Types of Cataract Surgery: All You Need to Know

Dinesh Patel
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Dr. Kaushal

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types of cataract surgery

A Cataract occurs when the natural lens in your eyes becomes cloudy.

Unfortunately, there’s no way to eliminate them without surgery. 

Some ophthalmologists are exploring alternatives, but at this time, only surgery can cure your Cataracts.

The surgery includes removing the faulty lens in your eye and replacing it with an artificial lens. 

As per the American Society of Cataract and Refractive Surgery (ASCRS), 3 million Americans undergo surgery for it annually.

Your doctor can recommend different surgeries based on the condition and severity.

This article will help you decide on your treatment. Continue reading to learn more about different types of Cataract surgery.

Types of Cataract surgery

Doctors might recommend three types of surgeries to help you.

They all involve removing and replacing the natural lens with an artificial lens.

These are the surgical procedures for Cataracts.

cataract surgery side effectsSource: loonger_from_Getty_Images_Signature
Cataract surgery

Phacoemulsification

This Cataract surgery was developed by Charles Kelman in 1967.

It uses ultrasonic waves to break the lens into tiny pieces, which are suctioned out of the eye with a vacuum.

The procedure is completed by replacing the damaged lens with an artificial one.

The eye’s lens is exposed from its surrounding capsule during the surgery.

Then a handheld ultrasound device emits high-frequency sound waves that shatter the lens into an emulsified gelatinous mass. 

The mass is finally flushed with sterile fluid and vacuumed out of the eye.

Before the development of Phacoemulsification in the 1960s, surgeons would remove the entire lens and capsule. 

This made inserting the replacement lens accurately a bit challenging. 

As a result, to correct their farsightedness, most people were forced to wear thick, heavy eyeglasses.

Consult your doctor as they can suggest if this procedure is suitable for you.

Femtosecond laser-assisted Cataract surgery (FLACS)

These types of surgeries are performed with the help of a laser.

The femtosecond laser (FSL) is helpful in eye surgeries due to its ultrafast pulses in 10-15 seconds.

It requires less energy to break the tissue, reducing the surrounding tissue damage.

Here are some steps involved in the surgery:

  • Incision: With the help of built-in optical coherence tomography (OCT) imaging, a femtosecond laser is used to make an incision in the eye, producing a magnified, high-resolution image of your eye
  • Cataract fragmentation: A femtosecond laser may “soften” the Cataract by breaking it into small pieces. This is done to reduce the vibration required in the next stage
  • Phacoemulsification: The Cataract is broken into tiny fragments with a high-speed ultrasound vibration. It is gently suctioned out of the eye
  • Capsulotomy: A circular opening is made within the capsule that holds the lens to gain access to the Cataract. A femtosecond laser allows for a precise circular shape, size, and center over the Cataract and proper placement of the new lens
  • Replacement: A new lens is inserted into the existing capsule

The laser device performs incision, Cataract fragmentation, and capsulotomy. The insertion of the new lens is done manually.

You may be given pain medication as needed during your recovery. Your nurses will ensure you are comfortable walking and eating normally.

After the procedure
If there are no signs of complications (such as pain, bleeding, or swelling), you should be able to go home within a few hours.

Before you are discharged, you will be given instructions on post-surgical eye care, when to schedule a follow-up appointment, and warning signs of complications.

Your doctor may also recommend eye drops such as Megabrom for post-operative care.

Extracapsular Cataract extraction (ECCE)

It is a category of eye surgery in which the eye’s lens is removed while the elastic capsule that covers the lens is left partially intact.

By doing so, it allows an intraocular lens (IOL) implantation. There are various benefits of this surgery.

“With extracapsular extraction, however, there’s very little cost other than the fluid and some tubing. Even the cortical cleanup can be done with a manual device. In a humanitarian aid setting, extracapsular extraction is a much better solution.” 

George G. Ulrich, MD

In this surgery, the doctor makes a longer incision on the cornea’s side and removes the cloudy core of the lens in one piece. Suction is used to remove the remainder of the lens.

Antibiotic eye drops may be prescribed before Cataract surgery to prevent infection.

Cataract surgery is typically performed as an outpatient procedure using local anesthesia (numbing gel in the eye) and light intravenous sedation. 

During surgery, you should not see any instruments approaching your eye, nor should you feel any pain.

The incision to remove the Cataract is usually so small that no stitches are required. 

After the natural lens is removed, it is frequently replaced by an artificial lens known as an intraocular lens (IOL). 

An IOL is a clear, plastic lens that becomes a permanent part of your eye and requires no maintenance. 

It focuses light onto the retina, improving your vision. The new lens will not be felt or seen.

Some people are unable to wear an IOL. They could have another eye disease or have complications during surgery.

A soft contact lens or high-magnification glasses may be recommended for these patients.

Your doctor will advise the best way to recover. It might include eye drops for post-operative care.

When is the right time to get surgery?

What are the disadvantages of cataract surgerySource: psisa_from_Getty_Images
Cataract surgery

Many people with Cataracts have no visible symptoms. 

Suppose you are diagnosed with a Cataract that does not interfere with your daily activities or prevent you from leading an active and productive life.

In that case, your doctor may try to monitor the condition.

However, suppose you need help with reading, experience glare while driving or engage in normal daily activities. It may be time to consider Cataract surgery.

The patient and their symptoms determine the best time to remove a Cataract. 

However, suppose a person has Cataracts in both eyes and needs surgeries. In that case, they will usually be performed a few weeks apart. 

Cataract surgery on both eyes simultaneously is not advised. There is an increased risk of complications affecting both eyes, the most concerning of which is infection.

Read “How Long Between Cataract Surgery on Each Eye?” to know more about how long you should wait before getting Cataract surgery on the other eye.

Conclusion

Cataract surgery is the only effective treatment.

There are three significant types of Cataract surgery your doctor might recommend.

Phacoemulsification is the most common type performed in the developed world.

Extracapsular Cataract extraction is a third valuable option in some mature Cataracts and complicated procedures where Phacoemulsification is risky or impossible.

FLACS procedure is carried out with the help of a femtosecond laser and might involve Phacoemulsification.

Check with your doctor for the best-suited surgery. Based on your condition, they can provide you with the correct treatment.

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Frequently Asked Questions

What are the three types of Cataract surgery?

Doctors might recommend three types of Cataract surgery: Phacoemulsification, Femtosecond Laser-Assisted Cataract surgery (FLACs), and Extracapsular Cataract Extraction (ECCE).

What is the most common Cataract surgery?

Doctors recommend winter surgery because the weather will help you recover faster. However, this is not a rule. If your vision is becoming excessively blurred and your daily activities are hampered, you should immediately remove the Cataract.

What type of Cataract surgery is best?

Laser-assisted Cataract surgery is the most recent and advanced method. As a pre-treatment to “soften” Cataracts, many ophthalmologists prefer laser over traditional Cataract surgery.

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