Cataract surgery

Cataracts are cloudy areas in the lens of the eye. This transparent structure focuses images on the light-sensitive retina. Cataracts occur when proteins in the lens form abnormal clumps that gradually get larger. Eventually they distort or block the passage of light through the lens and interfere with vision. “Cataract” means “huge waterfall,” which is how some people describe their clouded sight—like trying to look through a waterfall.

Drugs, eye drops, diets, exercises, or glasses can’t reverse the problem. Surgical removal of the clouded lens is the only effective cure for cataract. For most people, the only choice is when to undergo the procedure. The JAMA study and earlier work suggests that acting before vision becomes too impaired may be best.

Once an inpatient procedure requiring up to a week of hospitalization, cataract surgery is today performed under local anesthesia on an outpatient basis. It is considered one of the safest of all surgeries.

Here’s how cataract surgery is usually done: The surgeon makes a small incision in the eye. The damaged lens is removed one of two ways—surgically, in a process called extracapsular extraction, or using high-frequency sound waves. The latter procedure, called phacoemulsification, is the most common today. The surgeon inserts a needle-like probe through the incision. Sound waves are directed at the lens, breaking it apart, and the pieces are suctioned out of the eye. A new artificial lens is then placed inside the eye.

Other benefits of cataract surgery

Besides the immediate benefit of improved vision on everyday activities, and the longer-term one of preventing broken hips, cataract surgery may have other, less obvious benefits. These include:

• More independence. Most cataract sufferers are older adults for whom vision trouble threatens the prospects of living independently.
• Better physical fitness. A person with poor vision may be afraid to go out for a walk or get other exercise. Improved vision could encourage more physical activity and all of the medical benefits that follow (such as a lower risk of diabetes and heart disease).
• Better mental health. Loss of visual cues can contribute to confusion, especially in unfamiliar surroundings. And, the loss of independence and constriction of activities that come with failing vision may trigger depression.

In the future, it’s likely that cataract surgery will become even safer and more routine. Hopefully, we will discover ways to prevent cataracts. As the effectiveness of screening and treatment for eye disease improves, the importance of getting eye check-ups will only increase.