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Cataract Surgery

A cataract is a cloudiness that develops in the normally clear lens of the eye. The lens, about the size of an aspirin, is the transparent fine focusing part of the eye located behind the pupil. It is comprised of a strong, transparent outer covering or capsule filled with a clear gel material. When the gel becomes cloudy, the incoming light rays are distorted or blocked before reaching the retina at the back of the eye. As the cataract develops, vision is increasingly reduced. Your family optometrist will usually discover developing cataracts in the course of routine eye exams. If you have cataracts that are causing visual difficulties, your doctor will usually recommend surgery, the only known cure for cataracts.

Causes of cataract development

Cataracts are most commonly caused by age. In fact, almost everyone who lives long enough will develop cataracts. Age-related cataracts are brought about by chemical changes within the lens of the eye. These changes result in the lens hardening and becoming cloudy. Cataracts can also be caused by severe injuries to the eye, reactions to certain drugs, exposure to harmful chemicals or radiation, and some eye diseases and physical conditions such as diabetes. Smoking and exposure to high amounts of sunlight have been shown to increase the onset of cataract formation. Babies can also be born with congenital cataracts. Cataract symptoms

Cataracts vary in the way they develop, but generally, people experience one or more of these common symptoms:

Gradual loss of color vision.
Increased haziness, blurring, distortion and yellowed vision.
Dark spots or shadows that move with the eye.
Need for more light to read or see clearly.
Night glare, halos or colored rings around lights.
Becoming more nearsighted and not needing reading glasses.
Double vision.
Being able to see better without glasses.
In advanced stages, a white or yellow pupil.

Cataract solution

Unfortunately, there is no way to prevent or reverse the development of cataracts. Although there is evidence that antioxidants such as vitamin A, C and E may delay their development, there is no known way to prevent cataracts or to make the cloudy lens clear again. If there are no other serious problems with the eye, an experienced cataract surgeon can restore vision in over 99% of the cases. In fact, cataract surgery is one of the most successful surgeries being performed. The surgery involves two main parts: First, the cloudy lens must be removed and secondly, the focusing power must be replaced.

Removing the cloudy lens

Instead of removing the entire lens and capsule, the most modern treatment involves the surgeon making a small opening in the front of the clear covering to remove the cloudy gel inside the capsule. The rest of the capsule is left intact to provide a sac for holding the new artificial lens. The most ideal method of removing the gel from the lens is to use an ultrasound probe which vibrates at 40,000 times per second. This procedure, known as phacoemulsification, causes the least amount of trauma to the eye when performed by an experienced surgeon. Reaching into the capsule with the ultrasonic probe, the surgeon uses the controlled vibrations of the tip to break up the hardened, cloudy gel and suction it out of the eye.

Replacing the focusing power

In removing the lens of the eye, the natural focusing ability is also removed during cataract surgery. To replace it, a tiny artificial lens implant, usually made of flexible, acrylic plastic or silicone, is inserted into the original lens capsule. This lens implant is held securely in place by gentle, flexible loops. Lens implants, or intraocular lenses ("IOLs") are available in a wide range of power so many patients can achieve not only better vision but freedom from glasses and contacts, as well.

Cataract surgery risk

As with any surgery, there are risks involved with cataract surgery, though serious problems are very rare. Problems that do occur can generally be resolved so vision is not permanently lost. Under the care of an experienced surgeon, there is usually nothing to worry about.

After-surgery care

Patients usually return to see their surgeon for two or three visits after routine cataract surgery. The use of prescription eye drops is often necessary for several weeks. Because most cataracts are done without sutures, it is important that the patient refrain from rubbing the eye for two weeks after surgery.

In some cases, the clear capsule that holds the new plastic lens becomes cloudy or frosted over. Again, vision is reduced. Some people think their cataract has returned, but it can be easily treated with the laser. In a short office visit, the beam of laser light is used to make a small opening in the back of the cloudy capsule to restore clear vision.