Cataracts - Resources

Highlights	Prognosis	Treatment
Introduction	Prevention	Surgery
Causes	Symptoms	Resources
Risk Factors	Diagnosis	References

Surgery

Preparation for Surgery

Cataract surgery is usually done as an outpatient procedure under local anesthesia and takes less than an hour. Preoperative preparations may include:

Having a general physical examination is important for patients with medical problems such as diabetes. Diabetes can cause damage to the blood vessels of the eye’s retina, a condition called diabetic retinopathy. Recent research suggests that patients who have diabetic retinopathy and poor blood sugar control should not have their blood sugar rapidly corrected before cataract surgery. Correcting blood sugar too quickly before surgery may cause vision problems after surgery.
Reviewing all medications with the ophthalmologist. In particular, men who take tamsulosin (Flomax), or similar drugs for prostate problems, require special surgical techniques to prevent complications.
The ophthalmologist will use a painless ultrasound test to measure the length of the eye and determine the type of replacement lens that will be needed after the operation.
Topical antibiotics (such as ofloxacin or ciprofloxacin) may be applied preoperatively to protect against postoperative infection.
Most healthy patients receive either a local injection or topical anesthetic. They may also receive a sedative. Some patients may need general anesthesia.

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Surgical Procedures

All cataract procedures involve removal of the cataract-affected lens and replacing it with an artificial lens.

Phacoemulsification. Phacoemulsification (phaco means lens; emulsification means to liquefy) is the most common cataract procedure performed in the United States.

The procedure generally involves:

The surgeon makes a small incision.
A thin probe that transmits ultrasound is used to break up the clouded lens into small fragments.
The tiny pieces are sucked out with a vacuum-like device.
A replacement lens is then inserted into the capsular bag where the natural lens used to be. In most cases, this is an intraocular lens (IOL), which is foldable and slips in through the tiny incision.
Because the incision is so small, it is often watertight and does not require a suture afterward, particularly if a foldable lens has been used. A suture may be needed if a tear or break occurs during the procedure or the surgeon inserts a rigid lens that requires a wider incision.