Thousands of Australians undergo cataract surgery every year. If you’re one of them, you’re probably already familiar with the answer to how is cataract surgery done. However, if you’re still on that waiting list or are just trying to decide whether cataract surgery is something you need right now, here’s some easy reading to shed some light to explain how is cataract surgery done.
How is Cataract Surgery Done?
Once you and your eye care professional have decided the time is right, your experience with cataract surgery begins with a pre-surgery consultation. Prior to this point, your vision measurements, prescription, and any other pre-existing ocular conditions should already be known. However, some additional precise measurements are still required to properly plan your operation. These will include biometric readings to calculate the power of the artificial lens implant that will replace your cataract, known as an intraocular lens. At this appointment, your cataract surgeon may also conduct a dilated eye exam to ensure there are no other ocular conditions that have been overlooked. At this consultation, if you need more details on how is cataract surgery done or want to voice any other concerns, now is the time to do it.
If all is well, you’ll be scheduled a time in the operating theatre. Cataract surgery is performed as a day procedure under local or topical anaesthetic. A local anaesthetic is applied as an injection around the eye area while topical anaesthetic uses numbing eyedrops instilled on the surface of your eye. You’ll also have dilating eye drops to widen the pupil so the surgeon has room to access the cataract behind it.
Typically, cataract surgery is performed on one eye at a time to allow the first eye to heal fully before operating on the other. However, in some special circumstances, the surgeon may operate on both eyes within a very short time interval, such as the day after.
There are two techniques of modern cataract surgery. Phacoemulsification refers to an older method, which uses manual instruments for many of the surgical steps. A newer technique is known as femtosecond laser assisted cataract surgery. As the name suggests, this method employs the use of a high precision medical-grade laser tool, which replaces many of the manual instruments used in phacoemulsification. Not all cataract surgeons offer femtosecond laser assisted cataract surgery.
Once your eye is numbed, the surgeon will provide you with a target overhead to fix your eyes on. This helps to keep your eyes steady during the procedure. A small incision is then made near the edge of your cornea, which is the transparent dome of tissue at the very front of your eye.
If your surgeon is performing conventional cataract surgery, the incision will be created with a bladed tool, otherwise, a femtosecond laser can be used for this step.
The cataract is contained within a membrane casing, called the capsular bag or lens capsule. Once the cataract is removed, the intraocular lens will be inserted into the capsule to replace it. To extract the cataract from the capsule, the membrane must be carefully torn open, a procedure known as capsulorhexis. This can be performed with handheld instruments or the femtosecond laser.
The cataract must then be broken into smaller fragments that will then be suctioned from the eye. Both conventional phacoemulsification and femtosecond laser assisted cataract surgery will use ultrasound energy to complete this step. However, a femtosecond laser may be used to first soften the cataract, before then applying the ultrasound probe. Advocates of femtosecond laser assisted surgery prefer this method as it requires less ultrasound energy to be applied to the eye, which may minimise postoperative inflammation.
With the cataract extracted from the lens capsule, the intraocular lens can be inserted through the corneal incision and manipulated into position. Less commonly, the lens implant may be positioned between the cornea and the coloured iris instead, known as an anterior chamber intraocular lens.
After your procedure, your cataract surgeon will talk you through the recommended guidelines to promote a speedy recovery. This will include things like avoiding certain activities and environments, keeping the eye area clean, and using medicated eye drops.
Your vision can take around 4 to 6 weeks to settle and clear completely. During this period, you’ll have a few review appointments with your cataract surgeon. Once he or she is satisfied that your eyes have healed completely, you will most likely be discharged back to the care of your optometrist for an update of your prescription and ongoing eyecare.
Choosing Your Cataract Surgeon
In Australia, we’re fortunate to have access to a large number of highly skilled and experienced cataract specialists. However, this can make the choice a little overwhelming, especially when it comes to something as precious as your sight.
If you have any friends or relatives who have had a positive experience with a particular private cataract surgeon, you may want to make enquiries at the same clinic. Consider factors such as costs, accessibility, and, if your vision is particularly bothersome, waiting times.
The public system provides high-quality cataract surgery and many of the surgeons in public hospitals also operate privately. Be aware that although public surgery is free, you will have less of a choice with intraocular lens type and waiting lists may be up to 12 months, or even longer.
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Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.