What are the risks of not having intraocular lens implantation during cataract surgery?

This is a persistent question that comes up from patients that demonstrates how powerful language can be in creating misunderstanding.

"Cataract," being a noun, is understood as a "thing" that somehow got into the eye and is now disturbing one's vision. So surgically removing that thing should restore your eyesight to the way it used to be before -just like removing a tumor or a growth of some kind, right?


The word "cataract" historically meant "turbulent opacity." In fact, we still say "the cataracts of the Nile" where the normally clear River water turns opaquely white in those areas of turbulence as it flows over rocks and through rapids. In fact, that is what the white pupil of the blind, cataractous eye looked like to pre-modern physicians: some sort of turbulence that opacified the normally clear fluids of the eye.

Today, we call that a "fully mature" cataract. Over the past 30+ years the meaning of the word "cataract" has come to mean "the age-related deterioration of the lens of the eye to the point where glasses are no longer able to compensate satisfactorily." The area of the pupil may not look much different at all!

If your ophthalmologist "just removes the cataract," not replacing that deteriorated lens, (s)he will leave the patient needing a spectacle lens 5-10x thicker than the strongest drugstore reading glasses available to see ANYTHING except blobs of color or vague ares of light and dark.

So nowadays, anywhere in the world, a cataract operation includes an artificial lens implant to compensate for having removed that deteriorated, cloudy, or aged lens.

J. Trevor Woodhams, MD - Chief of Surgery, Woodhams Eye Clinic