When Should You Have Cataract Surgery? How To Determine If You Are Ready & The Hazards Of Waiting Too Long

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If you are developing a cataract in one or both eyes, then you likely realize that there is a large chance you will need cataract replacement surgery one day. However, you may not know when you should begin looking into it. Experts do advise that people who are just developing cataracts wait until they are affecting their vision to obtain surgery, but how long of a wait is too long? Read on to find out the current cataract removal recommendations agreed on by the healthcare community and what happens if you wait too long to obtain surgery. 

Why Early Cataract Removal is Often Being Advised by Surgeons After Decades of Telling Patients to Wait

If you have an older relative or friend who developed cataracts and since had them removed, they may tell you that doctors won't perform cataract replacement until your vision becomes bad, because that was the standard advice given to cataract sufferers until just recently. This was well-intended advice, because before safer, modern cataract replacement surgeries were developed, there were many potential surgical complications that came with old cataract-removal techniques that they wanted their patients to avoid unless completely necessary. 

Along with the fact that there are newer, safer cataract surgeries, a cataract surgeon who developed a cataract of his own recently made headlines in the medical community and made many other cataract surgeons realize they were still waiting too long to advise patients to have cataract surgery; they were relying on vision charts that didn't tell the whole story about how cataracts affect a person's vision and life. When the surgeon developed mild cataracts, he experienced impaired night vision, dominance of the eye that didn't have the cataract, lost of color contrast, and other symptoms that could not be measured by the vision chart he used to use exclusively to determine whether he would perform surgery on patients yet or not. 

He now advises that patients have cataract surgery as soon as they feel their vision is impaired in any way, and so do many other cataract surgeons. 

What Happens if You Wait Too Long for Cataract Surgery?

While you technically can choose to wait as long as you want to have cataract surgery, it is important to realize the complications that can arise when you wait too long. Of course, your vision will gradually become worse as the cataracts develop and you could even lose your eyesight altogether, but there are other reasons to not wait too long for cataract removal. 

1. Surgery Will Become More Invasive the Longer You Wait

Generally, the more advanced your cataracts become, the more invasive the surgery to remove them will be and the greater the risk of complications. 

Early cataracts can be removed with a simple, modern surgery called phacoemulsification. This procedure only takes about 30 minutes, and it can often be performed in an outpatient setting, meaning you won't be stuck in a hospital bed for days. Typically, general anesthesia is not needed to perform this cataract removal process, but only local anesthetic in the form of numbing eye drops or mild twilight sedation that doesn't have the health risks of general sedation. If you opt for this early cataract procedure, a thin incision will first be made on the surface of your eye. Then, a tiny probe is inserted into your cataract-laden lens, and it vibrates slightly to dissolve the cataract while suctioning the dissolved bits at the same time. A new eye lens, called a foldable intraocular lens, is then inserted, and you will then have perfectly clear vision with little to no disruption of your normal daily activities. 

However, if you wait until your cataract has progressed too much, it will be too thick and tough for the phacoemulsification to work safely, so you will need to have your cataract removed with a more advanced surgery called extracapsular cataract surgery. This surgery begins with a much larger incision being made in the white area of your eye next to the lens, and then the lens of your eye being cut out in one large piece. Then, a more rigid, non-foldable intraocular lens is placed in your eye. Stitches may be needed after this surgery, and it takes about twice as long to perform as phacoemulsification. It will also take longer after this surgery for your eye(s) to completely heal and for your vision to become clear. Being a bit more invasive, the chances of complications occurring increases. 

Don't worry that cataracts will return if you have cataract surgery too soon, because it is impossible for new cataracts to form after you have cataract replacement surgery. 

2. Some Doctors Believe That Advanced Cataracts Can Cause Glaucoma

If you have both cataracts and glaucoma, then the good news is that removal of cataracts can also improve your glaucoma. Cataracts begin to put more and more pressure on your eyes as they thicken, and removing this unnaturally thick lens can often lower pressure in your eyes. While there is no consensus yet in the medical community on it, many eye doctors also believe that thick cataracts can even cause glaucoma. 

If you have early cataracts, then realize that while eye doctors used to advise that you wait until a specific time to have them removed, most now suggest that you have cataract replacement as soon as you want to after they begin developing. While cataracts worsen at different rates in different people, they never heal or clear up on their own. If you wish to wait a bit, then know what to expect and why it can be hazardous to wait too long to have cataract replacement surgery. 

For more information, talk to a professional, like those at Country Hills Eye Center.