Cataract Surgery
Cataract surgery is a procedure used to remove the natural lens in the eye when it becomes clouded. The natural lens is replaced with a plastic, artificial lens that is permanent, requires no care, and can significantly improve vision. Newer artificial lenses can have the natural focusing ability of a young lens, allowing for distance and some near vision, as well.
Cataract removal is one of the most frequently performed surgical procedures in the world. The surgery is typically an outpatient procedure that takes less than an hour. Most patients are awake during the procedure and need only local anesthesia. If you need to have cataracts in both eyes removed, you will typically have two separate surgeries. This way, the first eye can heal before the second eye surgery.
There are two types of cataract surgery:
- Phacoemulsification cataract surgery involves making an incision in the side of the cornea (the clear outer covering of the eye) and inserting a tiny probe into the eye. The probe emits ultrasound waves that soften and break up the lens into little pieces so it can be suctioned out. This process is called phacoemulsification.
- Capsulorhexis the natural lens is covered by a thin layer called the lens capsule- a small regular central opening is made in the capsule in order to facilitate the lens removal with phacoemulsification – this is called the capsulorhexis. This is one of the key steps in cataract surgery – it can be made manually or with Femtosecond Laser. Laser Assisted Capsulorhexis is one of the latest innovations in cataract surgery – Now available at our centre – speak to your ophthalmologist about FLACS – Femtosecond Laser Assisted Cataract Surgery. During this procedure, the surgeon removes the cataract but leaves most of the thin outer membrane of the lens, called the lens capsule, in place. The incision made for this procedure is so small that the surgeon generally does not need to use sutures to close the opening.
- Extracapsular surgery requires a somewhat larger incision in the cornea to allow the lens core to be removed in one piece. This approach may be used if your cataract has advanced to the point where phacoemulsification can’t break up the clouded lens. Through this incision, your surgeon opens the lens capsule, removes the central portion of the lens and leaves the capsule in place.
Once your surgeon removes the natural lens, he or she generally replaces it with a clear plastic lens called an intraocular lens (IOL). The IOL is placed in the lens capsule that was left in the eye. The artificial lens can focus light onto the back of the eye and improve vision.
Intraocular lenses come in three basic forms: monofocal, astigmatic (toric), and multifocal lenses.
- Monofocal lenses are the most commonly implanted lenses. They have the same power in all areas of the lens. They can have a fixed focus or allow for changes in focus.
- Fixed Focus Monofocal IOLs can provide excellent distance vision. However, since these lenses have a fixed focus set for distance vision, you may need to use reading glasses for good near vision.
- Astigmatic (Toric) IOLs have astigmatism correction in them. They can be used for patients who have a lot of astigmatism and want to reduce it.
- Multifocal lenses are like bifocal eyeglasses. Several areas of the lens have different powers, which allow individuals to see clearly at far, intermediate and near distances. However, these multifocal lenses are not suitable for everyone. For some individuals, they may cause more problems with night vision and glare than monofocal IOL lenses.
The type of intraocular lens implant that will work best for you will depend on your current vision status and your vision and lifestyle needs. Your optometrist and cataract surgeon can advise you on the most suitable lens implant.
What happens after cataract surgery?
Normally you can go home the day of your surgery, but you won’t be able to drive. You might need help for a few days because your doctor may limit activities such as bending and lifting.
It is normal to feel itching and some mild discomfort after cataract surgery. You may also have temporary fluid discharge from your eye and be sensitive to light. Avoid rubbing or pressing on your eye. Try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs and do light household chores.
Your doctor may prescribe medications to prevent infection and control eye pressure. After a few days, your eye should be comfortable. Often, your eye will be completely healed within about four to six weeks.
During this healing time, your eye health and vision need to be monitored. Typical follow-up visits occur 1 day, 3 days, 2 weeks, 8 weeks and 6 months after surgery.
Once your eyes have healed,a final check for glasses is done. Most people need to wear glasses after cataract surgery, at least for some activities.
