Surgeries for
cataract
When should I have the surgery?
Usually, you can decide if, and at what stage to have the operation.
The cataract may need no treatment at all if the vision is only a little
blurry. A change in your eyeglass prescription may improve vision for a
while. If visual impairment interferes with your ability to read, to
work, or to do the things you enjoy then you will probably want to
consider surgery.
In the past, eye specialists often waited until the cataract became
'ripe' before suggesting you had it removed. Nowadays, with modern
surgery the operation can be carried out at any stage of the cataract's
development, and in fact, is a little safer to do before the cataract
becomes 'ripe'.
What are the surgical options?
Majority of cataracts today are removed by Extracapsular surgery, in
which the posterior capsule of the natural lens is left in place to
support the IOL, which is implanted at the time of surgery. There are
two types of extracapsular surgery.
- Conventional extracapsular surgery: The nucleus
of the lens, which is too hard to simply remove by aspiration, is
taken out in one piece, and the softer parts of the lens are then
aspirated. The surgeon makes an incision (10-12 mm in size) where
the cornea and sclera meet. Carefully entering the eye through the
incision, the surgeon gently opens the front of the capsule and
removes the hard center, or nucleus, of the lens. Using a
microscopic instrument, the surgeon then suctions out the soft lens
cortex, leaving the capsule in place.
- Phacoemulsification:
It is a form of extracapsular surgery. In phacoemulsification, the
hard nucleus is broken up by ultrasonic fragmentation (using sound
waves) within the eye, and can then be aspirated. This allows a
smaller incision (3 mm in size) to be used.
The other way of removing cataract is Intracapsular surgery, in
which the whole lens is removed in a single piece, without leaving the
posterior capsule behind. The patients are rehabilitated with glasses or
contact lenses. This form of surgery is being done in a few villages and
camp surgeries in India.
