Cataract Surgery in Toulon: Technique, Lens Implants and Recovery

Expert insight

“Cataract surgery restores clear, vivid vision and offers greater independence from glasses! Today it is true refractive surgery: the clouded lens is removed and replaced with an artificial lens chosen to measure, correcting myopia, hyperopia, astigmatism and presbyopia. It is often riskier to live with poor vision than to have surgery!”

Dr Hugo Bourdon

What is cataract surgery?

A cataract is the progressive clouding of the crystalline lens, the eye’s natural lens that focuses light. It causes a gradual decline in vision: blurred vision, dulled colours, glare, difficulty driving at night. Cataracts mainly affect people over 60, but can occur earlier with diabetes, eye trauma or prolonged corticosteroid treatment.

Cataract surgery — called phacoemulsification — consists of removing the clouded lens through a micro-incision and replacing it with a perfectly clear intraocular implant. This implant is essential: without it, the eye cannot focus. It is calculated to measure thanks to the ocular biometry performed during the consultation.

What are the surgical techniques?

Phacoemulsification — the modern gold standard

This is the technique used in the vast majority of cases:

• A micro-incision of about 2 mm is made at the edge of the cornea.
• An ultrasound probe is introduced to fragment and aspirate the clouded lens while protecting the surrounding structures.
• The implant, folded inside an injector, is inserted into the lens capsule where it unfolds automatically.
• The incision is self-sealing (hydrosuture): no stitches are needed.

Laser cataract surgery (femtosecond) — a debated addition

Contrary to popular belief, cataracts are not removed with a laser. The lens is always aspirated by ultrasound. However, a femtosecond laser can perform certain preliminary steps (incisions, opening the capsule, pre-fragmenting the lens). In practice, this option lengthens the procedure without significantly improving the visual outcome or recovery. Its value remains debated within the ophthalmology community.

Not to be confused with YAG laser capsulotomy, which treats secondary cataract and is not a surgical operation.

Extracapsular extraction (ECCE) — for very advanced cataracts

In rare cases of extremely dense cataract (“white” or “brown”) that cannot be fragmented by ultrasound, the surgeon may remove the lens in one piece through a larger incision. This older technique sometimes requires a suture and entails a slightly longer recovery.

What can cataract surgery correct?

Cataract surgery is not limited to removing a clouded lens: today it is true refractive surgery. The choice of implant makes it possible to correct, at the same time:

• The cataract — the clouded lens is replaced with a perfectly clear implant.
• Myopia and hyperopia — corrected by calculating the implant power (biometry).
• Astigmatism — corrected with a toric implant aligned along the axis of the astigmatism.
• Presbyopia — compensated with a multifocal or extended-depth-of-focus (EDOF) implant, giving sharp vision at several distances.
• Glaucoma — cataract surgery naturally lowers eye pressure by freeing space in the drainage angle. An additional step (placing a trabecular stent) can be carried out during the same operation.

In patients over 50 without a cataract but wishing to correct presbyopia and refractive errors, this is called PreLex (clear lens exchange for refractive purposes).

The intraocular implant: the heart of the operation

The intraocular implant is a lens made of biocompatible polymer — invisible, painless, perfectly tolerated and with an unlimited lifespan. It normally never needs to be replaced. Choosing the implant is the most important step of the operation, because it determines the final visual outcome and the degree of independence from glasses.

Your surgeon will recommend the implant best suited to your needs, your lifestyle and your ocular anatomy.

When should you have cataract surgery?

Surgery is recommended as soon as the cataract affects quality of life:

• Difficulty driving, especially at night (glare from headlights).
• Difficulty reading, working on a screen or performing precise tasks.
• Dulled colours, a sense of veiled or yellowish vision.
• Visual acuity below 5/10 — driving must legally be suspended until surgery.

There is no age limit for the operation. Because the implant has an unlimited lifespan, both a young 40-year-old patient and a centenarian can benefit. In older people, better vision reduces the risk of falls and improves independence.

What does the pre-operative assessment involve?

A full assessment is essential to confirm the indication and calculate the custom implant. It includes seven examinations:

1. Visual acuity measurement — confirms the vision loss caused by the cataract.
2. Slit-lamp examination — direct view of the lens clouding and assessment of its density.
3. Ocular biometry — measures eye length, corneal curvature and lens thickness. These measurements are essential to calculate the implant power.
4. Macular OCT — checks the central retina to rule out macular oedema, AMD or underlying glaucoma that could limit visual recovery.
5. Corneal topography (if a toric implant is considered) — precise mapping of the astigmatism to choose and align the implant.
6. Fundus examination — checks the retina, particularly in myopic and diabetic patients.
7. Anaesthesia consultation — assessment of general health and current treatments (anticoagulants, antidiabetics). The anaesthetist will specify which treatments to take or pause on the day of surgery.

What are the contraindications?

Very few situations contraindicate cataract surgery:

• Active eye infection or inflammation — surgery is postponed until it resolves.
• Severe systemic infection — any uncontrolled infection is an anaesthetic and infectious risk.
• Inability to lie still — the procedure requires a minimum of patient cooperation.
• Severely uncontrolled diabetes — increased risk of retinal complications. Surgery is possible once blood sugar is better controlled.

Anticoagulants are not a contraindication: the micro-incision and the absence of sutures allow surgery without stopping them in most cases.

How does cataract surgery proceed?

Before the operation

• The arrival time is given the day before by telephone.
• Arrive fasting (no food, drink or tobacco for 6 hours beforehand), without make-up.
• Bring your health insurance card, complementary insurance details and a means of payment.
• Preparation in the ophthalmology unit: sterile gown, cap, face wash, removal of hearing aids on the operated side.
• Dilating drops are instilled to widen the pupil.

The 10 steps of the operation

1. Positioning — lying on your back, head resting in a headrest. The anaesthetist gives sedation to relax you.
2. Local anaesthesia — anaesthetic drops numb the eye. No pain, no anxiety.
3. Sterile preparation — disinfection of the eye and face, placement of a sterile drape and a lid speculum to keep the eye open.
4. Micro-incision — an incision of about 2 mm is made at the edge of the cornea.
5. Capsulorhexis — controlled circular opening of the anterior lens capsule.
6. Phacoemulsification — the ultrasound probe fragments and aspirates the clouded lens. The central step of the operation.
7. Implant placement — the folded implant is injected into the remaining capsule, where it unfolds and positions itself automatically.
8. Intracameral antibiotic injection — an antibiotic is delivered directly into the eye to divide the infection risk by 10.
9. Closure — the incision seals itself by hydrosuture. No stitches.
10. Protection — a transparent shield is placed over the operated eye.

Total operating time: about 10 minutes. Allow 3 to 5 hours at the clinic (preparation and monitoring included).

What about the second eye?

If both eyes have a cataract, they are operated 1 to 2 weeks apart — exceptionally on the same day, as a safety measure. A check-up is carried out between the two eyes to verify the result of the first.

Aftercare and recovery

Post-operative treatment

• Antibiotic and anti-inflammatory eye drops for 1 month. Instil them at regular times and do not stop them early.
• Protective shield at night for 1 week — it protects the eye from rubbing during sleep. Wash it each morning with clear water and mild soap.
• Rinse with saline during the first week to remove any secretions.

Visual recovery

• Colours are brighter from the next day — often the first thing patients notice.
• Vision improves within 1 to 7 days on average. With a dense cataract, recovery may take a few extra days.
• Vision stabilises within 3 to 4 weeks — the time for the implant to settle definitively and the inflammation to subside.
• The eye may stay sensitive to light and itchy for 1 to 3 months. This is benign and temporary.

Returning to activities

Glasses after cataract surgery

• Glasses can be prescribed as early as 7 to 10 days after surgery, although most surgeons prefer to wait 3 to 4 weeks for a stabilised final correction.
• In the meantime, if near vision is uncomfortable, +2.5 or +3 reading glasses from the pharmacy can help.
• Post-operative glasses are reimbursed with no waiting period. If needed, ask for the mention “post-operative correction” on the prescription.
• Sunglasses: choose category 3 lenses with a UV filter. Some implants already include a UV filter.

What are the benefits?

• Clear, vivid vision — brighter colours, sharper contrast, the veil disappears.
• Greater independence from glasses — especially with multifocal or EDOF implants, allowing far and near vision without correction.
• Improved safety — less risk of falls (far vision restored) and better driving (less glare).
• A definitive result — the implant lasts a lifetime. There is no need to change it.
• Speed and comfort — 10 minutes, painless, recovery within a few days.

What are the possible complications?

The success rate of cataract surgery is above 95%. Patients’ main complaints are in fact benign and temporary after-effects — not complications.

Benign effects (common and temporary)

• Blood spot on the white of the eye (subconjunctival haemorrhage) — clears within 1 to 2 weeks.
• Temporary dry eye — treated with artificial tears.
• Night-time halos — more frequent with multifocal implants, they fade over time (neuroadaptation).
• Light sensitivity — the artificial lens lets in more light than the old, yellowed lens.

True complications (rare)

Cataract and glaucoma: a double benefit

In patients with both glaucoma and a cataract — a common situation in older patients — cataract surgery offers a double benefit: improved vision and lower eye pressure. Removing the bulky lens opens the drainage angle of the aqueous humour, naturally lowering the pressure. An additional step can be performed during the same operation: placing a trabecular stent (iStent-type MIGS) or filtering surgery, depending on the severity of the glaucoma.

Cost, reimbursement and coverage

• Cataract surgery is covered by French Social Security and complementary insurance. It treats a disease — it is not cosmetic surgery.
• Dr Bourdon’s fees: €273 (Social Security rate) + €250 fee supplement (covered in whole or part by complementary insurance).
• Premium implants (multifocal, EDOF, high-end toric) — an extra charge may apply for certain non-reimbursed implants, to be discussed at the pre-operative consultation.
• Post-operative consultations and glasses are reimbursed normally (no 2-year waiting period).

Frequently asked questions about cataract surgery

Sources and references

• QualiDoc — Cataract surgery
• National Eye Institute — Cataract Surgery
• NHS — Cataract Surgery
• EyeWiki — Cataract (American Academy of Ophthalmology)

Article written and reviewed by Dr Hugo Bourdon, ophthalmic surgeon at the Clinique Saint-Michel ELSAN and the Centre Iris – Institut Toulonnais d’Ophtalmologie (281 rue Jean Jaurès, Toulon). Last updated: 20 May 2026.