Cataract surgery involves removing the natural lens which has become discoloured and hard, and replacing it with an intraocular lens (IOL).
The Procedure
Preparation
After you have discussed the treatment plan with your ophthalmologist and have decided to proceed with cataract surgery, other tests may be required, such as a blood test. Your ophthalmologist will need to examine your eyes using an "A scan" to determine the optical lens that will replace the cloudy lens. You may be given:
- Eye drops for use before and after surgery
- Instructions about preparation for surgery and care after surgery
- Consent form to read and sign
On the Day
Cataract surgery is usually performed as a day-only procedure and takes approximately half an hour. However, if there are other medical problems or concerns the ophthalmologist may recommend the patient be hospitalised.
Cataract removal is usually performed under local anaesthesia and light sedation - a specialist anaesthetist gives the anaesthetic and sedative. You may be able to see movement and light during the surgery, but will not be able to see the surgery.
Artifical Lenses
The artifical lens is also called an "intraocular lens implant". It is a transparent plastic disc with a similar shape to a natural lens. Two plastic extensions press against the capsule and lock the lens in place in the back portion of the lens capsule. They are made of silicone, acrylic or PMMA, but other materials are under development.
The lens implant is prepared according to your surgeon's prescription and made for distance vision. Most people fitted with modern intraocular lenses will not need spectacles for distance vision, however, others may require glasses for both distance and close vision.
Surgical Techniques
The surgical technique most commonly used is called Phacoemulsification Surgery or Small Insicion Catarat Surgery. Phacoemulsification is pronounced fay-ko-emul-sah-fah-kay-shun.
This procedure enables the removal of the cataract and implantation of the artificial lens through the mico incision (less than 3mm) and ensures little discomfort, a low chance of post-operative complications, fast healing time, and a quick return to normal activities. The operation usually takes from 20 - 60 minutes.
- Step 1 Once a small incision is made, a small tip is inserted to break the cataract into small fragments via ultrasonic vibration. These are then removed by suction via the incision.
- Step 2 The artifical lens of choice is usually a foldable intraocular lens and can be folded to less than half its size, allowing insertion through the tiny incision. Once inserted, the lens unfolds to its normal full size. The incision is nomally so small that it often requires no stitches, or perhaps only one or two.
- Step 3 After surgery the eye is covered with a shield for protection.
What are Cataracts?