Advances In Cataract Surgery |
|
Of all the fields of medicine, cataract surgery has been one of
the greatest beneficiaries from advances in techniques and
technology. Not so long ago, it involved lengthy delays marked
by deteriorating vision while the cataract "ripened," an
extended and confining recovery period, plus the need for
unsightly "cataract" glasses or contact lenses to achieve
functional vision after surgery. |
Now, the surgery is a simple, out-patient procedure. The stay at an ambulatory surgery center is just a few hours and recovery time after is dramatically reduced. Many people enjoy improved vision with minimal dependence upon corrective eyewear.
Diagnosing A
Cataract |
|
| "No-Stitch" Cataract Surgery Using a Self-Sealing Wound |
|
| Although sutures were a major advance, they have been supplanted in most cases by the use of a self-sealing incision. The shape of the incision creates a flap that takes advantage of the natural fluid pressure inside the eye to seal it shut without the need for sutures. |
|
| Not every surgery can be performed as a "No-Stitch" procedure. The decision to place a suture is made by the surgeon and always has your best interests in mind. |
|
| The advantages of "No-Stitch" using a self-sealing wound include the following: |
|
- Shorter surgery time
- The ability to stop surgery at any point in the procedure
- Dramatically reduced recovery time
- Less surgically-induced astigmatism
- Less discomfort after surgery
|
|
| To perform "no-stitch", two other advances were necessary: the development of microsurgical techniques and the creation of foldable artificial lens implants. |
|
| Microsurgical Techniques |
|
| Cataract surgery is a delicate operation that involves manipulation of the tiny structures of the eye. High-powered microscopes allow the surgeon to view the parts of the eye clearly. |
|
| A large incision is no longer required to allow the cataract to be plucked from the eye like a grape. Now, just a tiny incision is necessary so that a probe approximately the width of a match stick can be used to remove the
cataract. By use of ultrasound, the probe dissolves the cataract, allowing it to be gently vacuumed from the eye. |
|
| Foldable Artificial Lens Implants |
|
| Cataract surgery removes the cloudy, natural lens of the eye. Once the natural lens of the eye is gone, another means is needed to bring light rays into proper focus upon the retina. Thick cataract glasses and then contact lenses were used after to perform this function. Unfortunately, both offer a less than satisfactory solution. |
|
| Tiny artificial lenses, called intraocular lenses, that could be placed inside the eye proved to be a dramatic solution to clear vision following surgery. They are made of inert materials that do not trigger any rejection responses by the body. Through the use of careful measurements of the eye taken before surgery, your doctor may be able to select a lens power to correct for nearsightedness or farsightedness, helping to reduce dependence upon corrective eye wear after surgery. |
|
| A small opening is made in the front of the capsule that holds the natural lens. |
 |
|
| A tiny incision is made to allow for the insertion of a phacoemulsification tip which is used to remove the cataract. By use of ultrasound, the probe dissolves the cataract, allowing it to be gently vacuumed from the eye. |
 |
|
| By using soft material that can be folded, the artificial lens can be inserted inside the eye through the original surgical incision. |
 |
|
| The lens unfolds to fill the capsule much as the natural lens of the eye had done prior to cataract surgery. |
 |
|
| Illustrations courtesy of Staar Surgical Co., Monrovia, CA |
|
|
Risks and
Benefits of Cataract Surgery |
