What does it involve?
The technique used to operate on cataracts is called phacoemulsification, which consists of using ultrasound to break up the cataract.
The technique can be carried out by making an incision of about three millimetres, through which the opaque content of the lens is extracted. The sac that envelops it is left inside the eye. It is common to use it to replace the natural lens with an intraocular lens, thereby avoiding the need for correction with thick glasses.
When is it carried out?
The best time for cataract surgery is when reduced vision caused by cataracts interferes with the patient’s daily activities. In the past, cataracts were not operated on until the patient was almost blind. Surgery is sometimes recommended for basically refractive purposes: in patients with presbyopia, myopia or high hyperopia, crystalline lens surgery with intraocular lens implants not only helps to improve vision, but also, at the same time, allows patients to dispense with the need for glasses or contact lenses in many of their daily activities.
Prior examination
The ophthalmologist uses examination equipment to determine the type of cataract, size, location, surgical indication and prognosis. The tests performed on patients consist of visual acuity and eye pressure tests, an examination of the fundus and biometrics.
Also often carried out is Optical Coherence Tomography (OCT), which is a very useful method to determine indications for cataract surgery, especially in diabetic patients, and, in general, to monitor all post-operative patients. OCT is also used to detect other diseases affecting the retina.
Surgery
Cataract surgery takes about ten minutes. In general, it is performed under topical anaesthesia, i.e. anaesthetic drops, meaning that there is no need to cover the eye after surgery, and the patient can see with the eye when leaving theatre.
It requires the cooperation of the patient to keep looking at the microscope light. Where this is not possible, or in some special cataract cases, the area around the eye is anaesthetised with a local anaesthetic. In this case, the patient’s eye is covered for several hours after surgery.
Precautions
The patient can lead a normal life after surgery, but initially vision will not be perfect. For the first few days, patients should avoid physical exercise involving sudden or abrupt movements. It is very important for patients not to rub their eyes. At night, it is advisable not to sleep in a face-down position. It is also important to wear sunglasses when out of the house to help protect the eye and prevent glare, which is common after surgery.
Risks
All types of surgery carry some risk. Nowadays, the results of cataract surgery are excellent, and visual recovery is usually rapid and satisfactory after surgery. However, it is not possible to guarantee 100% success.
