Understanding Cataract Surgery: Types, Risks, and Post-Operative Care

Cataract surgery is a common and normally safe procedure designed to treat cataracts, which occur when proteins clump together and cloud the eye’s natural lens. This clouding gradually worsens, leading to vision impairment and, in severe cases, blindness.

The eye’s lens, located behind the iris and pupil, plays a crucial role in focusing on objects at various distances. When cataracts develop, they interfere with this function. During surgery, an ophthalmologist removes the cloudy lens and typically replaces it with an artificial one. This outpatient process does not require a hospital stay, allowing for a quick recovery.

How Long Does Cataract Surgery Take?

Cataract surgery typically lasts 10 to 15 minutes. However, the entire appointment may take several hours, including preparation and recovery. Consult your ophthalmologist about the expected duration so you can inform your driver in advance.

Signs Indicating the Need for Cataract Surgery

As you age, your chances of developing cataracts increase, and they tend to worsen over time. Cataracts can affect your vision in diverse ways, including:

• Blurry vision
• Impaired night vision
• Colours appear faded
• Sensitivity to glare and bright light
• Halos around light
• Double vision

Cataracts can be hereditary or present at birth. Congenital cataracts are the main cause of childhood blindness. However, performing surgery within the first six weeks gradually improves the chances of a successful outcome.

Types

Cataract surgery is not effective in restoring vision loss resulting from eye conditions like macular degeneration, glaucoma, or diabetic retinopathy. Some of the most often used cataract surgery methods among reliable sources are:

• Phacoemulsification – The certified surgeon will make a 2- to 3-millimetre-long incision in front of your eye for an ultrasonic probe during phacoemulsification. The probe uses vibration to break up the cataract and suction to remove fragments. After that, a foldable lens is put through the incision.
• Manual Extracapsular Cataract Surgery (MECS) – In MECS, the surgeon creates a larger incision, typically 9 to 13 millimeters, to remove the natural lens before implanting the intraocular lens (IOL). The bigger incision increases the risk of complications compared to phacoemulsification. However, MECS remains widely used in many regions due to its affordability.
• Manual minor incision cataract surgery (MSICS) – MSICS is a modification of the MECS method. It entails a smaller V-shaped incision on the outside of your eye and a broader incision on the inside. According to a 2013 study, phacoemulsification and MSICS had equivalent long-term outcomes. However, phacoemulsification may have superior short-term benefits in the three months following surgery, although MSIC is less expensive.
• Femtosecond laser-assisted cataract surgery (FLACS) – During the FLACS surgery, a medical surgeon may use a laser instead of a manual incision to make an incision in your eye. Furthermore, the laser can divide and soften the cataract, requiring less phacoemulsification energy to eliminate it. This can result in faster healing. Finally, the laser can perform an arcuate incision to correct astigmatism. Astigmatism occurs if the front of the eye is uneven, resulting in impaired vision. This increases the chances that you will be able to function without glasses. This approach, however, is more expensive than others. Whether the marginal advantages outweigh the costs is currently being debated.
• Intracapsular cataract surgery – It is an older treatment in which the lens capsule and entire lens are removed from the eye through a large incision. It is rarely performed nowadays due to the considerable risk of consequences.

Options for Lenses for Post-Cataract Surgeries

You have various alternatives for substitute lenses for your natural eyes. Your lifestyle and budget determine the sort of lens you should choose.

Monofocal lenses – The most frequent form of lens replacement is monofocal lenses, usually covered by insurance. However, insurance companies may deem other lenses to be a premium and not covered.

Monofocal lenses are designed to offer the best vision at a single distance. As a result, people frequently set them for farsightedness and wear reading glasses for close vision.

Toric lenses – This type of lens helps in correcting astigmatism. Toric lenses provide a 98% likelihood of achieving 0.75 diopters or less and a 94% chance of reaching 0.5 diopters or less, enhancing visual clarity.

Extended depth-of-focus – One correction zone is stretched in the extended-depth-of-focus lenses to improve your distance and intermediate vision. This is useful for using the computer and doing a variety of tasks.

Accommodating monofocal lenses – Unlike typical monofocal lenses, accommodating monofocal lenses allow you to modify the focal distance based on the activity of your eye muscles.

Multifocal lenses – By dividing the light, these glasses allow you to view far away and close objects. The drawback is that light splitting can generate halos and starbursts in certain people’s vision. You should talk to your doctor about it.

Preparatory Steps

A week before your treatment, an eye doctor will gather measurements. This will assist them in determining your eye’s size and shape and the best course of action for your surgery. They will also inquire as to whether you have been on drugs. They may give you eye drops to use before the surgery.

Cataract surgery is often performed in an outpatient surgery center or hospital, so you will not be required to remain overnight. However, you should plan a ride home once the surgery is finished. Your healthcare provider may advise you not to eat solid foods for 6 hours before surgery. You should also abstain from alcohol for at least 24 hours before the procedure.

Procedure

The precise procedure used by your physician will be determined by the surgical technique used. If you still have cataracts in both eyes, your procedures will most likely be weeks apart. Although there are a few commonly used phacoemulsification techniques that one can expect:

• A local anaesthetic injection or eye drops will be used to numb your eye. You will be awake during the procedure but unable to see what your surgeon is doing. You may be given a sedative to help you relax in some circumstances.
• While making a small incision in the front of your eye, your surgeon will look at it via a microscope. The ultrasonic probe will then be inserted into the incision to break up your lens and eliminate the cataract. Next, suction will be used to extract the pieces with the removal probe.
• A foldable lens implant will be introduced via the incision and placed in the place of your original lens. Stitches are usually not required with this technique.
• After your procedure, you will be asked to rest in a recovery facility for around 30 minutes before going home.

Complications

Like any other surgical procedure, cataract surgery comes with potential risks and complications. Some patients may develop an eye infection, experience bleeding inside the eye, or have persistent swelling in the front or the eye’s inside. Swelling of the retina at the eyes’ back can also occur. In more serious cases, the retina may detach from the back of the eye, causing more vision problems.

Other possible complications include damage to different parts of the eye, continuous pain that does not improve with over-the-counter medication, and blurred vision. Some patients may also see halos, glare, or dark shadows. In certain cases, the intraocular lens (IOL) implant may shift out of position, affecting vision.

Cataract surgery cannot reverse vision loss caused by other eye conditions like macular degeneration, glaucoma, or diabetic retinopathy. Your ophthalmologist will discuss the potential risks and advantages of the procedure to guide you in making an informed choice regarding your eye care.

Frequently Asked Questions