Types of Cataract Surgery

Types of Cataract Surgery

Extracapsular Cataract Extraction is a method of cataract surgery that involves removing the eye’s natural lenses while leaving the back of the capsule that holds the lens in place. This procedure requires a much smaller incision than the older process called Intracapsular Cataract Extraction in which the lens and the entire capsule were removed, which was associated with difficulties in lens replacement.

Phacoemulsification (Phaco) is more modern technique which is associated with better visual results, less inflammation and less need for capsulotomy (Capsulotomy is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye, thus providing a clear path for light to reach the retina thus reducing the opacity of the lens of the eye.) as compared to extracapsular cataract surgery. During phacoemulsification, a surgeon makes a small incision at the edge of the cornea and then creates an opening in the membrane that surrounds the lens. A small ultrasonic probe is then inserted, breaking up the cloudy lens into tiny fragments. The instrument vibrates at ultrasonic speed to chop and almost dissolve the lens material into tiny fragments. The fragments are then suctioned out of the capsule by an attachment on the probe tip. After the lens particles are removed, an intraocular lens implant, commonly referred to as an IOL, is implanted and positioned into the lenses natural capsule.

The IOL is inserted through the tiny corneal incision through a hollowed out tube. Once the lens is pushed through, it unfolds and is positioned in place. 

Phacoemulsification is typically performed in an outpatient surgery centre and normally does not require a hospital stay. The cataract surgery procedure is performed under local anaesthesia (an aesthetic injected around the eye) or topical anaesthesia (numbing drops inserted into the eye).

Phaco Surgery Recovery

The incision made in the cornea usually requires no stitches and is self-sealing. Within a few days, the incision heals completely. Post-operative eye drops are prescribed and usually consist of antibiotics, steroids, and a non-steroidal anti-inflammatory medication. These drops reduce inflammation and prevent infection. The antibiotic is usually discontinued within 7-10 days. The steroid and non-steroidal anti-inflammatory are taped over 3-6 weeks depending on the surgery. Most patients have vision improvement almost immediately and vision tends to steadily improve over 4-5 weeks.