The short story is that cataract surgery is permanent. Once you are all done, you are good for the rest of your life. Both the surgery and even the new artificial lens you receive to replace the cataract last forever.
Neat right?
To understand why this is the case, let’s first review what is involved with cataract surgery. Afterwards, let’s learn what CAN change after cataract surgery and even touch on something called after-cataract (which you’ll learn isn’t actually a cataract).
What’s Involved With Cataract Surgery
Within our eyes is a natural lens (at least before cataract surgery). This lens forms when our eye develops before birth and is important to focus light within our eye and allow us to see.
The lens; image by File:Three Internal chambers of the Eye.png: Artwork by Holly Fischer derivative work: Pixelsquid, CC BY 3.0, via Wikimedia Commons / cropped from original
But this lens changes over time.
Through normal aging processes, (and through certain medical conditions such as diabetes or with high steroid medication use), this lens can get cloudy. As this lens gets cloudy, it starts to scatter light and blur our vision. When our vision is significantly impaired from this lens, this lens is no longer called “the lens", it is called a cataract.
Learn more at Your Comprehensive Handbook To Learn What Are Cataracts
On to cataract surgery
Cataract surgery is a relatively straightforward process. A cataract is present, this cataract is removed, the cataract is no longer there.
The procedure starts off with your surgeon making a tiny incision into the cornea. This is followed by an opening into the capsule bag which surrounds the cataract.
Thanks to the brilliance of an ophthalmologist in the 1960s, Dr. Charles Kelman, modern cataract surgery uses a technique called phacoemulsification to remove the cataract. A tiny device is placed within the eye and uses ultrasound energy to break up the cataract into small pieces. This is promptly followed by a light vacuum which removes these cataract pieces from the eye. All of this is highly controlled minimizing any impact to the rest of the eye.
Once the cataract is removed, a new artificial lens is folded up, inserted through the tiny incision and placed within the capsule bag.
That’s all there is to cataract surgery.
Cataract surgery is permanent
That natural lens turned cataract that was removed during cataract surgery isn’t growing back. Why? The natural lens ONLY forms when the eye develops. It CAN'T regrow.
Once a cataract is removed, it is removed for good.
But what about the artificial lens placed? Will that lens eventually wear down and need to be replaced?
No it won’t!
Artificial lenses last forever
Just as how the phacoemulsification technology behind modern cataract surgery has existed for decades, the same can be said about artificial lenses. Artificial lenses are specifically designed to last forever.
Back in the 1940s another brilliant ophthalmologist, Sir Harold Ridley, came up with a way to successfully implant an artificial lens in the eye after cataract surgery.
During World War II, Dr. Ridley took care of eye injuries of pilots that had been shot down. The cockpit of these airplanes was made out of a combination of glass and a special plastic called PMMA or acrylic (also commonly known by the brand name Plexiglas). While taking care of pilots who got this material in their eye after their cockpit shattered, Ridley noticed that this plastic was completely nonreactive within the eye. Years later, he intentionally shaped this material into the shape of lens to correct vision after cataract surgery.
Decades later and we are still using acrylic artificial lenses after cataract surgery. Millions of these lenses are placed each year and there has never been any report of any reaction or allergy to these lenses.
With modern lens design, these lenses truly last forever.
Artificial lens used in cataract surgery; image by Frank C. Müller, CC BY-SA 3.0, via Wikimedia Commons
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So What Can Change?
While cataracts will never regrow and cataract surgery will never need to be repeated, this doesn’t mean that vision will never change. Certain things can cause your vision to become blurry years out after cataract surgery.
Cloudy capsule (after-cataract)
Remember that capsule bag that is used to hold the artificial lens during cataract surgery? It can get cloudy. And this is the biggest way vision can decline after cataract surgery.
Microscopic cataract particles can remain after cataract surgery. These cataract cells can attach to the capsule and start growing. As these cells grow, it makes the capsule cloudy, blurs vision and creates glare.
This happens often enough that colloquially this is referred to as an after cataract; although technically it isn’t a cataract. And unlike true cataracts, it is treated by a much more simple in-office laser procedure with minimal downtime.
Other ways vision can change
- Cataract surgery can increase the risk of a retinal detachment. Fortunately this is still uncommon but can occurs years out after cataract surgery.
- While the artificial lens is designed to last forever, rarely it can dislocate within the eye long after cataract surgery and cause the vision to become blurry. This requires another surgery to fix this lens back in place. Learn more about it at Key Symptoms Of Dislocated Lens After Cataract Surgery
- Vision can simply change due to some other unrelated issue. Cataract surgery only replaces the natural lens. Eye diseases such as macular degeneration or glaucoma can still occur in other parts of the eye.
For more in-depth reading, check out The BIGGEST Reason for Blurred Vision 2 Years After Cataract Surgery and The 3 Must Know Late Complications Of Cataract Surgery
Summary
Cataract surgery is a one time event. It is simply impossible for cataracts to return once it is removed. The artificial lens placed in the eye after cataract surgery is also designed to last forever. Vision can still change after cataract surgery, but due to other causes and not because the cataract returned; even though the most common cause of a change in vision, a cloudy capsule, is often called an after-cataract.
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