 CATARACT
SURGERYSeveral different procedures have been developed to remove cataracts. Currently the preferred technique in most cases is phacoemulsification. Extracapsular Extraction: This is a rather old technique in which a 12mm incision is performed in the eye to extract the lens as a whole. The lens' capsule is left in place to hold an intraocular lens. Multiple sutures are required to seal the eye after surgery. These sutures must be carefully tightened not to produce astigmatism. Phacoemulsification: Phacoemulsification ("phaco") was developed in the search for a way to extract cataracts through a smaller incision. It has become the preferred technique for cataract extraction. An ultrasound or laser probe is used to break the lens apart without harming the capsule. These fragments are then aspirated out of the eye. A foldable intraocular lens (IOL) is then introduced through the 3mm incision. Once inside the eye, the lens unfolds to take position inside the capsule. No sutures are needed, as the incision is self-sealing. The risk of astigmatism and sudden pressure changes inside the eye are minimized. The procedure is safe enough to be done under topical anesthesia (anesthetic eyedrops). Visual rehabilitation is extremely fast and patients don't need to suspend their everyday activities. Who will benefit from phacoemulsification? Most people suffering from cataracts will benefit from this procedure. Best results are obtained in persons with early cataracts. It is preferable not to wait until the cataract is ripe and vision is excessively low since the cataract will be to hard for the phacoemulsifier. Surgery is indicated as soon as vision is not adequate for daily activities. Is phacoemulsification safe? In the hands of a good surgeon phacoemulsifiaction is extremely safe due to these advantages:
Just as any other surgical procedure, phacoemulsification has risks. One out of a hundred persons operated on with this technique has some sort of complication. In almost every case there is a solution to the problem. Severe complications are extremely rare. How should I prepare for phacoemulsification? No special preparation is needed for phacoemulsifiaction. Your ophthalmologist should make sure there are no associated pathologies, which can interfere with the prognosis, by making an extensive examination of your eyes including pupil dilation. A measurement of your eye's length and corneal curvature is crucial for calculating the power of the intraocular lens to be implanted. What should I do during surgery? During surgery you will be lying on the operating bed. The operating microscope will be in front of you and you will always see the microscope's bright light. Your face will be covered with sterile drapes and oxygen will be provided under them. You should never touch these drapes. A small device will hold your lids open. During the procedure you should keep your eye as still as possible. The best way to achieve this is by looking at a single point throughout surgery. Usually the operating microscope's light is a good reference point. You will feel the hands of the surgeon on your forehead and the sound of the phacoemulsifier, similar to that of a hair trimmer. You will occasionally feel cold water over your eye that may even go down your cheek. This is the solution needed to keep your eye properly hydrated. Is phacoemulsification painful? How long does it take? Phacoemulsification is performed under topical anesthesia (anesthetic eyedrops). No injections or general anesthesia are required. The patient is awake during the procedure feeling no pain at all. Phacoemulsification takes about 15 minutes per eye. Once finished, you will go home without need for hospitalization. What should I do after surgery? It is important not to squeeze your eye the first couple of days after surgery. Normally there will be some foreign body sensation, similar to having an eyelash in your eye. No bandages are required so the patient walks out of the operating room by his own means even though vision will be blurry for 2 or 3 days. Eyedrops will be prescribed for 2 to 3 weeks. Two weeks after surgery you will be able to perform any activity without risk. What results can I expect? Over 90% of people achieve a vision better than 20/30 after phaco. If there is some kind of a retinal condition this could not be the case. Reading glasses are the rule after cataract surgery (in many cases they were also required before surgery due to presbyopia). Can a second procedure be necessary? In some cases the capsule may opacify some time after surgery, compromising vision. In these cases a central perforation in the capsule is required to restore vision. This is called a capsulotomy and is achieved with a YAG laser. The capsulotomy is performed as an outpatient procedure and produces no pain. No anesthetic is necessary and rehabilitation is immediate. Clínica Reinoso - Colombia WARNING! The information and/or responses in this eye care education service are not intended to replace consultation with an ophthalmologist. This service contains general eye care information only. Only a doctor can diagnose and treat a medical condition. In NO CASE will Clínica Reinoso or any doctor or sponsor be held liable for any decisions you may make upon reliance of such information. Updated: February 9, 2000 |