Cataracts: How do day surgery and overnight hospital stays compare?

Patients who return straight home after cataract surgery generally have as good outcomes as those who stay overnight in hospital.

The lens in an eye gets cloudy and blurry in more than 1 out of every 10 people over the age of 40. This condition is called a cataract. The word cataract comes from the Greek word meaning “waterfall” because people used to believe that the blurring was caused by a fluid in the eye.

The clouding of the eye lens reduces the clarity of vision, and in particular it gets difficult to see small things properly. At first glasses can help. But when the lens gets too cloudy, an operation to remove it is the only way to get good sight back.

Cataract operations are one of the most common surgical procedures in countries like Germany. Usually the lens can be removed through a very small cut in the cornea of the eye. It will then be broken up and sucked out. This process is called phacoemulsification. The lens is then usually replaced by an artificial lens, but some patients use special glasses or contact lenses which take on the role of the lens.

Because this procedure can be done under local anesthetic, in Germany and similar countries people usually have the choice of a stay in hospital or having day surgery. After day surgery, the person can return home within a few hours of the operation.

To find out whether this early discharge increases the risk of poor outcomes after the surgery, researchers from the Cochrane Collaboration (an international network of researchers) systematically analyzed trials of day surgery for cataracts. They found two trials that included around 1,300 people. The smaller of the two trials was finished more than 20 years ago, so the researchers relied mostly on the results of the second trial. This was done in Spain in 2001, with about 950 participants. A new search by the Cochrane researchers in 2011 did not produce any new trials. Therefore, they did not reach any new conclusions, either.

The outcome: four months after the procedure people had the same clarity of vision whether they had day surgery or were admitted to hospital. Short-term complications were somewhat more common in the day surgery patients, but this had no impact on the ultimate success of the procedure. However, this assessment is based on the results of one study, so it is possible that outcomes might vary between clinics.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

Next planned update: August 2014. You can find out more about how our health information is updated here.

© IQWiG (Institute for Quality and Efficiency in Health Care)