may interfere with your daily activities. You may not require surgery immediately if your lifestyle is not considerably affected. You can try changing your eyeglasses in the meantime. When considering surgery, you can ask yourself:

  • Does my vision problem affect my independence?
  • Am I unable to perform my job?
  • Do I have trouble driving?
  • Do I have issues reading or watching television?

If your replies are affirmative, then it may be time you consulted your ophthalmologist. The specialist will help you make the decision. If you settle for surgery, they will assist you through it and follow up on your progress.

Cataract Surgery for Clearer Vision

The surgery procedure involves removal of the cloudy natural lens, then replacing it with an artificial lens. The procedure is usually outpatient. In most cases, patients are awake as only local anesthesia is required. In case you have cataracts in both eyes, you will require two different procedures. This allows for the first eye to heal before the second is operated on.


The ophthalmologist makes an incision at the side of the cornea, and inserts a small probe into the eye. The probe produces ultrasound waves, which soften and break the lens into tiny pieces so that it can be suctioned out easily. The process is known as phacoemulsification. While at it, the surgeon removes cataracts leaving behind the outer membrane of the lens referred to as the lens capsule. The incision made is usually so tiny that there is no need of using sutures to close it. Nowadays, a new procedure called femtosecond laser is available for removing the cataract.

Replacing The Natural Lens

Upon removal of the natural lens, the ophthalmologist replaces it with a silcon, acrylic or polymethylmethacrylate (PMMA) lens known as the intraocular lens (IOL). IOL is placed in the lens capsule. The artificial lens focuses light to the back of the eye thus improving vision. In case the IOL cannot be used due to other eye issues, contact lenses and at times eyeglasses can be utilized.

Four main types of intraocular lenses are used: monofocal, multifocal, accommodating and astigmatic lenses.

Monofocal Lenses: They are the most commonly used IOLs. They have fixed focus for one distance only. The monofocal lens maybe for near focus, for mid-distance focus, or for distant focus. Only one of these three can be selected and the focus will not change after surgery.

Illustration of a Monofocus Lens

Multifocal lenses: This lens implant provides distance and near focus at all times.

Illustration of a Multifocus Lens

Accommodating Lenses: They are appropriate for patients who want near vision, intermediate vision and good distance vision without using contact lenses or eyeglasses. These lenses use the tiny muscles in the eye and work similar to the natural lens. The muscles in the eye cause the lens to flex slightly and this process is called accommodation.

Illustration of a Accommedating Lens

Astigmatic Lenses: These lenses have astigmatism correction inside them. Many people have a cornea which is not completely spherical in shape. They have an asymmetrical curvature of the cornea which is called astigmatism. If you have significant astigmatism, and you prefer not to be dependent on glasses/contacts after cataract surgery, a Toric IOL will correct the astigmatism and provide clear vision at either distance or near.

Illustration of a Astigmatic Lens

Cataract Surgery Complications

Cataract operations are some of the fastest and safest surgical procedures. Though uncommon, complications may occur. Most of the issues can be treated, though considerable vision loss may occur. They include:

  • Bleeding in the eye
  • Detachment of the retina
  • Inflammation or eye infection
  • Drooping eyelid
  • Increased pressure inside the eye
  • Swelling of the cornea
  • Accumulation of fluid in the retina
  • Dislocation of the implanted lens

The risks are potentially higher for people with eye problems

What is Secondary Cataract?

It occurs when the lens capsule that was left after surgery and that which supports the artificial implant becomes cloudy and impairs your vision. It may develop some months or years after a cataract operation. The condition is quite common, and there is no way to know whether it will occur. Treatment is quite simple. It is known as YAG laser capsulotomy. A tiny incision is made in the clouded capsule by the means of laser to allow light into the eye. The procedure is painless and may take less than 5 minutes.