Cataract Surgery

Cataract Surgery 

So now that you’re at the point where cataract surgery is the only option to get you seeing better, what can you expect??

Let me ease your mind by telling you that cataract surgery is one of the most SUCCESSFUL and SAFEST surgeries performed across the globe today.  They are short (time wise), no pain, rapid visual recovery and the results are outstanding! 

Cataract Surgery is simply the process of REMOVING your natural lens and replacing it with a new one made out of a plastic polymer.  That’s it….  

The hardest part of Cataract Surgery is you, the patient, deciding HOW you want to see after surgery which will dictate WHAT lens should be placed in your eye at the time of surgery.  I will go over these briefly in a bit. 

Before we get into the current surgical procedure let me give you a little history about how it used to be done.  

The image below shows what is known as Couching.  Couching was the oldest recorded method of cataract treatment.  A sharp instrument, usually a sharpened fish bone, was stabbed into the eye right behind the iris into the lens.  The lens was then mechanically dislocated, ie the sharp instrument was wiggled back and forth until the white cataract was no longer seen by the physician or whoever was performing the procedure.  The lens was not replaced.  As you can imagine there was a high rate of complications and the vision was VERY blurry afterwards but at least they could see something.

couching was an old method of treating cataracts before modern day surgery.  There was a high rate of complications.
Couching was performed by stabbing the lens with a sharp object and allowing it to fall into the back of the eye.

 As medicine advanced (thank God!), cataract surgery was performed through a large incision UNDER anesthesia.  The cataract was removed in whole (like popping a seed out of an avocado) and cleaned with a small vacuum.  The wound was closed with numerous sutures and patients were admitted to the hospital for 3-4 DAYS having to lay perfectly still with sandbags beside their head to prevent sudden movements.  Once they healed, they had to wear thick, high magnification glasses to see. 

intracapsular cataract surgery was the removal of the god given lens without replacing it.  Patients were left incredibly farsighted and wore special glasses to see.
Aphakic glasses were given after a cataract was removed but nothing was put in its place.

Cataract surgery advanced very rapidly starting with the advent of ultrasound or what we refer to as phacoemulsification.  The story goes like this, Dr. Charles Kelman, an Ophthalmologist in New York, was having his teeth cleaned and asked his dentist how they could clean plaque off his teeth without damaging the enamel.  His dentist explained that it was ultrasound and the rest was history. 

Thanks to Dr. Kelman, cataract surgery became an outpatient procedure with minimal pain and rapid recovery.  Fewer sutures were needed to seal the wounds and overnight hospital stays were no longer needed.  Around the same time, intraocular lenses were also being perfected so when the cataract was removed a lens could be placed back inside the eye to minimize the need for glasses.  This revolutionized outcomes because suddenly uncorrected vision immediately after surgery was dramatically improved.

Eye Surgery technology has advanced faster than almost all other specialties.  Today, cataract surgery takes 6-10 minutes, is done through a tiny incision that does not require incisions, a lens is placed that is customized for YOUR eye with little to no complications.

We even utilize a femtosecond laser to perform a lot of the steps of the procedure such as softening the cataract, making the incisions and treating astigmatism.  We also use an intraoperative aberrometer (say that 5 times fast lol) which remeasures the eye once the cataract is out to help increase the accuracy of our lens implant.

LASER cataract surgery in conjunction with ORA is has far superior results compared to traditional cataract surgery.
LASER assisted cataract surgery with ORA improves outcomes over traditional cataract surgery.

Small incisions are made in the clear part of the eye and the cataract (lens) is freed from the bag that holds it.  The ultrasound tip is then inserted into the eye and the cataract is broken into thousands of small pieces and “sucked” out of the eye.  The bag that used to hold the lens is polished and a new lens is then inserted through the small incision.  The lens unfolds and centers inside the bag.  The wounds are sealed with fluid and that’s it! 

 Once the surgery starts, it’s over in less than 10 minutes.  Most patients see an immediate improvement in vision, which is WONDERFUL!    

Even though your vision is immediately better, It takes about 5-7 days for the wounds to heal and then 3 weeks for the vision to be at a point when patients may get updated glasses if needed.  Most patients simply need readers for small print and nothing else.

Final visual outcome is dependent on numerous factors.  Assuming that your eyes are normal without any other diseases, such as macular degeneration, glaucoma, etc.., INTRAOCULAR LENS selection will dictate HOW you see after cataract surgery.

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