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How Is Cataract Surgery Performed?

Tina D. Turner MD

Tina D. Turner, M.D. Ophthalmologist

Contributing Editor Dr. Tina D. Turner received a B.A. in chemistry from the University of Tennessee and her M.D. from Baylor College of Medicine in Houston. She completed her ophthalmology residency at the University of Michigan's Kellogg Eye Center. She is currently a staff comprehensive ophthalmologist at Henry Ford Health System's Grosse Pointe Ophthalmology.

Performing Cataract Surgery

Most cataracts are highly treatable. Cataract surgery is one of the most common surgeries performed in the United States, with approximately 98% of patients experiencing improved vision if there are no other eye conditions present.

Two very small incisions (one larger, approximately three millimeters, or one-tenth of an inch, and one smaller, approximately one millimeter, or one thirty-second of an inch) are made in the cornea, which is the transparent dome-shaped tissue that covers the front part of the eye. A thick, glue-like, viscous material is injected into the front part of the eye to help maintain its shape during surgery.

This viscous material is made from substances that occur naturally in the body. Because it is thick, this material will not leak out of the incisions during surgery.

Phacoemulsification

The surgeon creates an opening in the natural "sac" or "bag" that holds the lens in place, called the lens capsule. The lens is separated from the lens capsule by using a balanced salt solution.

Once the capsule is open and the lens can move freely inside the capsule, a special ultrasound device is used to break the lens into small pieces and suck it out of the eye. This technique is called phacoemulsification.

Prior to the development of phacoemulsification, the lens used to be removed in one solid piece through a very large incision (8–12 millimeters, or ¼–½ inch). That surgery entailed considerably more risk and had a significantly longer recovery time.

After the lens is removed, additional viscous material is injected into the lens capsule to hold it open and make room for the new artificial lens. The folded artificial lens is inserted into the "sac" or capsule, where it is then allowed to unfold.

The viscous material that maintained the shape of the eye during surgery is removed. The two incisions usually self-seal and do not require stitches.

Phacoemulsification was introduced more than 40 years ago and is now the most common method surgcal method used to remove cataracts.

Lasers are not yet used to perform cataract surgery in the United States, but are being investigated in current clinical trials to determine their effectiveness and advantages over phacoemulsification.

 

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