Tina D. Turner, M.D.

Dr. Turner:

"Two very small incisions (one large, approximately three millimeters, or one-tenth of an inch, and one small, approximately one millimeter, or one thirty-second of an inch) are made in the cornea, which is the transparent dome-shaped membrane that covers the front part of the eye. A thick, gluey, viscous material (Amvisc® or Viscoat®) 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 used to remove cataracts. Lasers are not yet commonly used to perform cataract surgery in the United States, but are currently being investigated in clinical trials in the United States to determine their effectiveness and advantages over phacoemulsification."