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Cataract Surgery 101

A Cataract is often associated with old age. It is a common eye problem for older people. More than 20 million Americans who are 40 years old or above suffer from cataracts in at least one eye.  This results in the decline of one’s eyesight, a loss that cannot be arrested by contact lenses, eyeglasses or LASIK corneal refractive surgery.

The good news is that cataract surgery is available for those suffering from this problem. As a matter of fact, almost 30% of cataract patients over the age of 40 have already undergone this procedure.

This is considered as one of the safest and most effective surgical procedure, so long as the patient does not possess other existing eye problems like macular degeneration and diabetic retinopathy.

Surgery Preparation

•    The eye doctor would advise you on what to expect before, during and after the procedure. The different types of intraocular lens (or IOL) would also be presented. This will allow you to make an informed decision on whether or not you want to go on with the surgery.
•    Give your doctor a list of all the medicines and supplements you are taking, whether prescription or non-prescription. There are drugs that can increase your risk to complications after the surgery.
•    Your eye doctor will conduct a complete and comprehensive examination of your eye. This evaluation will determine the overall health of your eyes, as well as identify the risks that you may face.
•    Measurements will be made to size up the shape of your cornea and the length of your eye. The level of nearsightedness, astigmatism and farsightedness will also be determined.
•    Your eye doctor will choose the IOL that will best fit your needs and give you the clearest vision possible.

Surgery Procedure

Cataract surgery is very common and is done on an out-patient basis using simple local anesthesia. The procedure described below is called phacoemulsification. This involves using small incisions for the removal of the cataract, thereby allowing quicker recovery and lessening the risk of complications.

•    A high frequency ultrasound probe is utilized to break up the cloudy lens into tiny portions.
•    The small pieces are taken out of the eye using suction. The doctor will make sure that all the remaining parts of the cloudy lens are removed properly and completely.
•    An IOL is inserted behind the iris and the pupil. While there are times when the replacement lens needs to be placed at the front, this is not very common.
•    The incision is closed.
•    Protective goggles are worn during the early stages of recovery to keep your eyes safe.

The FDA in the USA has also approved the use of femtosecond lasers for cataract surgery. It means less dependence on hand-held tools. The procedure involves lens fragmentation so that a smaller amount of ultrasonic energy is required to break up and remove the cloudy lens. In Australia a select few advanced surgical centres have invested heavily in the femtosecond laser after it has been so successful in correcting vision in LASIK surgery for spectacle correction.

The cost is an issue, however. While laser surgery has better accuracy and it promises to reduce the risks very slightly, it has yet to be definitely proven that it necessarily improves safety, recovery period and visual results – time will tell.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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