Surgical Techniques for the Removal of Cataracts

Ophthalmologists use three different methods to remove a cataract.

1. Phacoemulsification: The most common surgical technique is phacoemulsification (pronounced "fay-ko-emul-sa-fah-kay-shun"). You may hear your ophthalmologist use this term.

Viewing the eye through a high-powered microscope placed above the patient, the ophthalmologist makes a three-millimetre incision at the junction where the cornea meets the sclera. A small probe, which vibrates at high frequencies, is inserted to divide the cloudy lens into small pieces. The pieces are gently suctioned away from the
lens capsule through the incision. Small instruments are used to remove lens fragments if they are difficult to remove.

The artificial lens is usually inserted into the lens capsule. However, in some cases, the artificial lens may have to be placed in front of the iris.

The incision is normally so small that it often requires no stitches, or perhaps only one or two. After surgery, the eye is covered with a shield for protection.

The operation usually takes from 20 to 60 minutes.

2. Extracapsular Cataract Extraction: This technique is used less commonly. It is effective for those patients whose lens nucleus is too hard to remove using phacoemulsification and suction.

The ophthalmologist makes a 10 to 12 millimetre incision at the border of the cornea and the sclera. The front of the capsule is opened, and the lens is removed. An intraocular lens is inserted and fixed in positioned. The incision is then closed with several sutures.

Inflammation caused by the procedure usually takes several days or weeks to settle down completely. Vision may remain hazy or cloudy during that time. Over the next three months, vision should slowly improve.

3. Intracapsular Extraction: The ophthalmologist removed the entire lens and lens capsule. This technique is rarely used and only in special cases.

Cataract Surgery on the Second Eye: If both lenses are affected by cataracts, your ophthalmologist will usually wait until the first eye has healed before operating on your second eye.

Pre-existing conditions: In some cases, pre-existing medical problems may interfere with the successful visual outcome that the patient was hoping for. For example, this may occur in people with glaucoma, macular degeneration or other serious eye conditions.

Even if the cataract surgery is successful in such patients, there is a possibility that vision will be improved only slightly or not at all.