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How Long Does Cataract Surgery Take From Start To Finish

How Long Does Cataract Surgery Take From Start To Finish

Cataract surgery can be shorter than the time it takes to get a coffee from the coffee shop. For real! Think about that next time you are sitting in the drive through lane with a half dozen cars in front of you.

Typical cataract surgery will only take somewhere between 10 and 20 minutes. Add in a little more time to clean and prepare the eyes and you are only inside the operating room for about a half hour. Fast!

Though, there is some variation between surgeons in how long cataract surgery takes and there are a few different situations that can make it take a little longer; ranging from using advanced technology or having a more challenging cataract to remove. Let’s explore all of it.

Cataract Surgery Is Quick

Going through major surgery is typically a big ordeal. You have to be put asleep during the procedure. It takes some time to bounce back afterwards. You are pretty much down for the count for the whole day or more.

But cataract surgery is different. Because of how quick cataract surgery is, it is NOT necessary to be put asleep. This means you are actually awake during cataract surgery (which does mean you do see some strange things…)

But being awake doesn’t mean that cataract surgery is painful. All that is needed for cataract surgery are numbing eyedrops with or without a little bit more lidocaine placed in the eye at the beginning of the procedure. And frequently combined with Valium or IV Versed to make you much more relaxed. Check out How To Overcome Being Terrified Of Cataract Surgery to see just how sedative medications are used during cataract surgery.

But because you don’t need to be put asleep, you spend less time in the operating room and less time in the post-op recovery room after the procedure. Although, you still do wait a little before the procedure getting eye drops and waiting for the eye to fully dilate.

Length depends on technique

Cataract surgery does have a pretty broad range. (I mean, 20 minutes is twice as long as 10 minutes). This is because how long cataract surgery takes depends a great deal on technique. And techniques differ wildly between different surgeons. And faster technique doesn’t necessarily mean better.

Let’s look first at where the cataract is inside the eye to understand the different steps: Particularly note that the cataract sits suspended within a capsule bag inside the eye.

Where the cataract is within the eye

Where the cataract is within the eye; image by File:Three Internal chambers of the Eye.png: Artwork by Holly Fischer derivative work: Pixelsquid, CC BY 3.0, via Wikimedia Commons / modified from original

The beginning parts of cataract surgery are pretty similar between all surgeons.

  1. Cushioning gel is placed inside the eye and a tiny incision is made (~1 minute)
  2. An opening is created in the capsule bag to access the cataract (~1 minute)
  3. Water is used to wash around the cataract and separate it from the capsule bag (~1 minute)

These beginning steps are roughly pretty similar. Depending on whether surgeons add a few other things (such as adding more lidocaine), it can add another minute or two.

The biggest differences in how long normal cataract surgery takes depends on the next two steps:

  1. The cataract is broken up and removed. (~4-6 minutes on average; can range anywhere from 2 to 10 minutes). This is the longest step and different surgeons have their own preferred techniques. The most common one breaks the cataract into four or more pizza pie slices to remove (named divide and conquer, no joke). But other slightly quicker techniques have evolved over time.
  2. Remove the soft outer shell layer of the cataract called the cortex stuck on the capsule bag. (~2 minutes on average; can range anywhere from 1-3 minutes).

Finally, the last remaining steps of cataract surgery are again pretty similar between all surgeons

  1. Add more cushioning gel to the eye and place the new artificial lens (~1 to 1.5 minutes)
  2. Remove all the remaining cushioning gel and seal up the tiny incisions (about another ~1 to 1.5 minutes)

That’s how long all of the standard steps of cataract surgery take. And with some variance between surgeons and well as how fast the scrub technician can pass the surgeon the tools, routine cataract surgery will take anywhere between 10 and 20 minutes.

What Makes Cataract Surgery Take Longer?

Not ALL cataract surgeries take 10-20 minutes. Some will take longer. There are certain things which will increase how long cataract surgery takes

Laser assisted cataract surgery

Many cataract surgeries today are being done with the assistance of lasers. The lasers are able to precisely create that opening through the capsule bag and break up the cataract (in addition to being able to perform other cool functions such as correcting astigmatism).

But lasers will add to the overall length of cataract surgery. The laser time itself isn’t actually all that long. The laser may only take 30-60 seconds to do the actual treatment. But once the eye is aligned with the laser, it can take a total 3-5 minutes when accounting for all the scans and measurements. Plus time for preparation and setup. So overall, having laser assisted cataract surgery can increase the time you spend in the operating room by a little over 10 minutes.

Realtime measurements of the eye during surgery

Special equations are used to figure out what power of artificial lens to place in the eye to give the best vision without glasses possible. But these equations have limitations and the accuracy of cataract surgery isn’t 100%.

So to help make things even more accurate, a special technology is able to measure the prescription of the eye once the cataract is removed to further calculate the best artificial lens power.

Of course, if you stop operating to take measurements, that will take some additional time. The measurements themselves take approximately about a minute and a half, but it can take another couple of minutes for the technician to prepare the new artificial lens to be placed within the eye.

Not looking straight ahead (or moving eyes around)

Those above two technologies will add a predictable amount of time to the cataract surgery.

But not looking straight ahead at the lights above makes things less predictable.

Surgeons can operate very efficiently when the eye isn’t moving around and centered under the microscope. But when surgeons have to adjust for any extra movement of the eye, the surgery slows down to prevent any issues.

This adds to the overall time of cataract surgery.

Dense or more complex or more complicated cataract

Remember that longest step of cataract surgery where the cataract is broken up into smaller pieces and removed? That can become even longer if the cataract is significantly more challenging.

Very dense cataracts fall into this category. It just takes more energy (and more time) to break up rock hard cataracts.

But other more complex situations will add to the time it takes for the cataract surgery. Especially if there is an issue such as a break in the capsule bag during cataract surgery. That can add anywhere between 10-20 minutes to the surgery time.

While most cataract surgery is very predictable, cataract surgery is still a surgery and can’t always be predicted.

Poor dilation

Also falling into the category of adding more complexity to cataract surgery is having an eye that doesn’t dilate very well.

Dilation is important for the surgeon to visualize the cataract to remove it quickly and efficiently.

If the eye doesn’t dilate very well, there are small pupil expansion rings or devices the surgeon may use during surgery to increase the dilation and allow the surgeon to see.

And of course, using additional devices and techniques will add to how long cataract surgery takes.

Summary

Cataract surgery is quick. The whole procedure will only take about 10-20 minutes. Using extra technology or having a more complex cataract increases that time some. Add in some additional time spent getting prepared for the procedure and a short time spent in recovery afterwards before you know it, you’re going home with cataract-free vision.

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