This article was originally published on The Conversation.
Cataract surgery is one of the most popular and commonly performed procedures globally. The majority of patients have great results with few issues.
Here are the statistics:
- By age 80, More than half of all Americans have cataracts.
- Nearly 4 million cataract surgeries are done in the U.S. every year Over 90% of patients achieve.
- 20/20 vision with glasses after the surgery , however, those with other eye conditions may not have the same level of success, including those with, a condition usually linked to elevated pressure in the eye; glaucomadiabetic retinopathy , which can lead to leakage in the retinal tissues; andmacular degeneration , a condition usually associated with age.The rate of post-surgery infection from endophthalmitis
- The is below 0.1%. As eye specialists who have
done thousands of these procedures , we know that many patients have misunderstandings about both cataracts and the surgery. For example, some believe a cataract is a growth on the eye’s surface.We like to compare a cataract with the frosted glass of a bathroom window, where light can be transmitted but details cannot. Or when turbulence from a storm causes normally clear water in the ocean to become murky. In much the same way, the eye’s once transparent lens becomes cloudy.
About the procedure
Cataract surgery removes the clouded lens of the eye and replaces it with a new, clear lens to restore your vision. Many patients report the procedure is painless.
usually an elective surgery
It’s that is done on an outpatient basis. The patient is often awake, under local anesthesia, with sedation similar to that used for dental procedures. We like to say patients receive the equivalent of three margaritas in their IV. Numbing drops are then applied to the eye’s surface, along with an anesthetic inside the eye. Patients with claustrophobia, or movement disorders such as Parkinson’s disease, may not be suitable candidates for awake surgeries and require general anesthesia.
Before surgery, patients receive dilating drops to make the pupil as large as possible. The surgeon makes a tiny incision, usually with a small pointed scalpel, between the clear and white part of the eye to gain access to the
lens capsule , a thin membrane similar in thickness to a plastic produce bag at the grocery store.This capsule is
supported by small fibers called zonules , which are arranged like the springs that support a trampoline from a frame. The surgeon then creates a small opening in the capsule, called a capsulotomy, to gain access to the cataract. The cataract is then broken into smaller parts so they are removable through the small incision.This is similar to a small jackhammer, breaking the large lens into smaller pieces for removal. That sounds scary, but it’s painless. Ultrasound emulsifies the lens and vacuum power then aspirates it from the eye.
Laser-assisted cataract surgery
has been found to have similar outcomes to traditional cataract surgery. Complications are rare
Severe complications, such as postoperative infection, bleeding in the eye or a postoperative retinal detachment are rare; they occur in approximately 1 in 1,000 cases. But even in many of these situations, proper management
can recover useful eyesight Capsular complications deserve more discussion. Some studies suggest that they happen.
in up to 2% of cases . If a hole or tear in the back of the eye called the vitreous occurs during cataract surgery, the clear gel may move to the front of the eye.If that occurs, the gel must be taken out during the cataract surgery. This will reduce the chance of more complications after the surgery, but those who have the procedure, known as a vitrectomy , are at a higher risk for more complications, including infections and swelling after the surgery.
After the surgery, patients generally go home right away. Most surgery centers require that the patient have someone drive them home, more for the anesthesia than the surgery. Patients start using postoperative drops on the same day and must wear an eye shield at bedtime for a few weeks after the surgery. Patients should keep the eye clean and avoid exposure to dust, debris and water. They should try not to bend over and should avoid heavy lifting or straining in the first week or so after the surgery. Lifting or straining can cause a surge of blood pressure to the face and eye.Known as a choroidal hemorrhage
, it can lead to bleeding into the wall of the eye and be devastating to vision.
Activities that cause only moderate increases in heart rate such as walking are acceptable. Routine postoperative check-ups are typically done the day after the surgery, about a week after the surgery, and about a month after the surgery.
A choice of lens The plastic lens used to replace the cataract, orintraocular lens
, needs careful sizing for best results and a detailed discussion between patient and surgeon.
Early intraocular lens technologies
were monofocal , and most patients with these lenses chose distance correction and used reading glasses for near tasks. This isstill the preferred approach
for about 90% of patients having cataract surgery today. Recent advances have led tointraocular lenses that offer multifocality – the opportunity to have near as well as distance vision, without glasses. Some multifocal lenses are even in the trifocal category, which includes distance, near, and intermediate vision, the latter of which in recent years has become very important for computer and phone use. Most patients with these advanced technology multifocal lenses
are happy with them . However, a small percentage of patients with multifocal lenses can be so bothered by visual disturbances – notably night glare and halos around light sources in the dark – that they request removal of the multifocal lens to exchange it for a standard intraocular lens. These exchanges are a reasonable option for such situations and offer relief for most affected patients. Identifying who’s an ideal candidate for a multifocal intraocular lens is an area of active research. Most clinicians would recommend against such a lens for a patient with a detail-oriented personality. Such patients tend to
focus on the shortcomings of these lenses despite their potential benefits.Like many other technologies, current advanced technology intraocular lenses are much better than earlier versions. Future options are likely to provide improved vision and fewer side effects than those currently available.
However, these newer lenses are often not covered by insurance companies and frequently involve significant out-of-pocket expenses for patients.
Choosing the best type of lens can be complex. Luckily, unless there are special circumstances, such as a cataract forming after an eye injury, there is usually no rush for adult cataract surgery.
Eye doctors discuss the upcoming procedure that millions of people are expected to undergo. substantial out-of-pocket costs for patients.
Deciding on what type of lens is best for you can be complicated. Fortunately, except in unusual circumstances, such as when a cataract develops after trauma to the eye, there is seldom a hurry for adult cataract surgery.
