Cataract surgery — regain clear vision
A cataract is the gradual clouding of the crystalline lens, the eye's natural lens. It is an expected change after age 60 that blurs vision, alters color perception and makes night driving difficult. Cataract surgery is one of the most frequently performed operations in the world, with around 20 to 28 million eyes operated on every year. Beyond removing the clouded lens, I use this procedure to tailor the correction of your presbyopia, astigmatism or myopia — this is known as refractive lens surgery.
What is a cataract?
The crystalline lens is the small natural lens, normally transparent, located behind the iris. With age, its protein fibers deteriorate: the lens gradually becomes cloudy and stiff. This is a cataract.
Mechanism & symptoms
A cataract is the gradual clouding of the crystalline lens. This natural lens, normally transparent, slowly loses its clarity. Light passes through it less easily and is scattered by the cloudy areas, so the image reaching the retina becomes blurred.
The first signs often appear insidiously:
- Hazy, blurred vision — like looking through frosted glass
- Dull colors, yellowish and less contrasted
- Glare from headlights at night or from bright sunlight during the day
- Double vision in one eye (covering the other eye does not make it go away)
- Frequent prescription changes — you need new glasses more often
- Difficulty in dim light — reading, night driving
Why does it develop?
In the vast majority of cases, cataract is related to the natural aging of the lens (age-related or senile cataract). It usually begins after age 60 and affects almost everyone beyond 75. Other factors can speed it up or trigger it:
- Diabetes and metabolic disorders
- A past eye injury (traumatic cataract)
- Long-term corticosteroids (oral, inhaled or eye drops)
- High myopia — earlier-onset cataract
- Smoking, prolonged UV exposure without protection
- Previous intraocular surgery (particularly vitrectomy)
- More rarely: congenital or hereditary cataract
Good to know: no medical treatment (eye drops, vitamins, glasses) can reverse a cataract. The only effective treatment is surgery. But it is never an emergency: you decide when, based on how much it affects your daily life.
When should you have surgery?
There is no fixed threshold and no required stage of "ripeness". It is the impact on your daily life that determines the need for surgery, decided together with your surgeon. After 45, reduced vision is sometimes due to presbyopia rather than cataract: my article "Cataract or presbyopia: what's the difference?" will help you see things more clearly.
- You have trouble reading road signs
- Night driving becomes uncomfortable, or even dangerous
- You are dazzled by headlights or a low sun
- Reading becomes tiring even with suitable glasses
- Your visual acuity keeps dropping despite a new prescription
- Your hobbies (golf, gardening, TV, screens) become difficult
- An advanced cataract is found during a routine eye exam
- You would like to take the opportunity to stop wearing glasses
- Associated retinal disease (AMD, epiretinal membrane) — the benefit must be weighed
- Severe dry eye disease — to be treated beforehand to optimize healing
- Associated corneal endothelial disease (a corneal transplant may be discussed)
- Certain special cases — general anesthesia or deeper sedation is possible
None of these situations is an absolute contraindication to surgery: they simply require appropriate preparation and follow-up.
Phacoemulsification + Intraocular Lenses
I perform cataract surgery by phacoemulsification, the standard technique in developed countries for some thirty years. Everything is done through a self-sealing 2.2 mm micro-incision that requires no stitches.
I start by opening a small window in the front capsule of the lens (capsulorhexis), then break up the clouded lens with ultrasound and aspirate it within a few minutes. I preserve the empty capsular bag, which will hold your new lens. The foldable intraocular lens (IOL) is then slipped into the bag, where it unfolds naturally and stays in place for life.
A standardized, reproducible operation. In France, around 800,000 cataract operations are performed every year, with an anatomical success rate above 99% reported in the major international registries (ESCRS, IRIS Registry). The 2.2 mm micro-incision heals on its own, without stitches, and the implanted lens stays in place for life.
Refractive lens surgery
Today, I take advantage of every cataract operation to correct your vision problems at the same time — myopia, hyperopia, astigmatism, presbyopia. The goal is independence from glasses in everyday life.
A unique opportunity
Since I am replacing your natural lens with an artificial one, we might as well choose one that also corrects your vision problems. This is called refractive lens surgery (or PRELEX — Presbyopia Refractive Lens Exchange — when it is performed on a lens that is still clear, without cataract).
The lens power calculation relies on high-precision optical biometry (Anterion), which measures the length of your eye, the curvature of your cornea and the depth of your anterior chamber. These data feed modern calculation formulas (Barrett, Pearl DGS, Kane) that allow me to reach the refractive target within ±0.5 diopter in about 80 to 90% of cases, according to recent studies.
Setting your refractive goal
Before surgery, we define together the visual goal that suits you best:
- Distance vision without glasses + reading glasses (the simplest option)
- Distance and intermediate vision without glasses (EDOF lens)
- Vision at all distances without glasses (trifocal lens)
- Mini-monovision — the dominant eye set for distance, the other slightly offset for near
- Simultaneous correction of corneal astigmatism ≥ 0.75 D (toric lens)
Your lifestyle (work, night driving, sports, reading, screens) guides this choice far more than your age or your raw visual acuity.
Three lens families to suit your life
There are three main families of intraocular lenses: monofocal (sharp distance vision, glasses for reading), EDOF (distance and intermediate vision, few halos) and multifocal or trifocal (vision at several distances, more noticeable halos at night). Each family is available in a toric version to correct corneal astigmatism. The right choice is the one that matches your lifestyle, your eye anatomy and your expectations — it is decided at the pre-operative assessment.
The 3 lens types at a glance
A comparison table setting out the main features side by side. The final decision is made at your personalized assessment, which takes your anatomy and lifestyle into account.
| Monofocal | EDOF | Multifocal / Trifocal | |
|---|---|---|---|
| Distance vision | ★★★★★ | ★★★★★ | ★★★★☆ |
| Intermediate vision (screens) | ★★☆☆☆ | ★★★★★ | ★★★★☆ |
| Near vision (reading) | ★☆☆☆☆ | ★★★☆☆ | ★★★★★ |
| Halos / glare | Very rare | Mild | Moderate |
| Independence from glasses | Distance only | Distance + intermediate | All distances |
| Astigmatism correction (toric version) | Yes | Yes | Yes |
| Night driving | Optimal | Comfortable | Needs to be anticipated |
| Retinal disease | Recommended | Possible | Contraindicated |
| Reimbursed by French national health insurance | Yes | Sometimes | No |
Advantages and points to consider
- Clear vision from the next day — very fast recovery
- A painless procedure under eye-drop anesthesia and light sedation
- Self-sealing 2.2 mm micro-incision, no stitches
- Outpatient surgery — you go home the same day
- Astigmatism and presbyopia can be corrected at the same time
- A permanent procedure for the lens (the capsule holding the implant may become cloudy in 20–30% of cases, simply treated with a YAG laser)
- A standardized technique backed by more than 30 years of clinical experience
- The two eyes are operated 1–2 weeks apart (rarely on the same day)
- Secondary cataract possible in 20–30% of cases — simple YAG laser treatment in the office
- Possible halos at night, especially with multifocal lenses
- Premium multifocal/trifocal and toric lenses: extra cost not covered by French national health insurance; some EDOF lenses may be covered, depending on the model
- Reading glasses sometimes useful, depending on the type of lens chosen
- Pre-operative anesthesia consultation required
- Gradual return to physical exertion and swimming
What happens after surgery?
Here is what the first days and weeks look like. Every patient recovers at their own pace — these milestones are averages observed in practice.
The day of surgery
Mild stinging, a foreign-body sensation and watering are normal for a few hours. Vision is still blurry and hazy. Rest and avoid screens. The protective eye shield is worn at night. First instillation of the prescribed eye drops.
Vision improves
Vision is generally improved, sometimes as early as day 1, as the post-operative corneal swelling clears. You can resume walking outdoors and gentle activities.
Back to work and screens
Most patients return to office work from day 3 to day 5. Regular breaks help offset temporary dryness. Avoid rubbing your eyes and wear sunglasses outdoors.
First check-up & second eye surgery
Eye check-up: vision is stabilizing. If all is well, I operate on the second eye 1 to 2 weeks after the first. You can resume brisk walking, cycling and social activities.
Stabilization check-up
Refraction is stable. If needed, I prescribe your final glasses (often for reading only, depending on the type of lens). You can resume swimming, contact sports and long car journeys.
Final result & neuroadaptation
With a multifocal lens, neuroadaptation is complete: your brain "learns" to automatically select the right image for each distance. Night halos decrease markedly. You can fully enjoy your new vision.
Do you think you have a cataract?
A comprehensive assessment allows me to evaluate how advanced your cataract is, rule out associated eye conditions and define with you the refractive goal that suits you.
What if your vision becomes hazy again?
"Secondary" cataract
In 20 to 30% of cases, a few months to several years after surgery, the posterior capsule (which supports the lens implant and was preserved during surgery) can in turn become cloudy. You then feel as if the cataract is coming back — but it is not. It is the capsule, not the lens (which was fully removed), that has become opaque.
The treatment is extremely simple: a YAG laser capsulotomy, performed in the office in a few minutes, completely painless and with no incision. Vision is restored immediately. No recurrence is possible after this procedure.
How to recognize it?
- Gradual decline in vision after a period of stable post-operative vision
- A feeling of wearing "dirty glasses" that you can no longer clean
- Glare and night halos that reappear
- Dull colors, as before the operation
Good news: this is not a failure of your initial surgery; it is a predictable and easily treatable change. Learn more about YAG capsulotomy →
From your first consultation to your new vision
Pre-operative assessment
Comprehensive evaluation: visual acuity, slit-lamp examination, fundus examination, macular OCT, optical biometry and corneal topography (Anterion). In-depth discussion of your visual habits and lifestyle. Shared decision on the type of lens. A detailed quote is provided.
Anesthesia consultation
Mandatory visit at least 48 hours before surgery. Pre-anesthetic evaluation, blood tests if needed, management of anticoagulants. Explanation of the topical anesthesia and light sedation you will receive on the day.
The day of surgery
Admission to the outpatient surgical unit around midday, having fasted. Eye-drop anesthesia + sedation. A 10-minute procedure. Rest in the recovery room. Home by mid-afternoon, accompanied. Prescription for eye drops and the protective eye shield.
Follow-up & second eye
Mandatory check-ups at 1 week and 1 month. The second eye is operated 1 to 2 weeks after the first. Final glasses are prescribed at 1 month, once refraction has stabilized. I remain reachable by phone between appointments.
Fees and insurance coverage
Cataract surgery is a procedure reimbursed by French national health insurance (Assurance Maladie). For information, additional fees apply: €500 per eye with a monofocal or toric lens, or €1,000 per eye with a premium lens (multifocal or EDOF, for independence from glasses). Some complementary health insurance plans (mutuelles) cover all or part of these fees depending on your contract, and a detailed quote is always provided before any decision. Payment in installments may be offered — ask about it during your consultation.
FAQ — Cataract surgery
Your cataract assessment starts here
I will see you in consultation to assess your lens, plan ahead for surgery and choose with you the lens implant that best fits your life. No commitment to surgery after the assessment — just the right information to decide at your own pace.