Cataract surgery

A cataract is a clouding of the lens of the eye and usually occurs as an "age-related cataract" from the age of 70, occasionally even earlier, sometimes as a complication of other eye diseases. Vision deteriorates and can no longer be improved by wearing stronger glasses. Often, sensitivity to glare also develops. Without surgery, the clouding of the lens progresses slowly and vision deteriorates. In some cases, complications such as an increase in eye pressure can also occur. There are no alternatives to surgery.

There is no need to be afraid of cataract surgery. It is the most frequently performed procedure in ophthalmology and in most cases it goes smoothly. Your vision usually improves significantly after just a few days and healing is complete after a month. Only in very few cases (less than 1 in 1000 cases) do serious problems occur. If you are at particular risk, your ophthalmologist will explain this to you when discussing the operation.

Cataracts are never an emergency and the operation can be planned at a time that is convenient for you. Ideally, it should be performed when you notice a disturbing reduction in vision yourself. However, the operation should always be performed before the lens becomes severely clouded and hardened, as the risk of surgery increases significantly in such cases.

The operation takes place in the eye operating theatre at Zollikerberg Hospital. Before the actual operation, the patient is prepared by having an infusion applied to the wrist or forearm. The operation itself takes about 20 minutes. The patient lies relatively flat on their back on a couch, with additional padding available if required. The eye is anaesthetised using drops (anaesthesia), no injection is required. In the case of surgically difficult eyes or on request, the operation is performed under anaesthetic; this will be discussed in advance. The eye is held open with a small eyelid retractor, blinking is no longer possible. The patient looks into the microscope and sees a bright light. As a rule, nothing or at most a slight tension and the water used to rinse the eye are felt. Rest is then the order of the day. After the operation, you can go home without a bandage, but you should wear sunglasses or the glasses you used before. We recommend that our patients are picked up by an accompanying person, but they can also travel by tram or train. Only in a few cases is an inpatient stay with an overnight stay in hospital necessary.

The cloudy lens is removed and a new one inserted: The eye is opened from above or from the side of the cornea through a two millimetre wide incision. The lens, which is located behind the pupil, is liquefied with an ultrasonic pen and suctioned out (technical term "phacoemulsification"). The lens envelope is left in place. A folded soft plastic lens is inserted into the eye through the same small opening using a tube. In most cases, no sutures are required as the incision is self-adhesive. The lens remains permanently in the shell of the removed lens.

You can continue to lead a normal life. You can bend down, carry normal loads (shopping bag, household appliances, etc.), read, work on the computer (PC) or laptop and watch television. You can wash your hair with normal care after two days. Simple physical activity such as walking or training on an exercise bike is also permitted. We recommend that you wear good sun protection. Avoid high-risk activities such as swimming, saunas, sports involving vibrations or working in the garden for a fortnight. You should not plan any trips abroad until one month after the operation due to the necessary follow-up checks and possible rare healing problems. Driving is not permitted on the day of the operation and afterwards only after consultation with your ophthalmologist (although you can often drive again after just a few days).

The procedure is covered by health insurance. Since 2018, there has been a flat-rate agreement with the health insurance companies on reimbursement (approx. 2000.00 per eye). Additional preliminary examinations and follow-up treatment by the ophthalmologist are covered by health insurance. Additional costs are incurred for modern artificial lenses, which are not covered by health insurance.

In the vast majority of patients (90 to 95 per cent), vision is significantly improved by the operation. In the case of previously damaged eyes, for example as a result of retinal diseases (e.g. macular degeneration) or glaucoma, only a limited improvement in vision can be achieved or it may even fail to materialise altogether. We will inform you about your prognosis before the operation.