Cataract Surgery: What to Expect

Symptoms of Cataract

Signs and symptoms include: 

• Decreased night vision 
• Light sensitivity
• One needs bright lights to perform everyday activities such as reading 
• Formation of halos around light 
• Colours fade
• Double vision in one eye
• Tunnel vision 
• Dry eyes in the morning

Cataracts often go unnoticed until they impact vision. Initially, new glasses, better lighting, or anti-glare sunglasses may help. If these solutions fail, surgery to replace the clouded lens with an artificial one may be necessary.

Types of cataract surgery

Modern cataract eye surgery replaces the lens with an intraocular lens (IOL). 

Common techniques include:

Phacoemulsification:

A  2- to 3-mm incision is made in the eye in phacoemulsification. An ultrasonic probe breaks up the cataract, and suction removes the fragments. 

A foldable lens is inserted through the incision, leaving a small wound that typically doesn’t require sutures to heal.

Manual extracapsular cataract surgery (MECS):

In Manual Extracapsular Cataract Surgery (MECS), a surgeon uses a larger 9-13 mm incision to remove the lens and insert the replacement IOL. 

Despite higher complication risks compared to phacoemulsification, its cost-effectiveness maintains its widespread use globally.

Manual small incision cataract surgery (MSICS):

 MSICS, Manual Small Incision Cataract Surgery, is a modified version of MECS, using a V-shaped incision—about 6.5 to 7 mm on the outside and up to 11 mm on the inside of the eye.

Femtosecond laser-assisted cataract surgery (FLACS):

In laser cataract Surgery, a laser creates an incision and softens the cataract, reducing the need for extensive phacoemulsification energy and promoting faster healing.

The laser in cataract laser surgery can create an arcuate incision to correct astigmatism, addressing the irregular shape of the eye’s front that causes blurry vision. 

This correction may increase the likelihood of functioning without glasses.

Intracapsular cataract surgery:

Intracapsular cataract surgery, an older method, removes the entire lens and capsule through a large incision. Due to a high risk of complications, this procedure is seldom performed today.

 How is cataract surgery done?

Cataract surgery is outpatient, allowing you to return home shortly after the procedure.

Steps involved in cataract surgery include:

• During cataract surgery, topical anesthesia is given to numb your eye’s surface using eye drops. 
• Additional medication may be provided for relaxation. Although awake during the surgery, you won’t perceive objects approaching, only a display of colorful lights.
• The surgeon will Create a small corneal incision using a laser or blade. Typically, no stitches are required for closure.
• Use phacoemulsification to break the cataract into small pieces with ultrasound, then suction them out for removal.
• Place the new lens through the same incision, typically folded for ease. The intraocular lens unfolds in the space once occupied by the cloudy lens.

After the surgery, safeguard your eye with a taped shield, resembling an eye patch, for protection.