Introduction
A cataract surgery is an operation performed on the eye to remove the lens. It is done to treat cataracts, where there is usually clouding of the lens.
It is quite a common surgery, especially among older individuals who tend to have a number of eye problems. The procedure takes less than hour. Replacement with a lens implant (intraocular lens) follows the removal of the opacified lens. The surgery is considered safe and effective in restoring proper vision.
Types of surgery
- Phacoemulsification – The surgery involves use of an ultrasound probe. After a small incision, the probe goes into the cataract. Through the transmission of ultrasound waves, the cataract emulsifies / breaks up. The probe then suctions out the small cataract fragments. The posterior capsule of the lens is left for the artificial lens to lie on. Stitching is not usually necessary after this surgery.
- Extracapsular cataract extraction (ECCE) – The procedure requires larger incisions than those in phacoemulsification. The lens is removed in one piece together with the anterior lens capsule. The surgery requires stitching due to the large incision.
For both procedures, the advanced laser techniques may be used to make the incisions. It can also be used to break the cataract for easy removal.
Purpose
A cataract surgery is recommended for individuals with cataracts. Cataracts cause clouding of the normal eye lens. The lens is responsible for refracting light on the retina. Obstruction such as due to cataracts causes blurred vision.
Cataracts are associated with old age but can also affect young persons. Besides diminished vision, other symptoms include sensitivity to light, seeing halos around lights, and fading of colors.
The surgical procedure is done to remove the clouded lens. The cataract does not have to be removed immediately if it causes no problems. However, where it interferes with normal day to day activities such as work, reading, or watching, it should be removed. It is also recommended when the affected individual has to depend on others due to the cataract.
Cataracts may also make it difficult for doctors to examine the eyes for other problems. In this case, the surgery is necessary. The aim of the surgery is to improve vision in those affected.
Preparation & expectation before surgery
Before undergoing surgery, some of the preparations required can include:
- A comprehensive eye test – It is meant to examine the eye for underlying conditions that may not allow for the surgery. The test is also done to determine the size and shape of the eye in order to choose a proper lens.
- Stopping some medications – Some drugs interfere with the surgical procedure and may cause bleeding. Due to this, the patient may have to stop taking them for a period of time before the operation.
- Avoiding foods and drinks – The patient is required to fast for about 12 hours before undergoing the procedure to prevent certain complications.
- Discussing the replacement lens – The eye care professional and the patient should discuss the type of lens that is appropriate. Based on the focusing ability, there are astigmatism correction lenses, multifocals, accommodating focus monofocals, and fixed focus lenses. The lens can be plastic, acrylic, or silicone.
- Use of antibiotic eye drops - They are necessary to prevent infections during the surgery.
Procedure
The surgery takes a short time and is carried out with the patient awake. Usually, the professional uses anaesthetics to numb the eye. In some cases, a sedative may help relax the patient.
The doctor issues an antibiotic injection to prevent an infections during the surgery. This is followed by an incision on the transparent surface of the eye known as the cornea. The cut is then made on the lens capsule and the lens is removed. The lens can be removed wholly as is the case in ECCE or in fragments through the phacoemulsification process.
Finally, the eye may be stitched depending on the size of the incision. The patient may wait for a short while before leaving the hospital.
After care, recovery, results
The intraocular lens does not need any care. However, the patient may need to take eye drops to reduce inflammation, prevent infection, and regulate eye pressure. Doctors may also recommend eye patches in some instances.
After the surgery, vision improves significantly within days. Patients can, however, expect blurry vision, itching, and discomfort within the first few days. Colors may also appear unusually brighter. It is recommended that follow-up be done regularly afterward.
Risks & complications
As with any other surgery, there are risks to a cataract surgery. Though not common, complications can include:
- Infection – Microorganisms can find their way into the eyes during the surgery or after when no preventive measures are taken. Individuals who get infections will complain of sensitivity to light, redness, and problems with vision. The solution to this is usually to take antibiotic drugs.
- Inflammation – The surgery may result in swelling and redness of the eye. It is not a problem in the first few days but if it persists, the patient should report to the doctor.
- Detachment of the retina – In severe cases, the retina may pull from the back after the surgery. The detachment can result in loss of vision. Symptoms of the complication include seeing floaters or flashes of light.
- Bleeding – It may occur for no identifiable reason. The bleeding does not cause much problem if little. However, a lot of bleeding can cause vision loss.
- High eye pressure – Fluid may build up due to the surgery, what is referred to as ocular hypertension. The raised pressure decreases vision and can lead to glaucoma where the optic nerve gets damaged.
- Secondary cataract – Eventually, a cataract surgery may result in a secondary cataract. It occurs due to the back part of the clouded lens that is left behind. The condition is known as posterior capsule opacification (PCO).
