A Cataract Is Not A Tomato

Ophthalmologists are often asked if a cataract must be “ripe” before surgery is elected. This notion stems from the fact that patients used to wait for their cataracts to harden, or “ripen” before they could have surgery. In those days, as various proteins in the normally flexible eye lens clumped together, and as the lens got stiffer, it was easier to remove a fairly intact lens through a relatively large incision. The best results were attained by extracting a solid lens that did not fall apart as it was lifted out. Today, lens “ripeness” is irrelevant as modern surgical procedure entails breaking up and suctioning out the clouded lens utilizing the “phacoemulsification” technique that requires a minuscule incision. There is no objective test to determine the need for cataract surgery. Patients must decide for themselves on the basis of their vision loss.