What is Cataract Surgery?
Cataract surgery is performed as a treatment for cataracts (clouding of the lens of the eye) and hampers everyday activities like reading and driving at night.
An ophthalmologist (eye doctor) performs it. The doctor removes the clouded lens and replaces it with an artificial lens, in most cases.
It is an outpatient-based procedure and the patient is discharged the same day. It is a common and safe procedure to treat cataracts.
When is cataract surgery recommended?
Doctors usually do not recommend cataract surgery hastily. The doctor advises the surgery under the following circumstances:
Daily activities, like reading and driving at night are hindered due to blurry vision, which cannot be corrected by eyeglasses. The prescription of eyeglasses needs to be changed too often.
The cataract deters the effective diagnosis of another condition in the eye or its treatment. E.g. difficulty diagnosing conditions such as diabetic retinopathy or macular degeneration
What are the Pre-surgery preparations for Cataract Surgery?
A week before the surgery, an ultrasound test is performed on the eye. This is to determine the shape and size of the eyeball and identify the right type of lens (called an intraocular lens) for the eye. It is a painless test.
Most of the patients operated on for cataracts are given an intraocular lens. The intraocular lens replaces the function of the natural lens. It helps focus light on the retina, which helps enhance the vision.
Patient preparation checklist for cataract surgery:
- The patient is not supposed to eat or drink 12 hours before the surgery.
- Any medication which enhances bleeding is stopped temporarily before the surgery (to curb the chance of excessive bleeding).
- Male patients must convey if they are consuming any medication for prostate problems (as it interferes with the cataract surgery).
What are the Types of Intraocular Lenses?
There are multiple types of Intraocular Lenses. The lens is made of different materials: plastic, silicone, or acrylic. Their flexibility also differs.
Depending on the choice made by the patient-guided by the recommendation of the doctor, two major types of artificial lens can be used for the implant:
- Rigid plastic lens: Needs a larger incision and therefore more stitches
- Flexible lens: Needs a small incision. Because of its flexibility, the doctor can gently fold the lens to fit it through the small incision and insert it into the empty pocket. Once the lens is appropriately positioned in the eye, it opens and sits into the empty pocket.
The choice also determines the cost of the surgery. The patient and doctor decide, based on which will suit the requirements of the patient and the cost.
How is Cataract surgery performed?
It is an outpatient procedure and the patient is sent home the same day with instructions for care. The length of the surgery is about an hour.
The doctor puts eye drops to dilate the pupil. This is followed by local anesthesia to numb the surrounding area for surgery.
The doctor may also give a sedative, to have the patient not be very alert during the surgery. In this procedure, the clouded lens is removed and replaced with the intraocular lens. Few cases, the lens pocket is left empty.
Removal of cataract:
Removing the lens in one piece: This is a less frequently used procedure. The procedure is called extracapsular cataract extraction. It requires a large incision.
Through this incision, the surgeon uses surgical tools to extract the front capsule of the lens and the clouded lens (together the cataract formed).
The back capsule of the lens is maintained intact to hold the artificial lens in place. Once the lens is positioned in place, the doctor stitches the incision. Stitches are required as the incision is large.
It is a procedure preferred for certain complications in the eye:
Removing the lens using an ultrasound probe and breaking the lens:
Here the surgeon makes a tiny incision in the cornea (front of the eye). Through this incision, the surgeon inserts a thin probe where there is the formation of a cataract.
The probe emits ultrasound waves and breaks the cataract in the lens into smaller fragments (emulsification).
These are then removed by suction. The lens capsule (back of the lens) is maintained unharmed to house the artificial intraocular lens. Few stitches may be used to facilitate the closure of the incision on the cornea. This completes the procedure.
What is the Post Surgery care to be taken?
The patient is sent home the same day of the procedure with protective eyewear to ensure the safety of the operated eye. This the patient may have to wear until the wound healing is complete during recovery.
There could be a mild itch or discomfort, which the patient has to bear and resist any temptation for rubbing the eye or applying pressure onto the eyeball. Vision may seem blurry until the surgery wound heals.
The vision begins to improve within a few days of the surgery and colours appear brighter. This is because the cataract has a yellow to brown tinge responsible for the dull appearance of colours, now removed with surgery.
The doctor usually schedules a visit within two days of the surgery to evaluate the wound healing at the incision made.
Subsequent visits are again within the following week and month. Complete healing happens in about eight weeks from surgery.
After the surgery and recovery of the eye, the doctor prescribes eyeglasses to the patient. Any discomfort post-surgery must be communicated to the surgeon immediately.
