Cataract surgery in the Netherlands: why aftercare is just as important as the procedure

Cataract in figures: a large-scale procedure

Cataract occurs when the lens of the eye gradually becomes cloudy, usually as part of the ageing process. Among people younger than 65, cataract occurs in about 3%, while among people aged 85 and over this rises to about 20%, according to figures from eye clinics in the Netherlands.

These figures translate into an impressive number of procedures: each year an estimated 160,000 to 180,000 cataract operations take place in the Netherlands, which amounts to roughly five hundred operations per day. This has made cataract surgery the most frequently performed operation in Dutch hospitals for years.

Figures from the Dutch Ophthalmological Society (NOG) for 2024 also show that the number of bilateral operations, in which both eyes are treated shortly after one another, has increased sharply: in 2024 this took place more than 16,000 times, more than double the year before. This means that a growing group of patients has to apply drops to two eyes at once after surgery instead of one.

The operation itself is short, the recovery is not

Cataract surgery itself is a relatively short procedure, often around twenty minutes, in which the cloudy lens is replaced by an artificial lens. Many patients can go home the same day. The final result of the operation, however, can only be properly assessed after three to four weeks, the period in which the eye has to heal and in which aftercare with eye drops plays a crucial role.

During these weeks, patients are usually prescribed a combination of anti-inflammatory and sometimes antibiotic eye drops, following a schedule that is most intensive in the first few days and is then gradually reduced.

Why this aftercare requires such precision

Although complications after cataract surgery are relatively rare, they are not negligible: a serious eye infection (endophthalmitis) occurs in about 1 in 1,000 operations. With an estimated 160,000 to 180,000 operations per year, this means a considerable number of patients each year for whom correct aftercare partly determines the eventual recovery.

In its own patient information, the Rotterdam Eye Hospital points out that adherence to the drop regimen after surgery cannot be taken for granted. In practice, care providers see that patients sometimes forget a drop, that stiffer fingers make it harder to squeeze properly, and that the importance of the drops is underestimated as soon as vision feels clear again. That underestimation is precisely the risk: even when vision is already good, the healing of the eye is often not yet complete.

Applying drops after surgery: a technical challenge at a vulnerable moment

What is highlighted less often in the figures and the medical information is how physically challenging applying the drops itself is during this period. Patients often combine several types of drops, with a prescribed interval of at least a few minutes between the different medicines. On top of that, the eye is extra sensitive after surgery, which means many people unconsciously apply drops more cautiously, and therefore more hesitantly, than usual.

Hospitals such as the Diakonessenhuis therefore explicitly point out to patients that they can apply the drops to their own eye, if necessary with the help of eye drop glasses, or that a partner or relative can assist. This mention in official patient information confirms what broader information about eye drops also shows: an aid that supports aiming and administering is already recognised by care providers themselves as a practical option during this vulnerable recovery period.

What this means for patients after cataract surgery

For anyone about to undergo cataract surgery, or who has just had it, a few insights from these figures are relevant:

• The drop schedule is often more intensive than expected, especially in the first days after surgery, sometimes with several applications per hour.
• Adherence cannot be taken for granted, not even for people who normally never have trouble with medication: fatigue, uncertainty and underestimating the importance all play a role.
• With bilateral operations, which are becoming increasingly common given the rising figures, there is the added factor that both eyes require precise aftercare at the same time.
• An aid such as the Oculoo eye drop glasses is already mentioned by hospitals themselves as practical support, alongside help from a partner or relative.

The role of Oculoo after cataract surgery

Oculoo was developed to support people who have difficulty administering eye drops. The eye drop glasses help position the bottle steadily above the eye and support the user while applying the drops.

This means the user does not have to rely solely on vision, hand stability or precise positioning above the eye. This can be particularly relevant during recovery after cataract surgery, when vision is temporarily reduced and the operated eye may be sensitive.

The aim is not to replace medical instructions. Oculoo supports the practical execution of the drop schedule prescribed by the ophthalmologist or pharmacy.

Conclusion

The figures on cataract surgery in the Netherlands show that this is a large-scale, very common procedure, with an operation that is short in itself but a recovery process that takes weeks. In that recovery process, aftercare with eye drops is at least as decisive for the final result as the operation itself, while care providers themselves indicate that adherence and correct administration are more difficult in practice than is often assumed. For patients who want to get through this phase independently, an aid that supports aiming and administering is an option that is already recognised within healthcare itself.