Cataract Surgery: What You Need to Know

 (photo credit: RF123)
(photo credit: RF123)
Cataract occur when the native crystalline lens of the eye becomes opaque and often require surgical intervention. The light from everything we see passes through the lens, and so this opacity obscures vision. It generally occurs during the aging process and can greatly diminish the quality of life.
What is Cataract Surgery?

"Cataract surgery is an intervention to remedy this loss of vision. When cataract develops to the point that it affects everyday activities, people seek out this surgery. During the procedure, the surgeon removes the affected lens and replaces it with an artificial lens. This restores the clearness required for the eye to function properly"
Dr. Avi Ohayon, Ophthalmologist, specialist in retina, vitreous and cataract surgery told Jerusalem Post.

Different Surgical Methods


Because of the wide range of severity in cataract and other considerations, there are several different methods for performing cataract surgery. The bulk of surgeries today are phacoemulsification. This procedure requires only a small incision in the cornea. In order to remove the lens, the surgeon inserts a device that softens the lens via ultrasound and then removes the lens using aspiration.
The more traditional method is called extracapsular cataract surgery. Instead of a small incision, a large incision is made. The surgeon can then remove the lens entirely without the need for ultrasonic softening. After that, the surgeon inserts an intraocular lens into the eye. 
The permanent implant does not allow for the same focus changing as the natural crystalline lens, with most patients requiring reading glasses afterward. Many innovations in the field focus on developing better artificial lenses such as lenses that correct corneal astigmatism and multifocal lenses, aimed to eliminate the need for glasses. 
Among the latest developments in cataract surgery is femtosecond laser cataract surgery. This method uses the latest technology to scan the eye and send precise instructions to a laser beam that then makes the required cuts.

The Procedure for Cataract Surgery


Before the surgery, the ophthalmologist will perform a biometric test to measure the eye. This is necessary in order to calculate the power of the artificial lens implant. Immediately prior to the procedure, the nurses administer eye drops that dilate the pupil. They then apply local anesthetic drops to the region.
Both common methods begin with an incision in the eye’s cornea. The surgeon uses an ultrasonic probe to soften and break up the lens before removal or removes it in one piece. If broken up, the surgeon applies aspiration to remove the lens through the small corneal incision. In the former case, the incision is very small and does not require stitching of any kind, on the other hand when removing the lens in a large incision there will be need for sutures. 

Complications and Risks

Overall, cataract surgery is very safe. Most patients do not exhibit significant side effects such as temporary dry eye. However, there are potential complications. As with other surgeries, an ocular infection can occur. This is rare for this type of surgery, causing an acute decrease of visual acuity and has to be treated immediately in order to save one’s vision. Retinal detachment is a rare and severe complication that can result in partial or complete sight loss in that eye.
If complicated, cataract procedure could leave some lens fragments behind. Smaller fragments are of no concern, but larger will require additional surgery to remove the fragments and prevent complications. Corneal or retinal edema sometimes occurs due to fluid buildup in the eye, with eye drops or potentially steroids required to alleviate the condition. The artificial lens can become dislocated, leading to blurred vision. Surgery could be necessary to reposition the lens.
After the surgery, any patient experiencing vision loss should contact their surgeon immediately. Pain and soreness can occur, but this is only a concern if over-the-counter pain medication does not relieve the pain. Redness and swelling are also causes to contact the surgeon. Patients that experience light flashes or spots should also consult their ophthalmologist. 

Recovering After Surgery


Immediately after the surgery, vision is blurry as the eye must heal. Improvement in vision generally occurs over the course of several days. Generally, patients are required to visit their surgeon several times, a day or two after the surgery, a week after, and a month or two after the procedure. This ensures that the eye is healing properly and that the
surgery was successful in restoring vision.
Patients often report seeing brighter colors after the procedure, as the cataract gave their natural lens a yellow tint. Some discomfort is also common, and touching the eye must be avoided. In order to protect the eye, the surgeon will often tell patients to wear an eyepatch for several days. Your surgeon will prescribe mandatory eye drops in all cases. In most cases, the eye has completely healed in about eight weeks and the need for glasses will be evaluated.