Cataract: Secondary Lens Implant

What is a secondary lens implant surgery?

A lens implant is a small, plastic lens that an eye provider can put in your eye to replace a lens that has been removed because of a cataract. A cataract is a cloudy area in the lens of the eye. The lens is located inside the eye behind the iris (the colored part of the eye). It helps focus light and images on the lining of the back of your eye. If the lens gets cloudy, it can cause trouble seeing. For some people, the lens gets cloudier over time and causes vision problems.

Usually the plastic lens is implanted during surgery to remove the cataract. A secondary lens implant is one that is done in a separate surgery after cataract surgery. In the past, cataract surgery did not routinely involve replacing the eye's cloudy lens with a plastic one. After the eye's lens was removed, people had to use contact lenses or glasses with thick lenses to replace it. Now, a plastic lens can be implanted into the eye, even years after a cataract was removed.

When is it used?

Sometimes after an injury or complex surgery, your provider may not be able to safely place a plastic lens in your eye during the first surgery. In this case, you may be able to have another operation to implant a lens at a later date, once your eye heals.

Secondary lens implants may be used to improve vision for people who no longer want to wear thick glasses or contact lenses after surgery to remove a cataract. Implanted lenses have several advantages. They do not have to be put in and taken out like contact lenses do. They do not cause distortion or magnification like cataract glasses do. In fact, lens implants often provide good distance vision even without glasses. However, most people still need reading glasses.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

  • Your eye will be measured so that a proper lens implant can be chosen.
  • Plan for your care and a ride home after the procedure.
  • You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
  • Do not wear eye makeup on the day of the surgery.
  • Follow any other instructions your healthcare provider gives you.
  • Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a sedative to relax you. Sometimes your provider will give you a shot to completely numb the eye. Eyedrops or numbing gel can sometimes be used instead of the shot.

Using a special microscope, your provider makes a small cut in the clear part of your eye. Then your provider will put an artificial lens in your eye. The provider may put one or more stitches in your eye to close the cut. You will have a patch or protective shield over the eye.

What happens after the procedure?

You will be in the recovery area for about an hour after surgery or until you are ready to go home. You should rest at home for the rest of the day. To protect your eye from injury, cover the eye at all times with sunglasses, glasses, or a special eye shield while your eye is healing

Your provider will see you the next day to examine your eye. He or she will go over the instructions for the eyedrops that you will need to use.

It may take several weeks for your vision to become clear.

Ask your healthcare provider:

  • How long it will take to recover
  • What activities you should avoid
  • How to take care of yourself at home and when you can return to your normal activities
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

  • Severe, permanent vision loss caused by serious bleeding or infection
  • The lens implant shifts out of place
  • Glaucoma (damage to the optic nerve usually caused by high pressure inside the eye)
  • Retinal tear or detachment
  • Need for another surgery

Every procedure or treatment has risks. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site:

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