Eye surgery
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Cataract surgery in Paris and Cachan
A cataract is the progressive clouding of the natural lens, the leading operable cause of declining vision after 60 and one of the most refined procedures in ophthalmology. Diagnosis, symptoms, choice of implant and patient journey: everything you need to know.
What is a cataract? Anatomy and mechanism
The natural lens is a transparent biological lens located behind the iris that focuses light onto the retina. With age, the proteins that make it up gradually lose their transparency: the lens turns yellow, then brown, sometimes opaque. This is what we call a cataract. This clouding filters and scatters light, vision becomes blurred, colours darken, contrast fades.
A cataract is not painful and develops over several months to several years. It is bilateral in the vast majority of cases, often asymmetrical (one eye precedes the other by a few months to a few years). The only effective treatment is surgical: removing the clouded lens and replacing it with a transparent intraocular implant.
Key point
A cataract is a natural clouding of the lens, age-related in the vast majority of cases (more than 8 times out of 10). Its only effective treatment is surgical, but surgery is only warranted once the visual impairment becomes a genuine problem in your daily life.
Symptoms that should raise concern
The suggestive signs are progressive. They often appear insidiously and are sometimes wrongly put down to a simple need for a change of glasses:
- Blurred vision, a sense of “fog” or a permanent veil, without pain.
- Significant difficulty driving at night: halos around headlights, prolonged glare from low-angle lights.
- Reduced contrast: less distinct outlines, difficulty reading street names, washed-out colours (particularly blues and violets).
- Frequent changes in optical correction over a few months, with no lasting visual benefit.
- Need for stronger lighting to read, sew or cook.
- Monocular double vision (a single eye sees double, even with glasses removed), rarer but telling.
For a full overview of the symptoms, when to seek advice and the self-assessment to carry out before your appointment, see the dedicated page Cataract symptoms: when to seek advice.
When to seek advice
Difficulty driving at night, marked halos around headlights, new difficulty reading or a concrete impact on your daily activities are all legitimate reasons for a consultation, even without a scheduled follow-up appointment.
Causes and risk factors
- Age: the leading factor, generally from 55 to 60 onwards. Prevalence rises sharply after 70.
- Diabetes: promotes earlier and sometimes more progressive cataracts. Rigorous HbA1c monitoring remains a useful preventive measure. The specific features of diabetic cataract warrant tailored management.
- Cumulative sun exposure without UV protection: particularly in high mountains, at sea and in outdoor occupations.
- Ocular trauma: a direct blow can cause a cataract long after the event, sometimes years later.
- Long-term corticosteroids: whether systemic, oral, inhaled or topical to the eye.
- Chronic tobacco and alcohol use: recognised aggravating factors.
- Heredity: a family background in certain early or congenital forms.
- High myopia: associated with an earlier cataract, particularly in a lens already strained by axial length.
DIAGNOSIS
Diagnosis: examinations at the practice
A cataract is diagnosed during the consultation, through a slit-lamp examination after pupil dilation. It is confirmed and quantified by a complementary work-up designed to prepare for surgery: measurement of corrected visual acuity, optical biometry (Zeiss IOLMaster 700 at the practice) to calculate the power of the future implant, corneal topography to detect astigmatism, macular OCT to check the integrity of the central retina. The state of the corneal endothelium is also checked, since an early Fuchs’ dystrophy may lead to adapting the technique or considering a combined procedure: the surgical indications in this situation were the subject of a literature review co-authored by Dr Tourabaly (J Clin Med, 2025).
The details of the examinations, how they are carried out and the information they provide are covered on the page Cataract pre-operative assessment.
The different types of cataract
- Nuclear cataract: the most common, clouding of the lens nucleus. Slow progression, often responsible for a gradual myopic shift (paradoxically, one sees better up close without glasses).
- Cortical cataract: spoke-like opacities in the peripheral cortex. More marked difficulty with glare and halos.
- Posterior subcapsular cataract: clouding just behind the posterior capsule. Often rapid progression, with particular difficulty reading and in bright light. Common under corticosteroid therapy or in people with diabetes.
- Congenital cataract: present at birth or appearing in childhood. Prompt specialised management.
- Traumatic cataract: following an ocular injury.
To be distinguished from secondary cataract: a clouding of the posterior capsule that can appear several months to several years after a successful operation. It is simply treated with the YAG laser. See the dedicated page Secondary cataract: YAG laser.
PREMIUM IMPLANTS
Choosing your implant: an overview of the 4 families
The intraocular implant permanently replaces the removed lens. The choice of its power and its type determines long-term visual comfort. To picture what each implant family prioritises — distance, screen, reading — try our cataract implant vision simulator. Four broad families, according to your lifestyle, your astigmatism and your budget:
- Monofocal implant: the reference option reimbursed by French social security. Corrects vision at a single distance (usually distance vision), with glasses needed for reading.
- Toric implant: additionally corrects pre-existing corneal astigmatism. See the toric implant page.
- EDOF implant (extended depth of focus): covers distance vision and part of intermediate vision, with very few night-time halos. See the EDOF implant page.
- Multifocal (trifocal) implant: aiming for independence from glasses at all distances, suited to certain profiles. See the multifocal implant page.
Each family has its own indications, limitations and cost. The choice is made during the consultation after analysis of your expectations and your assessment. For a detailed discussion of implant choice according to age and lifestyle, see also Cataract after 60 and multifocal implant and Cataract with astigmatism.
Cataract — Comparator
Which implant after cataract surgery?
During cataract surgery, the clouded lens is replaced with an artificial implant. There are several families of them, depending on the distances you want to see sharply without glasses. Compare them.
| Criterion | Monofocal1 distanceisolated · click to close | Monofocal +distance + intermediateisolated · click to close | EDOFextended depthisolated · click to close | Multifocalall distancesisolated · click to close | Toriccorrects astigmatismisolated · click to close |
|---|---|---|---|---|---|
| Sharp vision | Sharp at a single distance (often distance vision). | Distance + intermediate (computer, dashboard). | Continuous sharp range distance → intermediate. | All distances: far, intermediate, near. | Additionally corrects astigmatism (combines with the other types). |
| Optics | A single focal point. | Focal point stretched towards intermediate. | Extends the sharp zone, without marked halos. | Several focal points (concentric rings). | A surface that compensates for astigmatism, with axis markers. |
| Independence from glasses | Glasses for near vision. | Glasses for near vision (sometimes). | Back-up glasses for fine near work. | Rarely needed. | Depends on the associated type. |
| Night-time halos | Very few. | Few. | Few. | Possible (rings of light at night). | Depends on the associated type. |
| For whom | Prioritises distance quality, accepts reading glasses. | Wants a little more autonomy (screen). | Wants smooth distance + intermediate, sensitive to halos. | Wants to do without glasses as much as possible. | Has astigmatism to correct. |
| Quality of life | Distance vision very clean; reading glasses accepted. | A little more autonomy (screen), without halos. | Smooth distance → intermediate, few halos: a good compromise. | Great freedom from glasses, at the cost of possible halos and an adjustment period. | Improves sharpness by correcting astigmatism. |
| Price / coverage | Covered (cataract); no surcharge. | Slight surcharge depending on the model. | Surcharge (out-of-pocket); base reimbursed if cataract. | Highest surcharge; base reimbursed if cataract. | Surcharge for astigmatism (added to the chosen type). |
| Recommended if… | you prioritise the best distance quality and accept reading glasses. | you want to see the screen without glasses, and near vision with them. | you want distance + intermediate without bothersome halos. | you are aiming for maximum independence from glasses. | you have astigmatism to correct (to be combined with the chosen type). |
Tip: hover over a row to follow it, click a column header to isolate it, or choose what matters most to you.
The choice of implant is discussed according to your lifestyle (reading, screens, night driving), your astigmatism and the state of your retina. An “all distances” implant is not suited to every eye: the assessment decides.
Educational diagram — Dr Moïse Tourabaly, ophthalmologist. For information purposes, does not replace medical advice: only the assessment determines the technique suited to your eye.
Cataract surgery in 4 steps
The clouded lens is removed through a micro-incision, then replaced with a soft implant inside the original capsule.
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1
Capsulorhexis
Through a 2.2 mm micro-incision, a circular opening is created in the capsule — the transparent envelope of the lens.
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2
Phacoemulsification
An ultrasound probe fragments the clouded lens (the cataract) into fine particles.
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3
Aspiration
The fragments are aspirated; the transparent capsular bag is carefully left in place.
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4
Implant placement
A soft, folded implant is injected into the bag, where it unfolds to replace the removed lens.
HOW THE PROCEDURE UNFOLDS
How does cataract surgery take place?
Cataract surgery is a phacoemulsification: the lens is fragmented by ultrasound then aspirated through a 2.2 mm micro-incision, and replaced with a soft, folded implant introduced into the original capsule. The procedure is carried out on an outpatient basis, under local anaesthesia with light sedation for your comfort, lasts around 15 to 30 minutes and allows you to return home the same day.
I perform all my cataract surgeries at Clinique Sainte-Geneviève (Paris 14). The complete journey: why this clinic, an hour-by-hour account, administrative file, anaesthesia consultation, aftermath, recovery, risks: is detailed on the dedicated page Cataract surgery at Clinique Sainte-Geneviève.
Depending on where you live, two pages detail access and the care pathway: cataract in Paris 13 (south-east Paris area) and cataract in Cachan (Val-de-Marne). The diagnostic consultation and biometry are carried out at the Cachan practice; the surgery takes place at Clinique Sainte-Geneviève (Paris 14).
Key figure
Cataract surgery is today one of the most refined procedures in ophthalmology, with more than 800,000 operations performed each year in France and a documented visual success rate above 95%.
How much does cataract surgery cost?
Cataract surgery is recognised as a medical procedure: the operation and the standard monofocal implant are fully covered by French social security and compliant complementary health insurance. The surgeon’s fees are set according to your contractual sector and your insurance.
A possible surcharge is left to your account only if you choose a premium implant (toric, EDOF, multifocal), whose additional cost is not covered by the state health insurance. This out-of-pocket amount is known in advance: a detailed quote is provided by my assistant before any decision. All the precise figures (social security rates, any fee supplements, the specific cost of each premium implant, complementary insurance reimbursement bases) are gathered on the page Cataract pricing.
Administrative coverage and supporting documents
Because cataract surgery is a medically necessary procedure (and not elective comfort surgery like LASIK), it entitles you to full administrative coverage:
- Sick leave: I can issue you a certificate of sick leave for the recovery period, tailored to your occupation. The typical duration is a few days to a week depending on the nature of your job (shorter for sedentary work, longer in the case of physical activity or exposure to dust).
- Transport voucher: for the day of surgery only, covering the round trip between your home and Clinique Sainte-Geneviève on the day of the procedure. The post-operative consultations (D+2, D+7, M+1) and the prior anaesthesia consultation, which is held at the clinic, are made by your own means.
- Surgical file: my assistant prepares all the necessary documents: quote (financial transparency on any premium implants), information sheet from the French Society of Ophthalmology (SFO: standard informed-consent document), pre-operative prescription (dilating eye drops to be instilled before the procedure), and post-operative prescription (antibiotic, anti-inflammatory, artificial tears if you experience dryness).
What is recovery like after cataract surgery?
Visual recovery is generally rapid. Sharp vision sets in within a few days, while complete recovery and refractive stabilisation occur at 4 to 6 weeks. The post-operative eye drops are to be continued for around a month. Driving is permitted as soon as your vision is comfortable (often within 48 to 72 hours), and office work most often from the next day. The long-term refractive results after cataract surgery were the subject of a study co-authored by Dr Tourabaly (Cornea, 2021).
The full details of the aftermath (things to do, things to avoid, warning signs to watch for, the schedule of follow-up consultations) are covered on the dedicated page Cataract post-operative course.
THE FIGURES
What are the risks of cataract surgery?
Cataract surgery is one of the most closely measured procedures in medicine: European and American registries track several million operations. No surgery is without risk, however, and giving you orders of magnitude is part of the information you are entitled to before you consent. The figures below come from large published cohorts; your own risk is assessed during consultation, based on your eye and your medical history.
| Complication | Observed frequency | Reference cohort |
|---|---|---|
| Posterior capsule rupture (during surgery) | 1.1% — roughly 1 case in 90 | European EUREQUO registry, 2,853,376 procedures (Segers, 2022). UK national registry: 1.01% across 961,208 procedures (Sim, 2024) |
| Retinal detachment at 1 year | 0.21% — roughly 1 case in 475 | IRIS Registry, 3,177,195 operated eyes (Morano, 2023) |
| Retinal detachment at 4 years (French data) | 0.99% — roughly 1 case in 100 | French national cohort, 2,680,167 eyes (Daien, 2015) |
| Endophthalmitis (infection inside the eye) | 0.04% — roughly 1 case in 2,500 | IRIS Registry, 8,542,838 eyes (Pershing, 2020) |
| Secondary cataract treated with YAG laser at 5 years | 5.8% to 19.3% depending on the monofocal lens model | Real-world study, 20,763 eyes (Ursell, 2020) |
These averages cover very different situations. The risk of capsule rupture rises in cases of pseudoexfoliation, a white or very dense cataract, diabetic retinopathy, high myopia or previous vitrectomy. For retinal detachment, the two weightiest factors are high myopia — a 6.1-fold higher risk in the French cohort — and younger age: between 40 and 54, the risk is multiplied by 5.2 compared with patients over 75. Endophthalmitis, finally, is more frequent when the cataract is operated on at the same time as another ophthalmic procedure (0.20%) than when it is operated on alone (0.04%; Pershing, 2020). This is precisely why the indication and the timing are discussed eye by eye, rather than according to an average.
After surgery: the signs that mean you should call straight away
Complications are rare, but the earlier they are seen, the better they can be dealt with. Contact the practice reception or an emergency eye service if, in the days or weeks following your procedure, you notice:
- intense pain that paracetamol does not relieve;
- a sudden drop in vision in the operated eye;
- a very red eye with discharge;
- the appearance of a dark veil, flashes of light or a shower of floaters;
- sensitivity to light that worsens instead of easing.
The most reliable guide fits into a single sentence: discomfort that worsens after having started to improve should prompt a call, without waiting for your next appointment. Normal recovery and day-by-day advice are set out in detail on the recovering from cataract surgery page.
FAIR INFORMATION
Special cases
Cataract and diabetes
A cataract appears earlier in people with diabetes and may progress more rapidly. A rigorous prior retinal work-up is essential to detect any associated diabetic retinopathy. Optimised glycaemic control, objectified by HbA1c, improves the post-operative course. Detailed specifics on Cataract and diabetes.
Cataract and astigmatism
Pre-existing corneal astigmatism can be corrected during the same operation thanks to a toric implant, which avoids the persistence of residual astigmatism after the procedure. See also Astigmatism and cataract.
Cataract after 60 and the wish for independence from glasses
Cataract surgery is an opportune moment to discuss a premium implant (multifocal or EDOF) that can significantly reduce your dependence on glasses at all distances. See Cataract after 60 and multifocal implant.
Can a cataract be prevented?
An age-related cataract is ultimately inevitable. A few preventive measures can nonetheless delay its onset or slow its progression:
- Suitable sun protection: sunglasses with a certified UV filter, worn as a matter of course at sea, in the mountains and during prolonged driving.
- Rigorous control of diabetes if you have it: an individualised HbA1c target with your GP.
- Stopping smoking and limiting alcohol consumption.
- A balanced diet rich in antioxidants (colourful vegetables, fruit, oily fish).
- Judicious use of corticosteroids, particularly long-term ocular ones.
- Regular ophthalmological screening from the age of 50, more frequent in the presence of a risk factor.
CLINICAL RESULTS
Cataract surgery in figures
Cataract surgery is the most commonly performed surgical procedure in the world, with around 30 million operations a year worldwide and more than 800,000 a year in France. The return of visual autonomy is rapid, and patient satisfaction is now measured against several objective criteria.
The most commonly performed surgery
Clareon PanOptix trifocal implant (Fujita 2026)
outpatient phacoemulsification
SURGICAL EXPERTISE
Why choose Dr Tourabaly for your cataract
Choosing your surgeon is an important decision. A few factual pointers on Dr Tourabaly’s background and approach may help inform that decision.
Academic background
Former Chef de Clinique at the National Ophthalmology Hospital of the Quinze-Vingts (Paris), Sorbonne University. Specialisation in cornea, anterior segment and cataract surgery with premium implants.
Mastery of premium implants
Regular practice with monofocal, toric (astigmatism correction), extended depth of focus (EDOF) and trifocal (PanOptix, Synergy) implants for patients seeking maximum independence from glasses.
Clinique Sainte-Geneviève facility
Outpatient surgery at Clinique Sainte-Geneviève (Paris 14), equipped with an operating theatre dedicated to ophthalmology, local anaesthesia, Zeiss IOLMaster 700 biometry and a latest-generation phacoemulsification unit.
Follow-up at the practice
Pre-operative consultation and IOL Master 700 biometry at the Cachan practice (94), where the biometry equipment is located. Post-operative check-ups at D+2, M+1 and then at 1 year at the practice according to your proximity. More than 1,100 Google reviews: 4.9/5. See testimonials.
PATIENT TESTIMONIALS
Reviews from patients operated on for cataract
Genuine reviews published on Google Maps: More than 1,100 reviews · 4.9/5.
An excellent surgeon. I had surgery for a retinal detachment in each eye and also for cataracts in both eyes, i.e. 4 operations over 2 years, all completely successful. He has just operated on me for a secondary cataract with the laser, very successfully. I recommend Dr Tourabaly 100%; I have complete confidence in him.
An excellent surgeon, very attentive and available. No pain during or after the cataract surgery. I have regained excellent vision thanks to the multifocal implants. I recommend him without hesitation.
Operated on for a cataract, right eye and left eye, everything went very well. My only regret is not having consulted Dr Tourabaly sooner… A truly spectacular result.
I was operated on as an emergency for a retinal detachment in my left eye at the Quinze-Vingts by Dr Tourabaly several months ago, then for the cataract. Thanks to his great skill, his attentive ear and his reassuring, objective explanations, I was able to regain my sight and get through those difficult moments. I have since chosen him as my ophthalmologist and I recommend him.
FAQ
Frequently asked questions
Book an appointment for a cataract assessment
Diagnostic consultation + Zeiss IOL Master 700 biometry at the Cachan practice (equipped with the CSO Sirius and the IOL Master 700). If surgery is decided, the operative journey takes place at Clinique Sainte-Geneviève (Paris 14).
Sources
- Haute Autorité de Santé. Good practice guidelines: cataract surgery in adults. HAS, 2018 (2024 update).
- European Society of Cataract and Refractive Surgeons. ESCRS guideline for cataract surgery 2024. Dublin: ESCRS, 2025.
- National Institute for Health and Care Excellence. Cataracts in adults: management (NG77). NICE, 2017 (updated May 2025).
- American Academy of Ophthalmology. Cataract in the Adult Eye Preferred Practice Pattern. AAO, 2021.
- Segers MHM, Behndig A, van den Biggelaar FJHM, et al. Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery. J Cataract Refract Surg. 2022;48(1):51-55. PMID 34074994.
- Sim PY, Donachie PHJ, Day AC, Buchan JC. The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 17, a risk factor model for posterior capsule rupture. Eye (Lond). 2024;38(18):3495-3503. PMID 39294232.
- Morano MJ, Khan MA, Zhang Q, et al. Incidence and risk factors for retinal detachment and retinal tear after cataract surgery: IRIS Registry analysis. Ophthalmol Sci. 2023;3(4):100314. PMID 37274012.
- Daien V, Le Pape A, Heve D, Carriere I, Villain M. Incidence, risk factors, and impact of age on retinal detachment after cataract surgery in France: a national population study. Ophthalmology. 2015;122(11):2179-2185. PMID 26278859.
- Pershing S, Lum F, Hsu S, et al. Endophthalmitis after cataract surgery in the United States: a report from the Intelligent Research in Sight Registry, 2013-2017. Ophthalmology. 2020;127(2):151-158. PMID 31611015.
- Ursell PG, Dhariwal M, O’Boyle D, Khan J, Venerus A. 5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes. Eye (Lond). 2020;34(5):960-968. PMID 31616057.
- Schweitzer C, Brezin A, Cochener B, et al. Femtosecond laser-assisted versus phacoemulsification cataract surgery (FEMCAT): a multicentre participant-masked randomised superiority and cost-effectiveness trial. Lancet. 2020;395(10219):212-224. PMID 31954466.
- Rosen E, Alió JL, Dick HB, et al. Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: metaanalysis of peer-reviewed publications. J Cataract Refract Surg. 2016;42(2):310-328. PMID 27026457.
- Ang MJ, Afshari NA. Cataract and systemic disease: a review. Clin Exp Ophthalmol. 2021;49(2):118-127. PMID 33426783.
- Lundström M, Dickman M, Henry Y, et al. Risk factors for refractive error after cataract surgery: analysis of 282 811 cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery. J Cataract Refract Surg. 2018;44(4):447-452. PMID 29685779.
- Arrêté du 21 décembre 2005 (French ministerial order setting out the medical conditions incompatible with obtaining or retaining a driving licence). JORF, 28 December 2005.
This content is for information only and does not replace an ophthalmological consultation. Every situation is individual and is discussed in consultation with your surgeon.