3 Types of Cataract Surgery

Cataracts are the largest single contributor to reversible blindness worldwide, so it’s a good thing that the condition can be reversed. Cataracts can be removed through surgery, which is a very common procedure and medically proven as safe. In fact, it has a 90% success rate, according to the National Eye Institute.

If you want to know more about the different approaches to correcting cataracts and clearing up your cloudy vision once and for all, read on and learn more!

Why is cataract surgery necessary?

Cataract surgery eliminates the cloudiness of the eye lens. The process entails artificial lens replacement to correct your vision. It’s a one-time procedure—if you had cataracts removed from one eye, you won’t have the same problem in that eye ever again.

When considering cataract surgery, ask yourself these:

• Can you safely do your job and drive?
• Do you have problems reading or watching television?
• Is it difficult to cook, shop, do yard work, climb stairs or take medications?
• Do vision problems affect your level of independence?
• Do bright lights make it more difficult to see?

Types of cataract surgery

Phacoemulsification

Phacoemulsification is a surgical procedure that uses an ultrasound probe to break up the cloudy lens for removal. First, the surgeon inserts a microscopic probe into the lens where the cataract has formed, through a tiny incision into the cornea. This probe transmits ultrasound waves to break up or emulsify the cataract so the surgeon can remove it in miniscule pieces.

The lens capsule, found at the back of your lens, is left intact so that it will hold the new artificial lens in place. Typically, the incision of this size is self-sealing, so it does not require sutures.

Extracapsular surgery

This surgery is a less frequently used approach that removes the lens as one piece through a larger incision. The doctor will use surgical tools to remove the front capsule and the natural lens containing the cataract. The back lens capsule is also left in place to support the new, artificial lens.

This cataract treatment is carried out when phacoemulsification cannot break up the hard and mature cataract. Stitches are required to close the large incision.

Laser-assisted cataract surgery

Laser-assisted cataract surgery allows the surgeon to use the laser to make the opening in the capsule and soften the cataract. A camera or ultrasound device is placed over your eye to map out the surface. The information gathered is transmitted to a computer that programs the exact location, size, and depth for incisions.

Instead of manual instruments, this approach uses a laser device. It will provide the same outcome as traditional cataract surgery, except for the tools and methods used. Whether traditional or laser surgery is right for you will depend on many factors that can only be assessed by your surgeon.

What is an artificial Intraocular Lens?

After removing the cataract, it will be replaced by an artificial one called an intraocular lens (IOL). An IOL is a precisely engineered lens that is usually made of high-quality acrylic or clear plastic. It focuses the light onto the retina to improve your vision. It also comes with a special coating to protect your eyes from harmful UV rays.

Like prescription eyeglasses or contact lenses, IOLs come in different focusing powers. To set this, your ophthalmologist needs to measure the length of your eye and the curve of your cornea.

Unlike a contact lens, an IOL is fixed permanently inside the eye with no need for any maintenance. Once it is in place, you will not feel or see the lens at all.

Types of intraocular lenses

Although all intraocular lenses are used to restore clarity of vision, there are many types of intraocular lens choices available today, with specific functions.

Source: American Academy of Ophthalmology

Replacing a cloudy lens and wearing glasses may be enough for some people. Others prefer to get the best possible vision without any glasses. Ophthalmic surgeons will help you choose the right lens for you according to your budget, goal and lifestyle.

Tap here to read more about the different lens technologies available at our clinic.

How do you prepare for cataract surgery?

Immediately after surgery, your vision may be blurry, so it’s essential to arrange for someone to take you home or help you move around.

To ensure your safety, your doctor will also ask about any medications or natural health products you are taking, as there are some that you may need to stop temporarily on or before the day of surgery. Some of these medications and supplements may increase the risk of complications during your surgery. Your doctor will outline what to avoid or provide alternatives. As such, see to it that you follow these specific instructions.

You may also be asked to hold off on any oral intake for up to 6 hours before the surgery. Failure to follow these dietary restrictions may cause the cancellation of your procedure.

What to expect during cataract surgery?

Besides physically preparing for cataract surgery, knowing what to expect helps ease your anxiety over the procedure. Typically, these are the following steps involved in cataract removal and lens replacement:

• To numb your eye, the surgeon may use anaesthetic eye drops or injections.
• A small incision is made along the side of the cornea.
• A high-frequency ultrasound device or laser breaks the cloudy lens into small fragments.
• Once the lens is fragmented, it is gently removed from the eye using suction.
• Once the fragments are suctioned off, the surgeon places the IOL behind the pupil, the exact spot where your natural lens was situated.
• The incision will heal on its own without any stitches.
• A protective shield is placed over the eye to secure it during the early stages of recovery.
• If surgery is necessary for both eyes, your surgeon will typically wait for a few days or weeks. This time frame gives the first eye time a chance to heal and for the surgeon to understand the refractive outcome

What can be expected after the procedure?

After cataract surgery, your vision will be blurry at first, but it will begin to improve within a few days. A cataract may mute the colours and cause your vision to appear yellow or brown-tinted, but colours may seem brighter after surgery.

You must continue to wear a protective shield for as long as your surgeon says. You may also be prescribed eye drops or medications to prevent infection, reduce inflammation and control eye pressure.

It’s normal to feel some mild discomfort and itching for a couple of days after surgery. Avoid rubbing or pushing on your eye. After a few days, most of the discomfort should disappear, and complete healing is often achieved within four weeks.

You may be required to see your cataract surgeon a day after surgery, the week after that, and then again after a month to monitor healing. Your doctor will let you know when your eyes have finally healed for you to get a final prescription for eyeglasses, around one to three months after surgery.

To get in-depth knowledge about the different types of cataracts, or cataract treatment in general, schedule a consultation with us today. At JL Eye Specialists, our medical director Dr Jimmy Lim who is a fellowship-trained cataract and refractive surgeon can help you personalise and form a treatment plan for your cataract concerns.