How are cataracts removed?
There are two principal methods. Extracapsular extraction, the most commonly performed cataract procedure, removes the natural lens. The lens is suctioned out, or broken into pieces with ultrasonic waves (phacoemulsification), then suctioned out. Usually a replacement lens (IOL) is inserted. Intracapsular extraction is performed much less often; this is when both the lens and membrane holding the lens in the eye are removed to ensure that the membrane won’t eventually grow cloudy and interfere with vision. When the membrane becomes cloudy, or if any bits of remaining natural lens become cloudy, this is called a secondary cataract. The problem with intracapsular extraction is that the membrane is no longer there to receive a replacement lens. Are lasers sometimes involved? YAG lasers are used in a later procedure to create a clear opening in the lens-containing membrane if the membrane becomes cloudy in the months following the original cataract removal.
Most cataracts are removed today using a method known as placoemulsification. This method utilizes a probe which is inserted into the eye and uses a high speed, ultrasonic tip to break the cataract up into very small pieces which are then vacuumed out of the eye through the same probe. The use of this probe has revolutionized cataract surgery so that it can be done through a very small (3 mm) incision. This incision is about one-fourth the size of the older type of cataract incisions. Because of this, the wound is self-sealing and most patients do not need a stitch to close the wound, thus the name “no-stitch” cataract surgery. Once the cataract is removed, an intraocular lens “implant” is placed into the eye in order to restore vision. Today’s implants are made out of various materials. Some of these materials are pliable and thus the lens can be folded prior to implantation and then unfolded inside the eye.
There are no known medications, eye drops, glasses or exercises that can cure or prevent cataracts from forming. Surgical removal is the only treatment for removing cataracts; however, surgery may not always be necessary. It is not recommended to remove a cataract if a patient is only experiencing a slight blur in vision. A simple adjustment to the eyeglass prescription may be a temporary solution. Cataract surgery is considered once the patient is visibly unable to perform everyday activities. The patient and doctor should decide together when surgery is necessary. How is cataract surgery performed? Prior to surgery, the patient and doctor discuss options for surgery, and together they decide which type of removal and lens replacement process is best. During surgery, the clouded lens is removed from the eye and replaced with an artificial lens through a small surgical incision. In most cases, the cloudy lens is replaced with a permanent intraocular lens.
