An In-Depth Look at the Cataracts Surgery Procedure

How are cataracts removed from the eye?

There are currently two methods of cataracts removal. One is known as the small incision method and the other the large incision method.

In the small incision cataracts removal process a very tiny incision is made in the cornea with the use of an extremely thin blade, usually made from a diamond. The slit is then widened slightly to form a circular opening. A procedure using a phacoemulsification machine is used to remove the inner nucleus of the lens. The phacoemulsification instrument is inserted into the small slit previously made and the end of this machine, made of a piece of metal probe, vibrates back and forth at a very high frequency (50,000 cycles per second) resulting in the emulsification (or breaking down into small pieces) of the central nucleus. The next step is to aspirate, or suck out, the broken up pieces of lens.

A few other minor steps are completed in order to remove any left over sections of lens. At this point the intraocular lens (IOL) is placed into the region where the natural lens was just removed from. To insert the IOL, it is first folded, and then gently pushed through the circular hole that was originally made in the cornea. Once the IOL has been placed inside, it unfolds on its own and takes on the permanent shape as the new lens. There is no sewing or stitching required, the lens will remain in place. Finally, an eye drop solution of saline is added to bring back the correct intraocular pressure within the eye.

Before more advanced methods had been developed, a majority of cataracts surgeries were performed using the large incision cataracts removal process. A larger cut was made, the cataracts removed in whole, without being broken up, an IOL placed into the region, and the eye was either stitched or sutured back up. Larger incisions entailed greater risks and an increased possibility for a longer recovery time. With the introduction of the small incision cataracts surgery, many of these problems have been eliminated. In some cases, large incision cataracts surgery must still be performed but the surgeon conducting the surgery will discuss this option with the patient should it become necessary. Likewise, in cases where a cataracts must be removed from a child or baby, the process is similar to one of the above methods.

The Replacement IOL

The replacement IOL, as discussed in the section Types of Intraocular Lenses, can be monofocal or multifocal. Regardless of the type, each one is centered in the eye upon replacement and is held there without any form of stitching or suturing. There are two flexible supports on each side of the lens which help to hold it in place within the eye through tension-loaded springs. Once the artificial lens is placed into position, there is no worry of it falling out or moving around within the eye.

After Surgery Symptoms

Some patients may find that they have some minor symptoms after surgery. This is common. Among the most commonly experienced symptoms are sensitivity to light and blurred vision - sometimes with halos around objects. Often patients will have watery eyes, or a feeling of sand being behind the eyelids. Eye redness may also occur and the dilation of the pupil may persist for one to two days after surgery. All of these symptoms will dissipate and disappear within a few days following the procedure.

Recovery Instructions Most surgeons will run down the list of does and don'ts after surgery. The list will depend on the type of surgery that was performed and the health condition of the patient. In many cases there are few, in any, limitations. If small incision surgery was performed the patient will be given full permission to carry on normal, everyday functions. However, if large incision surgery was used there will be a greater number of restrictions as the muscles and the walls of the eye may have been weakened. Straining, heavy lifting and bending should all be curtailed for the period recommended by the surgeon after large incision cataracts surgery.

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