CATARACT SURGERY
Using the most up to date methods and instrumentation, cataract surgery is typically performed using a small incision phacoemulsification technique. This means that the cataract surgery is accomplished using the smallest possible incision, and removal of the lens material is accomplished using an ultrasonic needle.
There is a common misconception that cataract surgery is done using a laser. This is not the case, and has never been the case. The use of laser energy produces too much heat to be adapted for this purpose, and would cause irreversible damage to the delicate tissues inside the eye.
Following proper dilation of the pupil and preparation of the surgical area
using betadine or other cleansers, a topical anesthetic is administered to the
surface of the eye. An incision of 2.5 to 3 millimeters in length is then
created at the junction of the cornea (the clear domed structure on the front of
the eye) and the sclera (the white part of the eye).
Another dose of anesthetic is then administered inside the eye through this
incision. The front part of the lens envelope, know as the lens capsule, is
carefully opened so that the lens material can be removed. This is accomplished
using a needle-like ultrasonic device which pulverizes the hardened and yellowed
lens proteins. The pulverized material is simultaneously vacuumed from the eye.
Once all of the cataract material has been removed, and assuming that the lens
capsule which was opened at the beginning of the surgery remains strong enough
to support the lens implant, a folded intraocular lens specifically chosen by
the surgeon to suit your individual needs is then inserted through the original
incision and maneuvered into the lens capsule and then centered. The lens will
remain inside your eye in this location without moving. Intraocular lenses
cannot be felt or sensed in any way by the patient.
In most cases, once the lens is centered within the lens capsule, the
instruments are removed, and the surgery is therefore complete. Under most
normal circumstances stitches (or sutures) are not required to keep the incision
sealed. Should the incision require a suture to be placed for proper sealing,
this suture is generally removed within the first week following surgery.
Recovery from surgery is generally very quick, with most patients achieving
noticeably better vision within the first 24 hours of the procedure. Patients
are generally asked to use two different eye medications, administered as drops
several times daily for the first few weeks after surgery. It is important that
during the first 7 post-operative days patients refrain from strenuous activity
such as lifting weights for exercise or lifting other heavy objects. Patients
should also refrain from eye rubbing during the first few weeks following
surgery.
If glasses are required following surgery to achieve the best possible vision
either for close up work such as reading, or for distance purposes, these will
be prescribed three to four weeks after surgery when full recovery is expected.
If both eyes are scheduled to have surgery within a few weeks of each other,
then glasses, if needed, will be prescribed following full recovery of the
second eye.
Patients should realize that it is not possible in all patients to totally
eliminate the need for eyeglasses.
