How the operation works

Cataract surgery is a common, quick and well-established procedure — one of the most frequently performed in the world. It is most often carried out under local anesthesia, on an outpatient basis: you arrive and leave the same day. Here is how it works, step by step.

On your arrival, the eye is prepared: drops are instilled to dilate the pupil and numb the surface of the eye. A light sedation may be offered to help you relax. The procedure does not require general anesthesia in the great majority of cases.

The anesthesia is local, most often with simple eye drops (topical anesthesia). The eye is numbed: the procedure is painless. You stay awake but relaxed, without seeing anything precise of the operation.

Through a micro-incision of a few millimeters, the clouded lens is broken up by ultrasound — this is phacoemulsification — then gently aspirated. The chosen implant is then inserted, folded, into the natural envelope of the lens (the capsular bag), where it unfolds and centers itself. The incision is so fine that it generally requires no stitches.

The procedure lasts on average about fifteen minutes per eye. During this time, you perceive lights and hear the device; a sensation of pressure is possible, but no pain. You are simply asked to look at the light and not move the eye.

A transparent protective shield is placed over the eye, and your eye drops are given to you with instructions. You go home the same day: arrange for someone to accompany you, as driving is not possible right afterwards. Recovery is generally straightforward.

When both eyes need surgery, the second is operated on a few weeks apart, after checking the good recovery of the first.

Phacoemulsification benefits from decades of refinement. Micro-incisions, ultrasound and foldable implants have made the procedure shorter, gentler and more precise. It is now a highly standardized procedure, performed millions of times each year worldwide.

Certain situations — high myopia, narrow pupil, very dense cataract, previous surgery, associated glaucoma or keratoconus — call for particular attention. They are identified during the work-up, which makes it possible to adapt the technique and equipment in advance. Discussing them in consultation avoids surprises and strengthens safety.