A cataract is the gradual clouding of the natural lens inside your eye. Colours start to look faded, headlights and sunlight cause glare, reading needs more and more light, and your glasses prescription may keep changing without making things sharper. Surgery is the only treatment that removes a cataract: the clouded lens is broken up and removed through a very small incision and replaced with a clear artificial intraocular lens (IOL). You stay awake under local anaesthesia, usually given as drops, and you do not see the instruments or the surgery itself.
For most people the operation is the simpler part. The real decision is the lens, because it shapes how you will see at different distances for the rest of your life.
When cataract surgery makes sense, and when to wait
There is no fixed stage at which a cataract must be removed. Surgery is usually recommended when the clouding interferes with your daily life: driving, especially at night, reading, work, hobbies or moving around safely. Early surgery is not always necessary, and your ophthalmologist will help you judge when the time is right. Wearing sunglasses that block UV light, eating a diet rich in fruit and leafy vegetables, not smoking and keeping conditions such as diabetes well controlled may help slow progression, but nothing reverses a cataract once it has formed.
It is worth being honest about travel. If you live in France or Belgium, cataract surgery with a standard monofocal lens is usually covered by public health insurance. Travelling to Istanbul mainly makes sense if you want a lens option that is not covered where you live, such as a multifocal or extended depth of focus lens, or if waiting times at home are long.
Surgery may need to wait, or a different plan may be wiser, if:
- your diabetes or blood pressure is not yet well controlled;
- you have an active eye infection, inflammation or untreated blepharitis, which should be settled first;
- you have another eye condition such as macular degeneration, glaucoma or diabetic retinopathy, which can limit the result and calls for close follow-up by a doctor near home;
- you hope to be completely free of glasses but have macular disease, significant dry eye or drive a lot at night, situations in which multifocal lenses often suit less well;
- you take blood thinners: never stop them on your own, but tell the surgeon in advance.
How the operation and the lens choice work
Everything starts with a detailed assessment: your vision, eye pressure, the front and back of the eye, and biometry. Biometry measures the length of your eye and the curvature of your cornea so that the power of the implant can be calculated. Your surgeon will also ask about your work, screens, reading and driving habits, because these determine which lens suits you.
The standard technique is phacoemulsification. Through an incision of a few millimetres, an ultrasound probe breaks up the clouded lens and gently removes it, leaving its thin outer capsule in place. The folded implant is then placed inside that capsule, where it opens out. The procedure itself typically takes about 20 minutes per eye, longer for a dense or complex cataract, and anaesthesia is local: drops, sometimes an injection around the eye, occasionally with light sedation.
Conventional or laser-assisted surgery
In femtosecond laser-assisted surgery, a laser makes the incisions, opens the capsule and softens the lens before it is removed. It may add precision in some steps but is not always needed. Both methods are safe and effective; your surgeon will recommend one based on your eye anatomy.
The main types of lens
- Monofocal: sharp vision at one distance, usually far. Reading glasses are needed, and it remains the most comfortable choice for night driving.
- Toric: also corrects astigmatism; otherwise it behaves like the lens type it is built on.
- Multifocal: often lets you read without glasses, but may bring glare, halos around lights and some loss of contrast.
- Extended depth of focus (EDOF): improves the intermediate range, such as a computer screen; reading glasses may still be needed and halos can occur.
- Light-adjustable: the only type that can be fine-tuned after surgery.
No published percentage exists for how often halos and glare occur with so-called premium lenses, so nobody can honestly put a figure on that risk for you.
Your stay in Istanbul, day by day
For one eye, plan on 3 to 4 days. A typical schedule:
- Day 1: arrival, transfer to the hotel, consultation, full examination and biometry. The lens choice is confirmed with you.
- Day 2: surgery. You spend a few hours at the clinic in total and return to the hotel with a protective shield, drops and written instructions. Vision is blurred for some hours.
- Day 3: check the next morning: eye pressure, the healing wound and the position of the lens. The drop schedule is gone through with you.
- Day 4: your flight home once the surgeon has confirmed you are fit to fly.
Most surgeons operate on one eye at a time. If both eyes are treated during the same trip, the second is usually done on a separate day after the first has been checked, which adds a few days.
On flying, guidance varies. Some aviation medical guidelines advise waiting about a week after surgery inside the eye, while many eye surgeons allow a flight within a few days after uncomplicated cataract surgery, as no gas is placed in the eye. If gas has been used, which is not part of routine cataract surgery, the wait is two weeks for SF6 and six weeks for C3F8. Your surgeon decides for your own eye before you leave.
What your written quote should cover
Esthappy organises the consultation, surgeon and clinic fees, hotel, airport and clinic transfers and an interpreter. Your written quote should list exactly what is included, in particular:
- the pre-operative examination and biometry;
- the type and model of lens proposed, and whether one or both eyes are included;
- laser assistance, if it is part of the plan;
- post-operative checks in Istanbul;
- eye drops and the protective shield;
- the number of hotel nights and transfers;
- what happens if an additional procedure or a longer stay is needed.
Recovery, week by week
First 24 hours: blurred vision, a gritty or watery feeling and mild discomfort are usual. Rest, use the drops exactly as prescribed and wear the shield at night.
First week: vision usually improves within a few days, and most people return to desk work after 2 to 5 days. Avoid rubbing the eye, swimming, dusty places, eye make-up and heavy lifting.
Weeks 2 to 4: drops continue for about four weeks, generally with a tapering schedule.
Months 1 to 3: once the eye has stabilised, usually after around a month, an optician can prescribe new glasses if needed. With multifocal or EDOF lenses, the brain may take weeks to months to adapt to the new way of seeing.
Risks and how they are reduced
A national audit of 180,114 operations found that 94.6% of eyes reached 6/12 vision or better where there was no other eye disease, compared with 79.9% where there was. Intraoperative complications occurred in 4.2% of cases, posterior capsule rupture in 1.95%, endophthalmitis (a serious internal infection) within three months in 0.03%, and retinal detachment surgery within three months in 0.03%.
Other possible problems include a temporary rise in eye pressure, inflammation, swelling of the cornea or the central retina, a lens that is off-target or moves out of position, and dry eye. Months or years later, the capsule behind the lens can turn cloudy; this is treated with a quick laser procedure in clinic. Risk is reduced by a thorough pre-operative assessment, accurate biometry, sterile technique with antibiotic protection, careful use of your drops, and keeping your hands away from the eye.
Questions to ask before booking
- Which lens do you recommend for my eyes and habits, and why not the alternatives?
- Does anything in my eyes make a multifocal or EDOF lens less suitable?
- Will both eyes be operated on, and on which days?
- Do you suggest laser assistance, and what would it change in my case?
- What will I receive in writing about the lens model and power?
- When will I be fit to fly, and who follows me up at home?
Once you are home
Book an appointment with an eye doctor near home before you leave, ideally within the first weeks, and agree who supervises the drop schedule. You can send photos and updates for remote follow-up, but a photo cannot replace an examination. Seek urgent local care for increasing pain, worsening vision, growing redness, or new flashes, floaters or a shadow across your vision.
Take home your operation report, your drop prescription and, above all, the model and power of the implanted lens in writing. You will need this information at every future eye examination and for any new glasses prescription.