11 Sep Cataract Surgery
Cataract Surgery is the most commonly performed surgery in the world and one of the most successful. If poor vision and glare are affecting your life and your cataracts are considered “medically necessary,” then it may be time for cataract surgery.
Cataract surgery involves removing the cloudy cataract lens from inside your eye and replacing it with an intraocular lens.
During the cataract removal procedure, I expect you to be completely comfortable as the procedure is usually painless.
Anesthesia for Cataract Surgery
As a general rule, you are awake, but groggy, during your cataract removal procedure. The anesthetist will keep you relaxed and I’ll keep your eye numb with some topical medicines.
It’s natural to feel a little anxious during the surgery, but we can calm you with some sedatives given through your I.V.
It would be very unusual to feel any pain during your cataract removal. The most annoying part of cataract surgery is the bright light from the microscope.
During the surgery, I cover your eye with a plastic drape to keep the area clean. This drape has some adhesive to keep it in place. The second most annoying part of cataract surgery for you is when the drape is removed at the end of surgery.
I want your eye surgery to be a great experience for you. Since you are awake enough to talk, you can let me know if you need more sedation.
The Cataract Surgery Procedure
We clean around your eye with disinfectant. A small eyelid holder is placed to keep your eye open during the cataract surgery procedure so you don’t have to worry about blinking.
There are several other people in the room during your cataract surgery other than just you and me. A “circulator” circulates around the room, opening supplies, making sure you are comfortable, keeping records, and ensuring that everything is flowing perfectly.
A “scrub tech” stands at my side to hand me instruments, make adjustment to the cataract removal machine, drip fluid on your eye so it wont dry out, and unwrap the replacement lens (intraocular lens) that I will place near the end of the surgery.
It is also common for other doctors to be present to observe advanced cataract surgery techniques when I operate.
Music is usually playing and you could suggest a particular station if you have a particular preference. Remember, it is all about you during your cataract surgery procedure.
How is Cataract Surgery Done?
Cataract surgery is a type of microsurgery and requires the use of an operating microscope.
I usually sit to the side of your head and will rest my wrists and hands on your forehead and cheek.
The microscope magnifies your eye so it looks the size of a basketball to me. This allows me to see even the finest details of your eye.
You can’t really see what I am doing because I am too close to your eye for you to focus and the microscope light is bright enough that it is hard for you to see anything during the cataract surgery. If you are claustrophobic the relaxing medicine really helps, and I can tape the plastic drape to the microscope above you so it is lifted off the eye that we are not fixing. This allows you to see off to that side of the room and helps you relax and not feel closed in. If you have this condition, please let me know so we can accommodate your specific needs.
Manual Cataract Surgery vs. Laser Cataract Surgery
Prior to 2011 all cataracts were removed manually. Since that time we have had a laser that can perform many of the precision oriented parts of the cataract surgery. The Eye Center of Norther Colorado, P.C. was the twelve center in the nation to have this technology and the first in Colorado. I have been using the laser for cataract surgery since August of 2011 and have a growing preference for this approach.
Manual Cataract Surgery
In manual cataract surgery, steel blades and instruments are used to make incisions, open up the lens capsule and break up your cataract. Grooves are carved dividing the cataract into four quadrands using a vibrating tip that acts like a minature jackhammer that emits ultrasound to emulsify the cataract. This process is called phacoemulsification.
Each quadrant of cataract is then emulsified using the same phaco tip into microscopic pieces that are vacuumed out of the eye.
Laser Cataract Surgery
Laser cataract surgery, a detailed scan is made of your eye that defines the exact anatomy. This information is used to guide a high precision femtosecond laser that makes the incisions, opens the lens capsule, divides the cataract into quadrants, softens the harder center part of the cataract, and makes incisions to round your eye and decrease your astigmatism. Laser cataract surgery is more precise than doing the procedure by hand. The phaco tip is then used to emulsify and vacuum out the already dismantled cataract.
Laser cataract surgery has a number of distinct advantages, but often requires so additional out of pocket costs.
Intraocular Lens Placement
An intraocular lens (IOL) is used as a replacement lens for the cataract lens that has been removed. These intraocular lenses come in a variety of types and powers. Some intraocular lenses correct for distance without glasses, other for reading without glasses, while other advanced technology IOLs can correct astigmatism or even give many patients good vision for both reading AND distance without glasses. Prior to your cataract surgery procedure, you and your eye surgeon will discuss which IOL is the best for you and your lifestyle.
Eye Drops after Catarct Surgery
Eye drops are placed, your eye is patched closed, and you are taken to the recovery area to reunite with your family. The eye drops used after cataract surgery include antibotics to prevent infections and anti-inflammatory eye drops to decreas inflammation and keep your eye comfortable. We usually ask you to remove the eye patch after three hours and start your post operative eye drops.
Since it is an outpatient procedure, your family or friends can take you home soon after cataract surgery to let you recover at home. If you have specific questions about driving or flying after cataract surgery, please click the links to those specific subject to learn more.
The recovery from cataract surgery is usually painless, easy, and quick. If you are having a more difficult time, it is important that you discuss this with your eye doctor.
I hope this post on cataract surgery has been helpful. If you have any other questions about cataract removal, please schedule a consult with me so we can visit more on the subject or post a question below.