Cataract surgery is done to remove the lens of the eye that has become opaque, and mostly replace the lens with a synthetic one. The lens of the eye is situated behind the pupil (the smaller circle of the black part of the eye) and helps in focusing of objects of various distances from the eye.
Cataract surgery is performed only when the lens becomes too cloudy that it interferes with the vision. The person has trouble with daily activities such as reading, seeing bright light or driving.
Types of cataract surgery:
Most cataract surgeries involve replacing the clouded lens by a transparent lens called intraocular lens (IOL). Some of the common types of cataract surgeries include:
- Phaco-emulsification is a procedure of surgery in which the surgeon makes a 2 to 3 millimeter long incision in front of the eye. An ultrasonic probe is used to break the cataract lens and suction is used to remove the broken pieces. A flexible lens is inserted and kept in place of the removed cataract. The incision is left to heal on its own without sutures. The eye is covered with a patch, covering the incision too, for a few days until healing takes place.
- Manual extracpsular cataract surgery (MECS) is a procedure in which the incision is as large as 9 to 13 millimeters long. The cataract lens is removed and an IOL is replaced. It is lower in cost be has higher risk of complications as the incision is larger.
- Manual small incision cataract surgery (MSICS) is a procedure involving a smaller V-shaped incision that is narrower on the outside of the eye and wider on the inside. The outer incision is about 6.5 mm to 7 mm and the inner incision is as wide as 11 mm. The cataract is removed and the lens is replaced in the same way as MECS.
- Femtosecond laser-assisted cataract surgery (FLACS) is a procedure in which the surgeon uses laser to make incision in the eye. The laser also softens the cataract so that it is easy to break it and remove it. Laser also makes an accurate incision to correct astigmatism too. The technique is much more expensive than others, but tends to result in rapid healing.
- Intracapsular cataract surgery is an older procedure, involving removal of the entire lens and the lens capsule from the eye through a large incision. But the technique involves high risk of complications and is rarely performed during the modern times.
Before the cataract surgery various measurements of the eye are taken by the doctor and certain medicines like blood thinners are stopped. Cataract is usually an outpatient procedure and the patient is asked to wait in the recovery area for about half an hour or more. But some patients may be asked to stay overnight.
The procedure is done with local anesthesia and sometimes a mild sedative is given to relax the patient. Otherwise the patient is awake during the procedure but cannot see what the surgeon is doing. The surgeon uses a microscope to look into the eye and perform one of the procedures mentioned above.
Post surgical care in cataract surgery:
It might take 3-4 weeks for the cataract to heal completely. Special eye drops are prescribed for pain, irritation and prevent infections. A protective mask for the eye is prescribed so that the patient does not scratch his or her eye during sleep. Sunglasses must be worn while going outdoors to protect eyes from sunlight. Reading, driving and other such activities may be possible only after complete recovery.