What is Cataract Surgery? Understand How the Procedure Works

Ask any eyecare professional and you’ll probably hear that cataracts and cataract surgery are discussed multiple times on any typical day. With cataracts being a natural part of ageing, cataract surgery is one of the most commonly performed surgical procedures in the world. So, what is cataract surgery and how does it work? Keep reading to find out. 

What Are Eye Cataracts?

Before delving into “what is cataract eye surgery”, it helps to first understand what a cataract is. Cataracts form in the eye’s crystalline lens, which sits just behind the coloured iris. In a young eye, this lens is transparent, allowing light to easily pass through. As we get older, the lens gradually becomes hazy and forms opacities. At some point, this is considered a cataract. 

The majority of cataracts are a result of older age, known as senile cataracts. However, an opacity in the lens may arise from other causes, including:

• Physical trauma
• Electrocution
• Chemical injury
• Systemic metabolic diseases and syndromes
• Congenital causes
• From certain medications
• From certain eye procedures

In the early stages of a cataract, you may not even notice you have one. Cataracts are often first detected during a routine eye exam before causing any symptoms. If the cataract is not bothering you or affecting your lifestyle, it isn’t necessary to hurry into cataract surgery. As the cataract progresses, you may find your glasses or contact lens prescription needs updating to restore your clarity of vision. 

Eventually, simply changing your glasses or contacts will not be sufficient to improve your vision. At this stage, you may wish to discuss your options for cataract surgery with your eye care professional, and ask for more details about exactly what is cataract eye surgery going to look like for you.

What is Cataract Surgery?

Cataract surgery is the only definitive way of treating a cataract. In brief, it involves removing your natural lens with the cataract, and replacing it with a clear lens implant, known as an intraocular lens. There are two methods of cataract surgery in current use – phacoemulsification and femtosecond laser-assisted cataract surgery. 

Phacoemulsification is the conventional technique of cataract extraction. It typically involves the use of manual, hand-held instruments to complete the various steps involved in cataract surgery. Conversely, femtosecond laser-assisted cataract surgery is much newer. As the name suggests, this technique involves a highly precise medical laser to replace many of the manual steps found in phacoemulsification. Although it may feel natural to lean towards a more modern method of cataract surgery, both phacoemulsification and femtosecond laser-assisted surgeries are considered safe and effective procedures. Studies have not noted a significant difference in terms of visual outcome between the two; both methods offer very high success rates. You will find that not all cataract surgeons offer both; some will prefer one technique over the other. 

Cataract Eye Surgery Steps

Your eye will be prepared for the surgery with sterilisation and topical anaesthetic eye drops or a local anaesthetic injection. General anaesthesia is not typically used for cataract surgery procedures; however, you can ask for a light sedative to help calm any anxious nerves. 

Your surgeon will give you an overhead target or light on which to fixate your eyes – this helps to keep your eyes steady during the operation. A small incision is made at the edge of the cornea, which allows entry to the cataract for the next steps. During phacoemulsification, this incision is created with a hand-held bladed tool, while in femtosecond laser-assisted surgery, the laser can be used for this step. 

The lens of the eye is contained within a membrane, called the capsular bag or lens capsule. Depending on which technique of cataract surgery is being used, this membrane can be gently cut open with a manual tool or the femtosecond laser, so that the cataract inside can be extracted. 

In conventional phacoemulsification, the next step of fragmenting the cataract is performed with an ultrasound probe. The ultrasound energy helps to break the cataract into pieces small enough to be suctioned out from the capsular bag. If the femtosecond laser is in use, this can be utilised to first soften the cataract before the ultrasound probe is applied. Proponents of femtosecond laser-assisted cataract surgery prefer this method as it requires less ultrasound energy to be applied to the eye, which can reduce post-operative inflammation. 

Once the cataract has been removed from the eye, your chosen intraocular lens is then inserted into the capsular bag and manipulated into position. During your pre-operative consultations, your surgeon will have taken measurements to calculate a lens implant that can correct your eye’s prescription. Furthermore, you may have been given the option of a premium intraocular lens, such as a multifocal or accommodating implant. Such intraocular lenses are able to greatly reduce your dependency on glasses for all activities post-cataract surgery. 

After Surgery

After your cataract procedure, your eye surgeon will place a protective plastic shield over your operated eye. You’ll also be given a list of post-operative guidelines to help you ensure your recovery is as smooth as possible, and to minimise the risk of complications. 

You will have a few review appointments to ensure your eye is healing as expected. However, if you ever feel your eye or vision is not right, be sure to contact your eye specialist on (03) 9070 3580 without delay.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.