What is cataract surgery? Cataract surgery is an eye surgery in which the cloudy lens is removed and replaced with an artificial lens. Cataract surgery is the most common surgery performed in all of medicine. It is also one of the safest surgical procedures.
When is cataract surgery performed? Cataract surgery is the only treatment for cataracts. Usually, surgery is delayed until the blurred vision is causing significant difficulties with activities of daily living. Years ago, surgeons had to wait until the cataract “ripened”, but newer technologies allow for removal much earlier.
What happens before surgery? Once the patient and ophthalmologist have agreed on a time for cataract surgery, the patient must have some testing done on their eye. This testing is to determine the exact lens that will be used to replace the clouded lens.
The patient and ophthalmologist can discuss whether the patient would like to be a bit near-sighted or a bit far-sighted following surgery. This is important because following surgery, the lens is not able to accommodate like the original lens (accommodation is focusing of light to account for different distances).
What type of anesthesia is used for surgery? Most of the time, cataract surgery is performed under local anesthesia. This means that only the eye is “frozen”. This is either done with eye drops or with an injection behind the eye. In rare instances, general anesthesia may be used (this means that the patient is asleep during surgery and cannot feel anything).
How is cataract surgery performed? For the hour or so before the surgery, eye drops are put on the patient’s eye. These eye drops help to freeze the eye and also dilate the pupil so that the surgery is easier for the doctor.
In the operating room, a sterile drape is put over the patient so that only the eye is exposed. Next, a speculum is place on the eye that keeps the eye open. The surgery is ready to begin.
The doctor performs the surgery while looking through a special microscope. Small incisions are made in the eye through which the surgical tools can be inserted.
The lens is actually surrounded by a thin capsule; this capsule can be compared to the skin of a grape. To get to the inside of the lens, the front of the capsule is removed.
Next, a special instrument called a phacoemulsifier is inserted into the eye. The phacoemulsifier is similar to a vacuum. It sucks up the bulk of the cloudy lens, leaving only the back capsule of the lens in place.
Finally, the artificial lens is inserted into the eye. Nowadays, most lenses are folded up so that only a small incision is needed to insert them into the eye. Usually there are no stitches required at the end of the surgery.
How long does the surgery take? Cataract surgery is one of the fastest surgeries in all of medicine. Usually, the actual surgery takes between 10 and 30 minutes, however this time is different for everyone.
What happens after surgery? After surgery, most patients are able to return home. However, eye drops are given to the patient. These eye drops are to avoid infection and to decrease swelling in the eye. Sometimes, a patch may need to be worn.
What are the long-term results of surgery? Most patients having cataract surgery have excellent vision that starts the moment they leave the operating room. Some patients may have a bit of blurring, but this usually resolves after a few days.
Like any surgery, there are complications that can occur from cataract surgery. Some examples include infection, retinal detachment and bleeding into the eye. Fortunately, these complications are rare; for example infection of the eye happens only in about 1 in 5000 surgeries.
What is a posterior capsule opacification? In about 30-50% of patients following surgery, the posterior capsule of the original lens (recall that this was left in during surgery) may become cloudy. This is not a serious complication; a simple laser treatment will easily treat this.
Will I need glasses after surgery?
Most patients will require glasses after surgery; it is advised that patients wait about 1 month following surgery before getting them.
