How Long Does Cataract Surgery Take? What To Expect During Procedure

When it comes to eye care and surgical operations, cataract surgery can be a daunting prospect. While the image of lying on an operating table under glaring bright lights, watching a scalpel coming towards your eye makes the whole procedure sound much worse than it actually is, most people would not want to spend any more time in an operating theatre than they absolutely have to. If you’re curious about how long does cataract surgery take, read on for an in-depth answer to this common question about cataract surgery.  

How Long Does Cataract Surgery Take?

In general, uncomplicated cataract surgery operations can be as fast as 10 to 15 minutes, while procedures that are more involved can take in excess of half an hour. In studies investigating factors that affect cataract surgery operating times, researchers noted several factors that typically come into play. 

Type of anaesthesia

Cataract surgery does not usually involve general anaesthesia unless there is a reason the patient cannot comply with instructions during the surgery, such as mental impairment. Instead, the ophthalmologist will use either a local anaesthetic injected around the eyeball or a topical anaesthetic eye drop to numb the eye before the procedure. Cataract operations that involve a topical anaesthetic result in a much shorter operating time compared to those using a local anaesthetic injection. 

The expertise of the surgeon

Unsurprisingly, the skill and experience of the operating eye surgeon will greatly influence the efficiency of the cataract surgery procedure. In a study recording the operating time of a few different grades of surgeons, it was observed that consultants (a highly experienced cataract surgeon) were able to complete the operation between 9 to 29 minutes while cataract surgeries performed by a junior ophthalmologist ranged in duration from 19 to 41 minutes. It was also found that as the operation increased in complexity, consultant cataract surgeons were able to maintain a relatively quick operating time except in cases of very high complexity. 

Complications during surgery

While cataract surgery is known as a highly successful procedure in Australia and the developed world, there is always a chance of the unexpected arising, no matter how skilled or experienced the eye surgeon. Unexpected, or even expected, complications during any eye care procedure can extend the duration of the process as the ophthalmologist may need to use additional interventions or move at a slower pace during the operation. Although complications can happen to anyone undergoing cataract surgery, there are some factors that may increase the risk of the operation becoming more complex:

• Older age, particularly those over 60
• The presence of diabetes
• Combining cataract surgery with another eye care procedure
• The presence of other eye diseases, such as glaucoma or pseudoexfoliation syndrome
• Taking certain medications
• Long-sightedness, also known as hyperopia or hypermetropia, which results in a narrow space between the iris and the cornea
• Very advanced cataract, as this can take a longer time and more energy to break into fragments

Small pupils

During cataract surgery, your pupil must be dilated to allow access to the ophthalmologist’s surgical instruments to the cataract. The pupil is the hole in the centre of the coloured iris of the eye; the lens, which is where the cataract forms, sits behind the iris. In most cases, the pupil can be dilated using topical eye drops. However, there are some pupils that don’t respond adequately to these drops, which means the eye surgeon must use another approach. These other techniques for opening the iris include tools such as iris hooks, expanders, or a ring known as a Malyugin ring. Pupils that are able to dilate well enough using topical eye drops alone are associated with faster surgery times compared to small pupils that require the surgeon to insert a device to stretch the iris wider. Out of the various tools used to widen the pupil, some are associated with longer operating times. For example, if your surgeon needs to use an iris hook to widen the pupil, this will take a longer time compared to applying a Malyugin ring. 

Ultimately, while it would be nice to know exactly how long does cataract surgery take, there is a multitude of factors that can unexpectedly lengthen the duration of this common procedure. Although many of these factors are out of your (and to some extent, your eye surgeon’s) hands, there are some things you can consider to help make your surgery as smooth as possible:

• Disclose all medical history during your pre-operation appointments, even if you think it may not be relevant. This includes any medications you’re currently taking or even stopped recently, any health conditions you have, and your full eye care history. 
• If you have the option, choose your ophthalmologist well. You may want to ask friends or family who have had cataract surgery if they had a good experience, or if your optometrist has any professional recommendations. 
• Follow any pre-operation instructions. Some ophthalmologists may recommend pre-operative treatment, such as regular lid wipes or eye drops to prepare the eye for surgery and reduce the risk of excessive inflammation or an infection. 

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Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.