Surgical procedures for clouding eyes: Varieties, pre-op preparation, and post-op healing
Cataracts, cloudy or opaque areas on the lens of the eye, are a common condition that affects vision in people aged 55 and older, though younger individuals can also be affected. While not everyone with cataracts requires surgery, it may become necessary when vision loss interferes with everyday activities such as reading or driving.
Two main types of cataract surgery are available: small incision cataract surgery (SICS), often known as phacoemulsification, and extracapsular cataract extraction (ECCE). Both procedures share some fundamental elements but differ primarily in incision size and lens removal technique.
Small Incision Cataract Surgery (Phacoemulsification)
The common steps involved in small incision cataract surgery are:
1. Anesthesia: The eye is numbed using local anesthesia such as eye drops or injection. 2. Incision: A very small incision, typically about 2.4 mm or smaller, is made usually in the cornea or limbus. 3. Ultrasound Probe Insertion: A tiny probe is inserted through this incision. The probe emits ultrasonic waves that emulsify (break up) the cloudy natural lens (cataract). 4. Lens Removal: The emulsified lens material is suctioned out through the same small incision. 5. Intraocular Lens (IOL) Implantation: A folded artificial lens implant is inserted through the small incision and unfolds inside the lens capsule. 6. Self-Sealing Incision: Because the incision is so small, it is generally self-sealing and does not require stitches. 7. Postoperative Care: Often no bandage or patch is needed, and the patient can usually go home the same day.
Extracapsular Cataract Extraction (ECCE)
1. Anesthesia: Similar local anesthesia is used. 2. Larger Incision: A much larger incision (approximately 10-12 mm) is made in the cornea or sclera. 3. Lens Removal: The lens is removed manually in one piece, leaving the posterior lens capsule intact. 4. Sutures: Because of the larger incision, sutures are usually required to close the wound. 5. IOL Implantation: An intraocular lens is implanted in the lens capsule or just behind the iris. 6. Longer Healing: Due to the larger incision and sutures, recovery time may be longer than with small incision surgery.
A summary table comparing the two procedures is provided below:
| Step | Small Incision Cataract Surgery (Phacoemulsification) | Extracapsular Cataract Extraction (ECCE) | |-------------------------------|-------------------------------------------------------------|----------------------------------------------------------| | Anesthesia | Local (drops or injection) | Local (drops or injection) | | Incision size | Small (~2.4 mm, self-sealing, no sutures usually) | Large (10-12 mm, requires sutures) | | Lens removal method | Ultrasound emulsification and suction | Manual removal in one piece | | IOL insertion | Folded IOL inserted through small incision | IOL inserted after lens removal | | Wound closure | Self-sealing, no stitches usually | Sutures required | | Recovery | Faster, outpatient same-day discharge | Longer recovery due to larger incision and sutures |
The choice between these surgeries depends on cataract density, surgeon expertise, and the patient's eye condition, with phacoemulsification being the more common modern approach due to its less invasive nature and faster recovery.
Common complications of cataract surgery include swelling of the cornea and eye, bleeding in the eye, vision loss, accumulation of fluid in the retina, detachment of the retina, pressure behind the eyes, drooping eyelid, dislocation or movement of the implanted lens. After surgery, a person will usually wait in the recovery room for about an hour. It's essential for the person to focus on preventing their eyes from becoming infected, such as by avoiding getting water in their eyes and applying any eye drops as prescribed.
Before surgery, a person may need to stop taking certain medications, avoid eating or drinking for up to 6 hours, and receive eye drops. Cataract surgery is a relatively quick procedure, and a person should arrange transport to get them to and from the clinic or surgery. They may also want to consider having someone stay with them to help out when they get home. Currently, surgery to remove the lens and replace it with a synthetic one is the only treatment option available for cataracts. The surgeon places a protective shield over the eye or eyes and sends the person to the recovery room. The person remains awake during the procedure and may see light and general movement, but will not be able to see what the surgeon is doing. A surgeon will usually ask the person to return for check-ups following surgery. These check-ups usually take place the day after surgery, a week later, and several weeks after the surgery.
Wearing sunglasses and quitting smoking can help slow down the development of cataracts, although there is no known way to prevent them from forming. Certain medical conditions, such as age-related macular degeneration (AMD) and underlying eye problems, can increase the risk of complications from cataract surgery. If you suspect you have cataracts or are considering cataract surgery, it's essential to consult with an eye doctor for a thorough examination and discussion of your options.
References: [1] American Academy of Ophthalmology. (2021). Cataract Surgery. Retrieved from
- Cataracts, a common condition affecting older adults, can also impact younger individuals.
- While not every individual with cataracts requires surgery, it may become necessary when vision loss interferes with daily activities.
- Science has advanced to offer two main types of cataract surgery: small incision cataract surgery (SICS) and extracapsular cataract extraction (ECCE).
- Both procedures share fundamental elements but differ primarily in incision size and lens removal technique.
- Small Incision Cataract Surgery (Phacoemulsification) involves steps such as anesthesia, incision, ultrasound probe insertion, lens removal, IOL implantation, self-sealing incision, and postoperative care.
- Extracapsular Cataract Extraction (ECCE) consists of anesthesia, larger incision, lens removal, sutures, IOL implantation, longer healing, and wound closure.
- A table summarizing the two procedures highlights differences in anesthesia, incision size, lens removal method, IOL insertion, and recovery time.
- Phacoemulsification is the more common modern approach due to its less invasive nature and faster recovery.
- Common complications of cataract surgery may include cornea and eye swelling, eye bleeding, vision loss, and retina detachment.
- After surgery, care involves focusing on avoiding eye infections, such as by avoiding water in the eyes and applying eye drops as prescribed.
- Before surgery, certain medications may need to be stopped, and avoiding eating or drinking for up to 6 hours may be necessary.
- Cataract surgery is relatively quick, and arranging transport for the procedure is essential.
- Having someone stay after the surgery to help can be beneficial.
- Currently, the only treatment option available for cataracts is surgery to remove the lens and replace it with a synthetic one.
- Wearing sunglasses and quitting smoking can help slow down cataract development but cannot prevent their formation.
- Underlying medical conditions, such as age-related macular degeneration and eye problems, can increase the risk of complications from cataract surgery.
- Consultations with an eye doctor for a thorough examination and discussion of options are essential if you suspect having cataracts or considering cataract surgery.
- The industry continues to explore advancements in cataract research and treatments.
- Mental health is an essential aspect of overall health and wellness, and it's critical to address stress or anxiety relating to cataract surgery.
- Workplace-wellness programs can play a crucial role in promoting awareness and education regarding cataracts and their treatments.
- Chronic diseases, such as diabetes, can impact vision and increase the risk of cataract development.
- Certain medications, such as oral contraceptives and steroids, may be associated with an increased risk of cataracts.
- Cancerexperts recommend regular eye exams as part of overall health monitoring during and after treatment.
- Respiratory conditions, like Chronic Obstructive Pulmonary Disease (COPD) and asthma, can affect eye health.
- Digestive health can also impact eye health, with conditions such as pancreatitis and chronic hepatitis potentially leading to cataracts.
- Exploring the relationship between hearing and eye health is another area of scientific interest.
- Eye-health is a significant part of overall health-and-wellness, including fitness-and-exercise, skin-care, and nutritional considerations.
- Autoimmune disorders, neurological disorders, and climate change can impact eye health, leading to changes in industry approaches to treatment and preventative care.
- In addition to cataracts, various medical conditions, mental health issues, chronic diseases, and skin conditions can require therapies-and-treatments, further underscoring the importance of accessing quality medical care and considering proper health-insurance options like Medicaid or Medicare.
