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Throughout recent years, cataract surgery has
greatly benefited from advances in technology and
the development of new techniques.
Initially, cataract surgery required a long waiting
period characterized by deteriorating vision while
the cataract "ripened," an extended and restrictive
recovery period, as well as the need for
unattractively thick "cataract" glasses or special
contact lenses to achieve useful vision after
surgery. |
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Now, the surgery
has evolved into a relatively simple, out-patient
procedure. The stay at an ambulatory surgery center
is just a few hours and recovery time after surgery
is dramatically reduced. Many people enjoy improved
vision with minimal dependence upon corrective
eyewear as a result of modern cataract surgery. |
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The Evolution
of Cataract Surgery |
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A few short years
ago, the accepted method of cataract surgery was to
open the front portion of the eye and pluck the
cataract out in one piece. This meant that the
cataract had to "mature" or "ripen" to the point
that it was firm, making it easier for the surgeon
to grasp. For the cataract to reach this stage,
vision in the eye became dramatically impaired,
often to the point of near blindness. |
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At first, there
were no suitable materials to use as sutures in the
eye, so the eye had to be bandaged and heal on its
own. This meant the patient was confined to bed with
their head literally sandbagged to prevent movement
that might jeopardize the healing process.
"Cataract" glasses with thick lenses or contact
lenses were required to assume the focusing power of
the natural lens, which was removed during surgery.
Unfortunately, memories of this type of have caused
many people to wait needlessly before having
cataract surgery. |
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"No-Stitch"
Cataract Surgery Using a Self-Sealing Wound |
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Although sutures
were a major advance, they have been supplanted in
most cases by the use of a self-sealing incision.
The shape of the incision creates a flap that takes
advantage of the natural fluid pressure inside the
eye to seal it shut without the need for sutures. |
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Not every
cataract surgery can be performed as a "No-Stitch"
procedure. The decision to place a suture is made by
the surgeon and always has your best interests in
mind. |
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The advantages of
"No-Stitch" cataract surgery using a self-sealing
wound include the following: |
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- Shorter surgery time
- The ability to stop surgery at any point in
the procedure
- Dramatically reduced recovery time
- Less surgically-induced astigmatism
- Less discomfort after surgery
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To perform
"no-stitch" cataract surgery, two other advances
were necessary: the development of microsurgical
techniques and the creation of foldable artificial
lens implants. |
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Microsurgical
Techniques |
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Cataract surgery
is a delicate operation that involves manipulation
of the tiny structures of the eye. High-powered
microscopes allow the surgeon to view the parts of
the eye clearly. |
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A large incision
is no longer required to allow the cataract to be
plucked from the eye like a grape. Now, just a tiny
incision is necessary so that a probe approximately
the width of a match stick can be used to remove the
cataract. By use of ultrasound, the probe dissolves
the cataract, allowing it to be gently vacuumed from
the eye. |
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Foldable
Artificial Lens Implants |
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Cataract surgery
removes the cloudy, natural lens of the eye. Once
the natural lens of the eye is gone, another means
is needed to bring light rays into proper focus upon
the retina. Thick cataract glasses and then contact
lenses were used after cataract surgery to perform
this function. Unfortunately, both offer a less than
satisfactory solution. |
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Tiny artificial
lenses, called intraocular lenses, that could be
placed inside the eye proved to be a dramatic
solution to clear vision following cataract surgery.
They are made of inert materials that do not trigger
any rejection responses by the body. Through the use
of careful measurements of the eye taken before
surgery, your doctor may be able to select a lens
power to correct for nearsightedness or
farsightedness, helping to reduce dependence upon
corrective eye wear after surgery. |
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| A small
opening is made in the front of the capsule that
holds the natural lens. |
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Illustration courtesy of Staar Surgical Co.,
Monrovia, CA |
| A tiny
incision is made to allow for the insertion of a
phacoemulsification tip which is used to remove the
cataract. By use of ultrasound, the probe dissolves
the cataract, allowing it to be gently vacuumed from
the eye. |
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| By using soft
material that can be folded, the artificial lens can
be inserted inside the eye through the original
surgical incision. |
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| The lens
unfolds to fill the capsule much as the natural lens
of the eye had done prior to cataract surgery. |
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Illustrations courtesy of Alcon Inc.., Fort Worth,
TX |
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Pain-free
Cataract Surgery |
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Cataract surgery
is a pain-free experience thanks to advances in
anesthesia. Our patients are awake during the
surgery and are able to resume normal activities
shortly afterwards. During the relative quick
procedure, the surgeon and members of his surgical
team attend to your needs. Two types of anesthesia
are used to keep our patients comfortable and
pain-free during surgery: topical and regional
anesthesia. |
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Topical, or
"Eye Drop" Anesthesia - Eye drops are used to
anesthetize (numb) the eye allowing patients to have
a painless cataract procedure. |
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Regional
Anesthesia - Through the use of an injection
gently given near the eye, an anesthetic blocks all
feeling in the region of the eye. To eliminate any
discomfort during the injection, it is usually given
while the patient is momentarily under the effects
of a general anesthetic. Regional anesthesia
gradually wears off over the course of a day. As it
does, the function of the eye is restored. |
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Each form of
anesthetic has its advantages. Your doctor will
consider your individual needs to select the form of
anesthesia that is best for you. Our goal is to make
your cataract surgery a pleasant and pain-free
experience. |
