What is cataract surgery?

Cataract surgery is all about removing the faulty lens in your eye, and in majority of the scenarios, replacing it with an artificial lens. Cataract surgery is considered to be one of the most successful clinical managements in the healthcare sector with direct improvements in visual acuity as well as reduced mortality according to a report in 2020 by National Institute of Health.

It also reported by National Institute of Health, that 3.7 million cataract surgeries were performed in the United States during 2015, with the number of cataract patients expected to reach 30.1 million in 2020.

Cataract is an eye condition leading to the cloudiness of a clear eye lens otherwise, which results in affecting your vision eventually. An ophthalmologist normally carries out a cataract operation, and in most of the cases, you don’t even need to stay in the hospital after the surgery is done, i.e. you get it done on outpatient basis.

So, why do you need a cataract surgery in the first place?

Well, if you want to get your cataracts problem treated, you need to undergo such a surgery. Since cataracts can inflict you with a blurry vision, also turning your eyesight sensitive to the glare from lights, turning your daily-life activities into a problem for you. This is when your doctor may advise you for cataract surgery.

Another possible scenario leading you to such a surgery can be the interference or hindrance of cataracts in treatment of other eye problems, such as age related macular degeneration, diabetic eye problems and other common eye diseases. With a clouded eye lens, optometrists fail to examine the back of the eye comprehensively.

When is the right time to have cataract surgery?

When dealing with cataract removal, you better ask yourself the following questions:

Types of cataract surgery

Yes, if you’re wondering, there are multiple ways of cataract removal once your eye doctor advises you to take up the surgery. So, let’s have a look at them:

i) Phacoemulsification

Also known as ‘Phaco’, it is the most common technique used for cataract removal nowadays. Usually, it takes no more than half an hour to remove cataract through phacoemulsification, and that too, requiring only minimal sedation, i.e. local anesthesia (injecting anesthesia around the eye) or topical anesthesia (administering numbing drops into the eye).

This cataract procedure requires a small surgical incision around the edge of the cornea, creating an opening through the membrane surrounding the lens. The next step involves inserting a small ultrasonic probe into the opening to break up the cloudy lens into tiny fragments using sound waves, which act as a microscopic jack hammer. An attachment on the probe tip is then used for suction of broken down cataract fragments.

Once the lens particles are removed, an intraocular lens implant, also referred commonly as an IOL, is implanted in the natural lens capsule. A hollowed out tube is used by the ophthalmologists to insert the IOL through a tiny corneal incision.

ii) Extracapsular cataract surgery

This is the cataract procedure used in case of highly advanced cataracts, which is too dense for phacoemulsification (the process of breaking down or dissolving the cataract into tiny fragments) or when phacoemulsification is not possible for various other reasons.

A slightly larger incision is required for this cataract removing technique, so that the cataract can be removed in one piece instead of being fragmented within the eye. Just like phacoemulsification, an artificial lens (IOL) is placed inside the same capsular bag.

A number of sutures are required to close the comparatively larger wound, which also results in slower recovery of the wound as well as visual function.

To initiate this cataract removal technique, the numbing medication is administered through an injection around the eye. An eye patch is also required after this kind of surgical process.

iii) Intracapsular cataract surgery

Though rarely used nowadays, this cataract removal technique may still be useful under certain circumstances. It requires an even larger incision as compared to extracapsular surgery, through which the entire lens with surrounding capsule is removed. Moreover, the IOL (intraocular lens) is placed in a different location, in front of the iris, in this surgical procedure.

Potential cataract surgery complications

The Harvard Health Publishing in 2020 reported that through phacoemulsification (procedural approach) 97% to 98% of all cataract cases done by an experienced surgeon are successful.

Since every single person with cataract can have varied health conditions, your ophthalmologist is supposed to discuss the specific potential complications of the type of cataract procedure most feasible for you, requiring your signatures on a consent form.

Some of the most common cataract surgery complications include persistent inflammation, ocular hypertension (also known as elevated intraocular pressure), cystoid macular edema (a condition where retina at the back of the eye is swollen) and retinal detachment. (You can find a detailed account of potential cataract surgery complications in this publication.)

Cataract Surgery Recovery

Cataract surgery recovery is also one of the most concerned aspects of cataract removal, especially the time required in restoration of functional vision after the procedure.

You’re expected to take first follow-up visit to your ophthalmologist within the first few days after the cataract surgery, followed by a subsequent visit within the first few weeks. In most of the cases, you’re prescribed with specific types of eye drops to reduce inflammation and protect against infection.

Most people observe an improvement in their visual function within several days of the surgery, enabling them to restart most of their daily activities including work. However, you need to have several visits to the doctor, who monitors and observe your eye(s) for any signs of complications.

Majority of people regain full activity after a few days of getting treated. Your doctor might fit you with a pair of glasses (if needed) once your vision is stabilized. This also depends upon the type of intraocular lens implanted in your eye.

There is also a possibility that you are unable to get cataract surgery, due to old age, for example. If so, you may consult your doctor for resorting to some of the contemporary low vision aids like IrisVision, which are designed to augment your visual capacity, returning you some of the independence that you once enjoyed before falling victim to this eye disease.