Cataracts - Microincision Phacoemulsification

Cataracts can be removed at any age. You no longer have to wait until the cataract "ripens" or until you lose your sight before surgery can be performed. In fact, the placement of an intraocular lens (IOL) implant to restore vision is best done in an eye when the cataract interferes with your daily activities or causes a decrease in vision.

In removing cataracts, the clouded lens (cataract) must be removed surgically. Cataracts cannot be removed via laser.

A common surgical procedure used today is extracapsular cataract extraction. The surgeon makes an incision in the eye and the front (anterior) capsule of the lens to remove the clouded lens. The lens tissue within the capsule is removed. The sac-like capsule that surrounds the lens remains in place. This capsule is left intact for two reasons: to avoid disturbing the gel, or vitreous, that fills most of the eye, and to support an intraocular lens.

After the cataract has been removed, the incision is closed. Often the sutures, which are finer than human hair, do not need to be removed. Some patients, in fact, don't even need sutures, and the "no suture" surgery is popular today.

Another common type of extracapsular cataract extraction is phacoemulsification (often just called "phaco"), where the surgeon removes the cataract through an even smaller incision than the one used in conventional surgery. In this procedure, the surgeon uses a computerized instrument consisting of a needle about the size of a ballpoint pen tip which vibrates at about 40,000 times a second.

This ultrasonic vibration dissolves the cataract into fine particles, which are then vacuumed through an opening in the instrument.

The benefits of the phaco approach include an early restoration of vision and return to normal activities. Phaco is well suited for patients with a less-advanced cataract, when an earlier return to activity is required or when increased physical activity is part of the convalescent period.