Key facts
- Cataract surgery replaces the clouded natural lens with a permanent implant: 10–20 minutes per eye, under anaesthetic eye drops, painless.
- The two eyes are operated 1–2 weeks apart; driving is generally possible from the second day with your surgeon’s approval.
- The choice of implant is the key decision: monofocal (reading glasses needed), trifocal (> 90 % spectacle independence), EDOF or toric.
- “Secondary cataract” (capsule opacification, 10–30 % of cases) is treated in 2 minutes with a YAG laser during a clinic visit.
Understanding cataracts
The crystalline lens is the eye’s transparent internal lens, sitting just behind the iris. With age its proteins progressively aggregate and oxidise, causing irreversible clouding: this is a cataract. It affects more than 20 % of people over 65 and more than 60 % over 85, and is the world’s leading cause of reversible blindness. In France more than 800,000 cataract operations are performed every year — it is the most frequently performed surgical procedure of all.
The three types of cataract
Nuclear cataract
The most common form. Clouding starts in the core of the lens and spreads outwards, causing progressive yellowing then browning of vision, sometimes with a transient myopic shift (“second sight” — reading suddenly improves before worsening again).
Cortical cataract
Spoke-like opacities develop in the periphery of the lens and progress slowly towards the centre. Mainly causes glare and discomfort in bright light.
Posterior subcapsular
Forms just under the back capsule of the lens. Impairs reading vision quickly with marked glare. More frequent in younger patients, diabetics and after prolonged corticosteroid treatment.
Risk factors
Non-modifiable
- Age — the main factor, risk rising from 50
- Family predisposition
- High myopia (beyond −6 dioptres)
- Previous intraocular surgery (vitrectomy) or eye trauma
Modifiable
- UV exposure — sunglasses recommended
- Smoking — multiplies the risk by 2 to 3
- Diabetes — earlier and faster cataracts
- Prolonged corticosteroid treatment, chronic alcohol use
How symptoms progress
A cataract usually evolves over several years. Early on: slight distance blur, a faint veil in dim light, more glare from headlights at night, halos around lights, more light needed for reading. At a moderate stage: clearly reduced acuity, yellowed colours, monocular double vision, spectacle changes that no longer help. At an advanced stage: permanently “milky” vision at all distances, difficulty recognising faces, driving no longer possible.
When should you have surgery?
- Difficulty driving, especially at night
- Trouble reading or working on screens
- Impact on independence and quality of life
- Corrected visual acuity below 5/10
- Medical indication: the retina can no longer be examined through the clouded lens (diabetes or AMD monitoring)
There is no need to wait for the cataract to “ripen” — earlier surgery means faster recovery and a technically simpler procedure.
Choosing your intraocular lens (IOL)
The clouded lens is replaced by a permanent intraocular implant. This prosthesis stays in your eye for life: its choice is the most important decision of the pre-operative work-up, made with your surgeon after biometry measurements. Four main families exist:
Monofocal
e.g. Alcon Clareon, J&J DCB00, Zeiss CT Lucia
One focal point, usually set for distance. Excellent optical quality at that distance, no halos, no loss of contrast — and fully reimbursed by French social security. Reading glasses required.
Ideal for: patients prioritising pure optical quality, professional drivers, patients with associated retinal disease.
Toric
e.g. Alcon Clareon Toric, Zeiss AT TORBI
Corrects pre-existing corneal astigmatism (from 0.75 dioptre of cylinder) in addition to distance vision. Requires precise alignment on the astigmatism axis during surgery. Reading glasses still needed.
Ideal for: astigmatic patients who want sharp uncorrected distance vision.
EDOF (extended depth of focus)
e.g. J&J PureSee, Alcon Vivity (and toric versions)
An extended focal zone gives sharp vision from distance to intermediate (60–80 cm: computer screen, dashboard) with very few halos — much better night-vision tolerance than multifocals. Small print may still need light reading glasses.
Ideal for: active screen users who want minimal night-time light phenomena.
Trifocal (multifocal)
e.g. Alcon PanOptix, J&J Odyssey, B+L enVista Envy
Diffractive rings create three focal points — distance, intermediate and near — giving full spectacle independence in more than 90 % of patients, including comfortable reading. Possible halos at night during the first months (neuroadaptation), slight contrast loss.
Ideal for: patients highly motivated to live without glasses, with a healthy retina and little residual astigmatism.
What your vision could look like
Photo-realistic simulations of everyday situations with each implant family — faithful to what operated patients actually report:
These simulations are an educational guide, not a guarantee: the real result depends on your cornea, pupil size, retinal health and neuroadaptation. The right implant is not the newest or the most expensive — it is the one whose optics match your biometry, your ocular health and your visual priorities. This decision is made together during your consultation.
The operation, step by step
Cataract surgery is a day-case procedure (in and out the same day), performed in a partner surgical centre in Paris by your IPO surgeon. The operation itself takes 10 to 20 minutes per eye.
The day before
- Antibiotic drops as prescribed
- Shower and hair wash with antiseptic soap
- No make-up, cream or perfume on the face
- Light dinner; fast for 6 hours before the scheduled time
- Continue your usual medications unless told otherwise
On the day
- Arrive 1 hour before the scheduled time
- Pupil dilated with drops (30–45 min)
- Comfortable clothes that open at the front
- Someone must accompany you home — driving is not allowed that day
Topical anaesthesia
Simple anaesthetic drops numb the eye completely. You stay awake and perceive only lights; light intravenous sedation can be added for comfort. No injection, no general anaesthesia in the vast majority of cases.
Micro-incision
A 2.2 mm self-sealing incision is made at the edge of the cornea. A viscoelastic gel protects the inner structures of the eye.
Capsulorhexis & phacoemulsification
The front of the lens capsule is opened in a perfect circle, then an ultrasound probe fragments and aspirates the clouded lens while preserving the capsular bag.
Implant insertion
The foldable implant is injected through the micro-incision and unfolds inside the capsular bag, centring itself automatically. Toric implants are aligned precisely on the astigmatism axis.
No stitches
The incision is hydrated to self-seal — no sutures. A transparent protective shell is placed over the eye and you go home the same day (someone must accompany you).
Recovery and follow-up
- Day 1: mandatory check-up at IPO; the protective shell is removed. Vision is already improved but still slightly blurry. Antibiotic and anti-inflammatory drops for 1–4 weeks.
- Days 2–7: vision sharpens rapidly. Driving is generally possible from the second day with your surgeon’s approval. Avoid rubbing the eye, swimming pools and dusty environments.
- Weeks 1–2: the second eye is usually operated. Normal activities resume progressively.
- Month 1: final refraction check; new glasses prescribed if needed (often only for reading, depending on the implant chosen).
Secondary cataract (posterior capsule opacification)
In 10–30 % of patients the capsule supporting the implant becomes cloudy months or years after surgery, blurring vision again. This is not a return of the cataract and is treated definitively in about 2 minutes with a YAG laser, painlessly, during an ordinary clinic visit at IPO.
Fees for international patients
For patients covered by French social security, standard cataract surgery is reimbursed; premium implants (toric, EDOF, trifocal) involve a supplement of roughly 300–800 € per eye, often partly covered by complementary insurance. International patients receive a detailed personal quote before surgery and an itemised invoice for their private insurer. See the patient information page for consultation fees and insurance paperwork.
Frequently asked questions
Is cataract surgery painful?
No. The operation is performed under anaesthetic eye drops and is painless. You may feel light touch or water on the eye. Mild scratchiness for a few hours afterwards is normal.
Are both eyes operated on the same day?
Usually not: the two eyes are operated 1 to 2 weeks apart, which allows the first eye's result to fine-tune the plan for the second.
How soon can I fly after cataract surgery?
Air travel is generally possible within a few days of uncomplicated cataract surgery — useful to know if you are visiting Paris. Discuss your travel dates with your surgeon so the post-operative check-ups can be scheduled before you leave.
Which implant should I choose?
It depends on your biometry, your ocular health and your priorities (driving at night, screen work, reading without glasses). Your surgeon will recommend the best option after the pre-operative measurements — the newest or most expensive implant is not automatically the right one for your eye.
Will I be awake during the operation? Is general anaesthesia possible?
You stay awake but the eye is completely numb — you perceive only lights and colours, not the instruments. Light intravenous sedation is often added so you feel relaxed. General anaesthesia is reserved for exceptional situations (severe anxiety, tremor, inability to lie still) and can be discussed with the anaesthetist.
Does the implant last for life? Can the cataract come back?
Yes — the implant is permanent and never wears out. A cataract cannot come back, but in 10–30 % of patients the capsule behind the implant becomes cloudy months or years later (“secondary cataract”). This is treated once and definitively with a 2-minute YAG laser procedure at the clinic.
Book a cataract consultation
Our surgeons will assess your cataract, measure your eye and help you choose the right implant — in English.