Cataracts - Resources

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Click the icon to see an illustrated series detailing cataract surgery.

Phacoemulsification requires only local anesthesia. Newer methods for administering local anesthesia produce few complications. Most phacoemulsification procedures now take about 15 minutes, and the patient is usually out of the operating room in about an hour. There is little discomfort afterward, and visual rehabilitation takes about 1 - 3 weeks.

Phacoemulsification is sometimes combined with glaucoma surgical procedures, for patients who have both glaucoma and cataracts.

Extracapsular or Intracapsular Cataract Extraction. Extracapsular cataract extraction, the original standard procedure, is now generally used only in patients who have an extremely hard lens. It typically involves the following steps:

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• The surgeon works under an operating microscope to make a small incision in the cornea of the eye.
• The surgeon extracts the clouded lens through this incision.
• The capsule is left in place, which adds structural strength to the eye and enhances the healing process. (Less commonly in intracapsular cataract extraction, the surgeon removes the lens and the entire capsule. This procedure has greater risks for swelling and retinal detachment.)
• A replacement lens is then usually inserted.
• A small suture is needed to stitch the incision together.

It takes about 2 - 4 weeks for vision to be completely restored.

Replacement Lenses and Glasses

With the clouded lens removed, the eye cannot focus a sharp image on the retina. A replacement lens or eyeglasses are therefore needed:

Intraocular Lenses (IOLs). In about 90% of cataract operations, an artificial lens, known as an intraocular lens (IOLs), is inserted. Most IOLs are made out of acrylic, although other materials, such as silicon, are also used.

IOLs are designed to improve specific aspects of vision. The choices include:

• Lenses that address a single fixed focal point. Such lenses are suitable either for reading or distance vision, but not both. If a distance lens is implanted, the surgeon prescribes glasses or contact lenses for reading. If a reading lens is implanted, lenses for seeing distances will be prescribed.
• Lenses that address multifocal points. Multifocal lenses can focus at different points for both reading and distance vision. However, contrast may be reduced, and some patients experience glare and halos, particularly at night.
• Lenses are available to correct astigmatism after cataract surgery.