Intraocular Lens: Not Your Granny’s Cataract Surgery

Everything you need to know about intraocular lens implant surgery

Thirteen years ago I began to notice my near vision was becoming a little blurry and began to consider intraocular lens implant surgery. I had undergone Lasik surgery 10 years earlier on my left eye to improve near vision and the right eye was left untouched for distance. Before that, I had worn one contact on the left eye to correct the blurry vision caused by presbyopia (hardening of the lens of the eye which occurs with aging).

My first thought, after consulting Dr. Google, of course, was a touch up of the Lasik surgery most likely would be the remedy. As it happens, some people do need this touch-up procedure around the 10year mark. Ergo, “There’s my problem!” After all, I had never had any other issues with my eyes other than aging. And at that point cataracts never registered in my self- diagnosis. I was 63 years old at the time and, conceptually to me, cataracts belonged in that “much older” age group of 75+, including my grandmother when she had her surgeries decades ago. I can recall the surgeries themselves were pretty horrific. Full-on hospital stays were required and complications very common. Viscerally, I see now I held a fear of that happening to me in the future.

I Was Too Young for Cataracts, Right?

On visiting the ophthalmologist that performed the original Lasik surgery, I confidently told him I needed a “re-do.” Agreeing that could be the case, he performed the usual reading chart exams, dilated the eyes, and then came the ophthalmoscope to do the deep dive. Imagine my surprise when he tells me I have a small cataract! He checks the left eye and lo and behold, there’s one lurking in there too!

intraocular lens


I told him I was too young to have cataracts, that cataracts occur in older people or someone with other underlying problems. He smiled and said that’s a common misconception. He added that since I have lived in sunny southern California most of my adult life and, by my own admission, was not always diligent about wearing sunglasses, a practice that could be a contributing factor.

Not Waiting for my Lens to Ripen

I quickly readjusted my thinking and we discussed the options. Trying hard not to think about Granny’s surgeries, I agreed I didn’t want to wait until the cataracts were worse or “ripened” as this is no longer necessary with modern surgical advances. In my grandmother’s day, the lens could not be extracted safely unless it was at an advanced stage of development and I do vividly remember that term… Must have been my young brain trying to picture something ripening in my eye like a piece of fruit. Yikes!

After another exam in my HMO facility, approval was given for Intraocular Lens Implant Surgery (IOL) and I was on my way. I was still teaching then and wanted to correct my vision as quickly as possible, and truthfully, to get it over with. Miraculously, a date was available in less than two weeks… No time to overthink or deciding to let them “ripen” awhile.

Going Through with Intraocular Lens Implant Surgery

I met with a wonderful ophthalmologist who walked me through the whole surgery and reassured me that it is a common outpatient surgery, taking an hour or less to perform. First, she would place eye drops in my left eye to dilate the pupil, then local anesthetics to numb the area and an optional sedative to help me relax. I would remain awake but groggy. The clouded lens will be removed and in my case, a flexible intraocular lens would be used. This allowed for a smaller incision that requires few or no stitches. The lens is folded and inserted into the empty capsule where the natural lens used to be. Once inside the eye, the folded IOL unfolds filling the capsule once again and voila! Simple enough, eh?


On the morning of the surgery, my friend Jo drove me to the clinic. She did her best to reassure me that indeed, nothing would go wrong and I would be that 20/20 vision girl once again. I still had my trepidations. In hindsight, I’m glad that I hadn’t pooh-poohed that sedative, which would have been my usual response. To my great delight, everything went just as planned with no discomfort that I can recall other than the residual sedative grogginess and some nausea later from the drug (spoiler: I decided to forego the sedative on the second surgery in the right eye 3 months later). I was able to go home in two and a half hours after arrival.

What to Expect After Intraocular Lens Implant Surgery

The bandage over my eye was removed later in the afternoon. I used a protective eye cap at night or if I napped the first week after surgery. I had no infections, used my eye drops religiously and vision cleared within two days, back to teaching the third day.

My left eye was refracted for near vision. It has worked perfectly for the past 13 years, no reading glasses or problems of any kind. I do use eye drops to moisturize most days as drier eyes tend to be more common.

What Happens When You’re Awake During Intraocular Lens Implant Surgery?

Now, no longer a novice at this and having conquered my fear, I had the second surgery on my right eye 3 months later and as noted above, waived the sedative. The anesthesiologist stood by just in case, a policy of the clinic. Actually, it was intriguing to “watch” the procedure. I can remember there was some pressure around the ring that holds the eye still at first but not uncomfortable. I gladly traded that for the loopiness and nausea I experienced the first time from the sedative. And it wasn’t that disconcerting at all to be awake during the procedure. As in the first surgery, I had no immediate problems after and was able to return to my usual schedule very quickly.

intraocular lens implant surgery

Possible Complication: PCO

The one and only minor complication occurred a year or so after surgery on the right eye. I started to experience slight cloudiness due to a posterior capsule opacification (PCO). Yes, I know scary name! It occurs because cells remaining after the surgery grow over the back (posterior) of the capsule. It thickens and becomes slightly opaque. To me, it almost felt like the cataract was growing back (an impossibility if you’re wondering). But it was treated with a quick, painless, outpatient laser treatment in 5 minutes. PCO is somewhat common and one of the reasons it may happen is the younger you are when you have the surgery, the more likely it is that this thickening will occur. See, I told you I was too young for this.

For over a decade now, I have enjoyed the freedom of no contacts, no more LASIK, and no glasses. I am indeed that 20/20 vision girl again!  I will stop short of saying it was worth having cataracts to get the visual acuity that I have now. However, I do hope I have encouraged anyone in the need of cataract surgery.



Everything you need to know about Intraocular Lens Implant Surgery



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