How are cataracts removed?

Cataract operations are one of the most commonly carried out surgical procedures in the world. However, it’s not something that most of us have much knowledge about, meaning that if you or a loved one has been told they need cataract removal, then it’s only natural to feel a little anxious.

The following provides a simple guide that will help you understand everything you need to know about the operation.

What is Cataract Eye Surgery?

Cataract surgery involves removing a diseased lens from the eye and replacing it with an artificial one. To understand the procedure, it’s first necessary to have a little knowledge about the condition itself.

A cataract forms when proteins within the eye clump together on the lens. The lens is pivotal for vision—as light enters the eye it flows through the lens to the retina at the very back of the eye. The retina is a thin layer of cells that transmit this received light to the brain, via the optic nerve. Here, they’re translated into the images that we see.

As you can imagine, light needs to travel unhindered through the eye. When the aforementioned proteins clump on the lens, they present a barrier to this free passage of light. This means the signal to the brain is interrupted and, as the condition worsens, the eyesight deteriorates.

Cataracts don’t happen overnight—they take many years to form. Because of this, the first time many of us know we have them is when they’re diagnosed during a routine eye examination. If this is the case, your ophthalmologist will monitor their evolution and recommend surgery at the appropriate time.

Cataract Eye Surgery: A step-by-step guide to what happens

When cataracts reach the stage where they’re having a significant effect on your vision, you’ll be advised that surgery is the next step. While this can be a worrying thought, you should take comfort in the fact that millions of cataract removals are carried out around the world every year. 

The first discussion you’ll have with the surgeon will be the option of which surgery to undergo and the type of artificial lens to be fitted. We’ll discuss these in more detail in the following sections.

The procedure itself is carried out within the eye surgeon’s office. It typically takes around 20 minutes per eye, and you’ll return home the same day. Only one eye is operated on at a time. If you require treatment on both, then the second one will be done at a later date. It’s quite usual for cataracts to evolve at different rates, meaning there might be quite a gap between the operations.

Once the initial conversations regarding surgery and lenses have taken place, you’ll be given a date to come in for the operation. On the day, the surgeon will explain how the procedure will go, but it’s typically something along the following lines:

  • You may be given a light sedation
  • Your eye will be numbed with anesthetic drops
  • An instrument will be placed over the eye to prevent you from blinking during the procedure
  • The operation will be carried out. It will be painless, and you’ll remain awake throughout
  • A protective shield will be placed over the eye once the operation is complete
  • You’ll remain in the recovery room for a while until you feel ready to leave

You won’t be able to drive yourself, so will need someone to take you home.

The Difference Between Traditional and Laser Cataract Surgery

There are two types of cataract surgery—traditional and laser. Both have the same result but are carried out a little differently.

During traditional cataract surgery, the eye doctor will use a tiny scalpel to manually make an incision in the cornea. A probe will be inserted to gain access to the lens capsule. The lens will be fractured into tiny pieces, using either a laser or sound waves. These will be suctioned out and the surgeon will manually place the new, artificial lens in place. The incision will be closed without the need for stitches.

Laser cataract surgery is slightly different. The internal anatomy of the eye will be digitally mapped and programmed into a computer. This information is then used to guide a laser to make the initial incision, enter the lens capsule, and break down the diseased lens. After the pieces are removed, the artificial lens is placed with highly accurate precision, thanks to the internal mapping of the eye. Again, the incision is closed without stitches.

Reasons to Have Laser Cataract Surgery

While both traditional and laser surgery are an excellent treatment for cataracts, some situations make laser the more obvious choice.

The first is that if you have astigmatism, then treatment for this can be carried out at the same time. The second is down to the artificial lens that you choose. There are different types, depending on your lifestyle and expectations. These artificial lenses are known as intraocular lenses, or IOLs. Much in the same way as eyeglasses, they can either have a single area of focus or be suitable for both near and far vision. Some also use the natural anatomy of the eye to help you see at different distances.

If you opt for one of the more advanced lenses—known as premium lenses—then they can only be fitted during laser cataract surgery. This is because they require an extremely precise location that’s only possible thanks to digital eye mapping.

Intraocular Lens Choice

There are different types of IOLs on offer.

  • Monofocal lenses: As the name suggests, these allow for good focus at a single distance—so either near or far vision. They can be fitted during traditional or laser eye surgery. You’ll likely have to wear glasses for either close-up or far distance vision post-operation
  • Toric lenses: To correct astigmatism
  • Multifocal lenses: These work in a similar fashion to bifocal glasses, with your prescription being built into the lens
  • EDOF lenses: This stands for Extended Depth of Focus and allows for good vision at both a medium and far distance
  • Accommodative lenses: Another advanced lens that works with the eye muscles to change focus. As such, they provide good vision at all distances

The type of lens that you choose will be discussed before your cataract surgery. The choice will be down to several factors, including your lifestyle and what types are covered by Medicare or other insurance. Of course, there’s always the option to pay for a premium lens yourself if your selected lens isn’t one covered by your policy.

Both traditional and the most advanced laser cataract surgery are offered at the Modern Cataract Surgery Clinic. 

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