How is a cataract removed?
A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound, a laser or surgical solution to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted. Occasionally, a doctor will perform intracapsular extraction; this is when both the lens and the membrane are removed, to ensure that the membrane itself 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. Read more about what to expect if you have cataract surgery.
There are several procedures for removing the cloudy lens. In each, a small incision is made in the front of the eye and an instrument is inserted into the eye to remove the lens. Your eye remains in its normal position during the operation. It is never removed from its socket. With the intracapsular method, which is rarely used today, the entire lens is taken out in one piece, along with its capsule (the membrane enclosing the lens). With the extracapsular method, the front part of the capsule is opened and the lens taken out, leaving the back part of the capsule in its normal position. The newest extracapsular techniques are referred to as “small incision” surgery. One of these involves phacoemulsification (FAKE-oh-ee-mull-sih-fuh-KAY-shun), in which a needle-like ultrasonic instrument is introduced into the eye. It delivers high-frequency sound waves to break up the opaque lens into tiny fragments that are then gently suctioned out through the instrument’s hollow tubing.
