Types of Cataract Surgery
Phacoemulsification (Phaco)
- Procedure: A small incision is made in the cornea. An ultrasound probe is inserted through this incision to break up (emulsify) the clouded lens into tiny pieces, which are then suctioned out. An artificial intraocular lens (IOL) is implanted to replace the natural lens.
- Advantages: Minimal incision size, shorter recovery time, fewer complications.
Extracapsular Cataract Extraction (ECCE)
- Procedure: A larger incision is made in the cornea to remove the cloudy lens in one piece. An IOL is then implanted. This method is less commonly used due to the larger incision required.
- Advantages: Suitable for very advanced cataracts where phacoemulsification is not feasible.
Intracapsular Cataract Extraction (ICCE)
- Procedure: The lens and the surrounding capsule are removed in one piece through a large incision. This method is rarely used today.
- Advantages: Historically used for specific complications but now largely obsolete due to advancements in techniques.
Intraocular Lenses (IOLs)
Monofocal IOLs
- Description: Provide clear vision at one distance (either near, intermediate, or far). Glasses may still be needed for other distances.
Multifocal IOLs
- Description: Provide multiple focusing distances, potentially reducing the need for glasses.
Toric IOLs
- Description: Correct astigmatism and provide clear vision at one distance.
Accommodative IOLs
- Description: Change shape or position within the eye to allow focusing at multiple distances.
The Surgical Procedure
Preoperative Preparation
- The eye is numbed with anesthetic drops, and a sedative may be given to help the patient relax.
Incision
- A small incision is made in the cornea.
Lens Removal
- The clouded lens is broken up using ultrasound (phacoemulsification) and removed.
IOL Implantation
- The artificial lens is folded and inserted through the incision, then unfolded and positioned in the lens capsule.
Incision Closure
- Often, the small incision heals on its own without the need for stitches.
Recovery
Immediate Post-Op
- The patient may wear an eye patch or shield for protection. Vision may be blurry initially but typically improves within a few days.
Activity Restrictions
- Avoid strenuous activities, bending over, and heavy lifting for a few weeks. Follow specific instructions from the surgeon.
Medications
- Use prescribed eye drops to prevent infection and inflammation.
Follow-Up Visits
- Attend all scheduled follow-up appointments to monitor healing and address any issues.
Potential Complications
Infection
- Though rare, it can be serious if it occurs.
Inflammation
- Usually controlled with medications.
Swelling
- Corneal or retinal swelling may occur.
Lens Dislocation
- The artificial lens may move out of place.
Posterior Capsule Opacification (PCO)
- Clouding of the lens capsule, treatable with a quick laser procedure (YAG laser capsulotomy).
Retinal Detachment
- Though uncommon, it’s a serious complication requiring prompt treatment.
Long-Term Outlook
Visual Improvement
- Most patients experience significantly improved vision. Glasses may still be needed for certain tasks, depending on the type of IOL.
Routine Monitoring
- Regular eye exams to monitor eye health and vision.
Cataract surgery is highly effective and can greatly enhance quality of life by restoring clear vision. Discussing options with an ophthalmologist will help determine the best approach and type of IOL for individual needs.
