Cataract surgery is a common and effective procedure to improve vision impaired by cataracts. There are two main types of cataract surgery, each with its own variations. Your doctor will guide you through the options to determine the best approach for your specific needs.
Types of Cataract Surgery
Phacoemulsification (Phaco):
Phacoemulsification, or phaco, is the most common type of cataract surgery today. Phakos literally means lens, and the surgical technique emulsifies the lens to that it can sucked out of the eye via a small incision. It involves making a small incision on the side of the cornea. A tiny probe emitting ultrasound waves softens and breaks up the lens, allowing for its removal by suction.
These are some variations of phaco:
A. Microincision Cataract Surgery (MICS):
MICS is a kind of phacoemulsification. It is a minimally invasive procedure with a tiny incision, typically less than 1.8 mm. This surgery is ideal for small or less dense cataracts, resulting in less trauma, minimal scarring, and a shorter recovery time.
B. Femtosecond Laser:
Femtosecond Laser-Assisted Cataract Surgery (FLACS) is an innovative option for cataract removal, providing enhanced precision through laser technology. This FDA-approved, computer-guided laser is programmed by the surgeon, offering several benefits.
i. Precision and Accuracy:
The Femtosecond laser allows for precise incisions and capsulotomy (opening in the lens capsule), contributing to improved accuracy during cataract surgery. This advanced level of precision can decrease aberrations, and enhance visual outcomes.
ii. Astigmatism Correction:
FLACS is particularly beneficial for patients with astigmatism. The laser can make precise incisions to correct astigmatism during cataract surgery, reducing the dependence on glasses for clear vision.
iii. Capsule Fragmentation:
The laser assists in breaking up the cataractous lens, facilitating its removal. Consequently, this leads to a smoother and more efficient surgical process.
iv. Customization:
FLACS provides a high degree of customization, allowing surgeons to tailor the procedure to the patient’s unique eye anatomy. This customization can contribute to improved postoperative visual results.
v. Reduced Energy Requirements:
The Femtosecond laser’s precise application often means less ultrasound energy is needed during the procedure. This may lead to a potentially faster recovery and reduced risk of complications.
Note: While Femtosecond Laser-Assisted Cataract Surgery offers these advantages, it is essential to note that not all patients may require or benefit from this advanced technology. Your surgeon will assess your specific needs and discuss whether FLACS is a suitable option for your cataract surgery.
Manual Extracapsular Surgery:
In phacoemulsification, the lens nucleus is dissolved and sucked out, hence phaco results in a smaller incision. Manual extracapsular surgery involves a longer incision on the cornea, removing the cataract’s dense nucleus in one piece. The remaining lens is then suctioned out. Small Incision Cataract Surgery (SICS) is a modern variation of this technique, considered safe and effective for cataract removal.
While these techniques are generally safe and effective, their use has declined significantly in current practice due to the availability of more refined cataract surgical options.
What to Expect during Cataract Surgery
Before Surgery:
Prior to cataract surgery, your doctor may prescribe antibiotic eye drops to prevent infection. The surgery is typically outpatient, performed with topical anesthesia; and in very few patients, a light intravenous sedation. The small incision usually does not require stitches, or bandages.
After Surgery:
After the natural lens is removed, an artificial lens, called an intraocular lens (IOL), is often implanted. The IOL becomes a permanent part of your eye, improving. Most surgeons send you home with eyedrops, and dark glasses, a few hours after surgery. Some may want you to wear an eye patch for a day.
Intraocular Lens (IOL) Options for Cataract Surgery:
There are various intraocular lens choices available, each catering to different vision needs:
Standard Lens Implants:
Monofocal lenses correct vision at one focal length. Patients require reading glasses after the implantation of monofocal lenses.
Premium IOLs:
These are high end lenses that allow better vision without glasses. These IOLs address specific vision related concerns, and decrease the dependence on glasses after cataract surgery.
Presbyopia-correcting IOLs aim to reduce the need for glasses by correcting distance and near vision. Toric IOLs are designed for patients with astigmatism. These correct both standard distance vision (myopia or hypermetropia) and astigmatism.
Remember
Understanding the potential risks and benefits of each of the surgical procedures can empower you to have informed discussions with your doctor, ensuring that the chosen surgical approach aligns with your individual eye health and vision goals.
Similarly, the decision on which IOL to use is individualized, and your doctor will guide you based on your specific vision requirements. Therefore, understanding these surgical options empowers you to make informed decisions about your cataract surgery.
