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decision pointShould I have cataract surgery?

Consider the following when making your decision:

  • Not all cataracts need to be removed. Your decision on whether to have surgery will probably be based on the extent to which the cataract interferes with your daily life. Many people with cataracts get along well with glasses or contact lenses and can delay surgery or avoid it altogether.
  • Vision problems caused by cataracts develop slowly over time, so you probably do not need to rush into having surgery.
  • Surgery for cataracts involves removing the lens from your eye. The lens must then be replaced. If replacement is not possible, you will use glasses or contact lenses to compensate for the lack of a lens.
  • If you have a cataract removed, you may still need to wear glasses or contacts for best vision.

What is cataract surgery?

A cataract is a painless, cloudy area in the lens of the eye. Cataract surgery removes the clouded lens. In order for you to see, the lens must be replaced. It may be replaced in one of two ways:

  • During the surgery, the doctor may implant an artificial lens in the capsule that held the natural lens. Most cataract surgery uses this option. If needed, you may also wear eyeglasses or contact lenses after surgery.
  • In a few cases, the doctor may not be able to replace the lens. After your eye has recovered from surgery, you will be fitted with eyeglasses or contact lenses to compensate for the removed natural lens.

Because the surgery involves replacing the lens in your eye, have your doctor review the advantages and disadvantages of contact lenses, glasses, and implanted lenses.

How effective is cataract surgery?

Cataract surgery is safe and effective.

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.1 But you may still need reading glasses or glasses for near vision.

Removing a cataract may also reduce your need for eyeglasses or contact lenses by improving other eye problems such as nearsightedness, farsightedness, or astigmatism. But the surgery is not done for this reason alone.

What are the risks of cataract surgery?

Complications of cataract surgery are uncommon.

The most common complication after cataract surgery is clouding of the back part of the lens covering (capsule) that remains after surgery. The cloudiness, which may develop gradually over several months or years, affects about 1 in 4 people within 5 years of having cataract surgery.2 If the cloudiness affects your vision, you may choose to have another procedure (Nd:YAG posterior capsulotomy) to correct this problem.

Overall, less than 5% of people develop a serious complication after cataract surgery.1 The risk of blindness after surgery is very low. Potential complications include:

  • Swelling of the retina (cystoid macular edema), which usually goes away on its own within a few weeks.
  • New or different astigmatism, which can usually be treated with corrective lenses and will not affect your eyesight.
  • Infection of the tissues in the eye (endophthalmitis). It affects less than 1% of people who have cataract surgery. This serious infection can lead to blindness.
  • Inflammation of the cornea, glaucoma, uveitis, retinal detachment, and vision problems, which can be caused by bits of the cataract that may have remained in the eye. The doctor can do a procedure called a vitrectomy to remove these particles and improve your vision.
  • Development of glaucoma after cataract surgery.
  • Retinal detachment. People who have had cataract surgery are at increased risk for retinal detachment.

Some of these complications can be successfully treated with an additional procedure or surgery. But even with treatment, these complications may leave you with poor vision or blindness in the affected eye. In some cases, the treatment itself may also cause further complications.

Your vision may be cloudy for up to 3 months after cataract surgery. This is normal and will go away as your eye heals.

What are the risks of not having cataract surgery?

If you choose not to have cataract surgery, the cataract and its effect on your vision will most likely continue to slowly get worse. This may affect your ability to do your everyday activities and drive safely, especially at night. Vision problems may lead to falls, accidents, and injuries.

Cataract surgery may have a slightly higher risk of complications if the cataract is severe. In the United States and in other countries where advanced surgical techniques are available, cataracts rarely cause blindness.

If you need more information, see the topic Cataracts.

This information will be helpful if you are considering whether to have cataract surgery. This information may not apply if:

  • Your child has cataracts. It is very important to remove congenital cataracts that are causing significant vision problems before the child is 3 months old to prevent permanent vision loss.
  • Your doctor has recommended cataract surgery so that he or she can monitor another eye problem, such as a retinal problem.

In general, your choices are:

  • Have cataract surgery.
  • Wait and consider having surgery later if vision problems caused by the cataract begin to interfere with your lifestyle.

The decision about whether to have cataract surgery takes into account your personal feelings and the medical facts.

Deciding whether to have cataract surgery
Reasons to have cataract surgery Reasons not to have cataract surgery
  • Poor eyesight is affecting your ability to do your job.
  • The glare from the sun or headlights is severe and bothers you while you drive.
  • Poor eyesight restricts your ability to participate in normal leisure or social activities.
  • You are afraid you may fall and hurt yourself because you can't see well.
  • Worsening eyesight is making you lose independence.

Are there other reasons you might want to have cataract surgery?

  • Vision loss is gradual and does not affect work or daily activities.
  • Another eye condition, such as glaucoma, diabetic retinopathy, or macular degeneration, may mean that cataract surgery will not improve your eyesight.
  • You have poor general health and are worried about having surgery.
  • Glasses or contact lenses improve your vision sufficiently.
  • You do not want to have surgery.

Are there other reasons you might not want to have cataract surgery?

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about cataract surgery. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

The cataract has affected my vision Yes No Unsure
Vision problems have negatively affected my quality of life and independence. Yes No Unsure
I have other eye conditions that make cataract surgery unlikely to improve my vision. Yes No Unsure
The idea of having surgery bothers me a great deal. Yes No Unsure
My general health adds significant risk to undergoing surgery. Yes No Unsure
Family or friends can provide support and assistance for a few weeks following surgery. Yes No Unsure
Less-than-perfect vision would be a satisfactory result of surgery. Yes No Unsure
Eyeglasses or contact lenses improve my vision enough to allow me to perform daily activities. Yes No NA*

*NA = Not applicable

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have cataract surgery.

Check the box below that represents your overall impression about your decision.

Leaning toward having cataract surgery

 

Leaning toward NOT having cataract surgery

         

Citations

  1. American Academy of Ophthalmology (2006). Cataract in the Adult Eye. Preferred Practice Pattern. San Francisco: American Academy of Ophthalmology. Available online: http://www.aao.org/ppp.

  2. Schaumberg DA, et al. (1998). A systematic overview of the incidence of posterior capsule opacification. Ophthalmology, 105(7): 1213–1221.

Author Jeannette Curtis
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Christopher J. Rudnisky, MD, FRCSC - Ophthalmology
Last Updated October 1, 2007

WebMD Medical Reference from Healthwise

Last Updated: December 07, 2009
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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