Important advances in surgical technique and more sophisticated technology have helped make surgery a safe and effective treatment for cataracts. Two things happen during cataract surgery - the clouded lens is removed, and a clear artificial lens is inserted.
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| How To Restore Eyesight |
Prior to surgery, your eye doctor will measure the size and shape of your eye to determine the proper lens implant power. This measurement is made with a painless ultrasound test. Cataract surgery is typically an outpatient procedure that takes less than an hour. Most people are awake, relaxed and comfortable during the surgery, needing only local anesthesia. On rare occasions some people may need to be put under general anesthesia.
Removing the cataract. The most commonly used procedure to remove a cataract is called phacoemulsification (fak-o-e-mulsih-fih-KA-shun), in which the surgeon removes the cataract while leaving most of the lens capsule (outer layer) in place. The capsule will help support the lens implant when it's inserted. An alternative procedure called extracapsular cataract extraction is similar to phacoemulsification but requires a larger incision.
Phacoemulsification. During phacoemulsification, phaco for short, the surgeon makes a small incision, about 1/8 inch (3 mm), where the cornea meets the conjunctiva and inserts a needle-thin probe. The surgeon then uses the probe, which vibrates with ultrasound waves, to break up (emulsify) the cataract and suction out the fragments. The lens capsule is left in place to provide support for the lens implant.
Extracapsular cataract extraction. If your cataract has advanced beyond the point where phacoemulsification can effectively break up the clouded lens, the surgeon may do an extracapsular cataract extraction. This procedure requires a larger incision, about 3/8 inch (10 mm), where the cornea and conjunctiva meet. Through this opening the surgeon opens the lens capsule, removes the nucleus in one piece and vacuums out the softer lens cortex, leaving the capsule shell in place.
Implanting the lens. Once the cataract has been removed through phacoemulsification or the extracapsular method, a clear artificial lens is implanted into the empty lens capsule to replace the original clouded lens. This lens implant, also known as an intraocular lens (IOL), is made of plastic, acrylic or silicone. It requires no care and becomes a permanent part of your eye. Whether or not you wore glasses before surgery, after surgery you'll likely need reading glasses.
Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close. However, many IOLs are flexible, allowing a smaller incision that requires no stitches. The surgeon can fold this type of lens and insert it into the empty capsule where the natural lens used to be. Once in place the lens unfolds to about 1/4 inch (6 mm).
After cataract surgery
With phacoemulsification and foldable lens implants, surgical incisions are very small, and no sutures are required. If all goes well you'll heal fast, and your vision will start to improve within a few days. If your surgery required a larger incision and sutures, full healing might take about 4 weeks.
Normally you can go home on the same day as surgery, but you won't be able to drive, so make sure to arrange for a ride home. You'll typically see your eye doctor the next day and during the next 4 to 6 weeks so that he or she can check the healing progress.
It's normal to feel mild discomfort for a couple of days after surgery. Avoid rubbing or pressing on your eye. Clean your eyelids with tissue or cotton balls to remove any crusty discharge. You may wear an eye patch or protective shield the day of surgery. Your doctor may prescribe medications to prevent infection and control eye pressure. After a couple of days, all discomfort should disappear.
Contact your doctor immediately if you experience any of the following signs or symptoms after cataract surgery. You may have developed a rare but very serious infection known as endophthalmitis (en-dof-thul-MI-tis).
- Vision loss
- Pain that persists despite the use of over-the-counter pain medications
- A significant increase in eye redness
- Light flashes or multiple spots (floaters) in front of your eye
- Nausea, vomiting or excessive coughing
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Complications after cataract surgery are relatively rare, and most can be treated. They include inflammation, infection, bleeding, swelling, retinal detachment and glaucoma. The risks are greater for people who have other eye diseases or serious medical problems. Occasionally cataract surgery fails to improve vision because of conditions such as glaucoma or macular degeneration. It is important to evaluate and treat these other eye problems, if possible, before making the decision to proceed with cataract surgery. To find out more, you can check out How To Restore Eyesight.