Treatment

Indications

• To improve vision in individuals with significant cataract-related visual disturbances (most common indication)

• Cataract causing significant difference in refractive power between the two eyes

• Preventing proper evaluation or treatment of the areas of the eye that are posterior to it (e.g., the fundus)

• Cataract causing glaucoma (e.g., angle closure glaucoma)

Contraindications

• Visual disturbances manageable with corrective lenses

• Vision is not expected to improve after surgery (e.g., concurrent ocular conditions also causing vision impairment)

• High surgical risk

• Blindness

• Glaucoma: phacolytic glaucoma, angle-closure glaucoma

• Deprivation amblyopia in congenital cataract

• Complications after cataract surgery are rare

  • Astigmatism caused by wound incision

  • Dislocation of the intraocular lens

  • Postoperative uveitis, endophthalmitis

  • Cystoid macular edema: an accumulation of fluid at the macula in tiny cyst-like cavities within the outer plexiform layer (Henle's layer) and inner nuclear layers of the retina

  • Posterior capsule opacification (PCO; secondary cataract) after ECCE

  • Rare complications: retinal detachment, progressive Fuchs dystrophy , loss of the eye

Several measures can help prevent the development and progression of cataracts:

• Smoking cessation (see “Counseling on smoking cessation”)

• Management of medical conditions associated with increased cataract risk (e.g., diabetes, hypertension, obesity)

• Avoidance of UVB radiation (e.g., wearing sunglasses, hats)

• Wearing eye protection during activities that carry risk of penetrating eye trauma (e.g., while cutting metal or wood)