A cataract is the progressive clouding of the lens inside the eye, leading to blurred vision and difficulty with daily activities. Cataract surgery removes the clouded lens and replaces it with an artificial intraocular lens (IOL), restoring vision. The procedure is performed while you are awake under local anaesthesia, and you do not see the instruments or the surgery itself.
Pre-operative assessment and biometry
Before cataract surgery, a detailed pre-operative assessment is performed. This includes measuring your vision, checking eye health, and using biometry to determine the exact power and type of IOL that will best suit your needs. Measurements such as the length of your eye and the curvature of your cornea ensure the new lens provides optimal vision. Your surgeon will discuss your lifestyle, visual goals, and any other eye conditions to tailor the procedure to you. For more on vision care, see our vision treatments overview.
Local vs laser cataract surgery
There are two main methods for cataract surgery: conventional (manual) and femtosecond laser-assisted. Both involve removing the clouded lens and implanting an IOL, but differ in technique:
| Method | How it works | What to expect |
|---|---|---|
| Conventional (local) | Manual incisions and ultrasound (phacoemulsification) break up the lens. | Most common; quick recovery; widely available. |
| Laser-assisted | Laser creates incisions and softens the lens before removal. | May improve precision; not always needed; higher cost. |
Both methods are safe and effective. Your surgeon will help decide which is best for you based on your eye anatomy and preferences.
Non-surgical delaying strategies
While surgery is the only way to remove cataracts, some non-surgical strategies may slow their progression. Protecting your eyes from UV light with sunglasses, maintaining a healthy diet rich in antioxidants (such as leafy greens and fruits), and managing conditions like diabetes can help delay the need for surgery. However, these methods cannot reverse cataracts once they form.
Choosing a lens
Choosing the type of intraocular lens is a key decision. The main IOL options include:
- Monofocal lens: Provides clear vision at one distance (usually far); reading glasses are often needed.
- Toric lens: Corrects astigmatism in addition to distance vision.
- Multifocal lens: Offers vision at multiple distances, reducing the need for glasses, but may cause glare or halos.
- Extended depth of focus lens: Improves range of vision but can still require reading glasses and may cause halos.
- Light-adjustable lens: Can be fine-tuned after surgery for optimal vision.
| Lens Type | Benefits | Considerations |
|---|---|---|
| Monofocal | Sharp vision at one distance; best for night driving | Reading glasses needed |
| Toric | Corrects astigmatism | Same as monofocal otherwise |
| Multifocal | Less need for glasses | Possible glare, halos, reduced contrast |
| EDOF | Improved intermediate range | May still need glasses; halos possible |
| Light-adjustable | Customisable after surgery | Requires special post-op care |
No published data can quantify how often halos and glare occur with premium lenses, so your surgeon will help you weigh the benefits and possible side effects. For more on decision-making, see our vision treatments blog.
Patient decision-making aids
Deciding on cataract surgery and lens type is personal. Shared decision-making tools, such as visual simulations, risk checklists, and lifestyle questionnaires, can help you and your surgeon choose the option that fits your needs. Discuss your daily activities, night driving, reading habits, and visual expectations. Bring your questions to your consultation, and consider involving family members in the discussion. More guidance is available in our treatment overview.
Audit figures and risks
A national audit of 180,114 operations found 94.6% of eyes reached 6/12 vision or better where there was no other eye disease, compared to 79.9% where there was. Intraoperative complications occurred in 4.2%, posterior capsule rupture in 1.95%, endophthalmitis within three months in 0.03%, and retinal detachment surgery within three months in 0.03%. Your surgeon will discuss your individual risk profile before surgery.
Post-operative quality of life outcomes
Beyond clearer vision, cataract surgery often leads to improved independence, reduced risk of falls, and better overall quality of life. Many patients report greater confidence in daily activities and safer mobility, especially in low-light conditions. These benefits are particularly important for older adults.
Afterwards, and flying home
Vision is blurred for some hours after surgery, and mild discomfort may continue for several days. Eye drops are prescribed for about four weeks to aid healing. Aviation guidelines recommend waiting at least one week before flying after routine surgery, longer if gas was used in the eye. Arrange a review with your local eye doctor before you travel home. For further information, visit our results page.
Frequently asked questions
How soon is surgery needed for cataracts?
Surgery is usually recommended when cataracts interfere with your daily life. There is no set timeline, and early surgery is not always necessary. Your ophthalmologist will help you decide when the time is right.
What are the types of intraocular lenses available?
Options include monofocal, toric, multifocal, extended depth of focus, and light-adjustable lenses. Each has different benefits and considerations, which your surgeon will discuss with you.
How long does recovery take?
Most people notice improvement within a few days, but full recovery and stabilisation of vision can take several weeks. Eye drops are used for about a month.
What risks or complications might occur?
Risks include infection, retinal detachment, and posterior capsule rupture, though serious complications are rare. Your surgeon will explain your individual risk factors.
Is laser cataract surgery better than conventional?
Laser-assisted surgery can offer more precision in certain steps, but both methods are safe and effective. The best choice depends on your eye health and surgeon’s recommendation.
Can I have both eyes operated on the same day?
It is possible in select cases, but most surgeons prefer to operate on one eye at a time to monitor healing and reduce risk. Discuss this with your surgeon during your consultation.