4 Questions About Cataract Surgery
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Let’s find out how cataracts are operated on and what the risks are as we answer four common questions about Cataract Surgery.
The way to remove cataracts from the eyes is through surgery. Cataract surgery makes it possible to recover clear vision.
Cataract surgery has become common in ophthalmology, and around 400,000 operations are performed in Spain annually.
It is an ‘outpatient procedure,’ which means the patients do not need to be admitted to the hospital.
# Question 1: How is cataract surgery performed?
Surgery is the only solution to treat cataracts. Since it is impossible to recover the loss of transparency of the crystalline lens in any other way, it must be replaced by an artificial intraocular lens.
Cataract surgery is performed under local anesthesia (with anesthetic drops or with a periocular injection), which allows the Cataract patient to be discharged the same day of the operation since there is no general anesthesia.
The most commonly used surgical technique is phacoemulsification. Where, by means of ultrasound, the crystalline lens is dissolved, extracted, and replaced by an artificial intraocular lens.
As indicated by Clínica Baviera, for cataract surgery using the phacoemulsification technique, the following series of steps are followed:
- Local anesthesia is through drops.
- Corneal cut (incision) to reach the opaque crystalline lens (the cataract).
- Partitioning and aspiration of the crystalline lens utilizing ultrasound with an instrument called a phaco emulsifier.
- Introduction of the folded artificial intraocular lens
At Clínica Oftalvist, pioneering in Spain in 2012, they show us how the cataract operation is performed with the Femtosecond laser:
- Opening the lens capsule in a circular shape with a laser is 10 times more precise.
- Extraction of the crystalline lens using the Femtosecond laser, softening the cataract.
- Implantation of the artificial intraocular lens.
Mayor Clinic uses yet another procedure, which is less frequent than the phacoemulsification method. It is the extracapsular cataract extraction:
- Larger incision to remove the lens, usually in one piece utilizing a surgical instrument.
- The posterior lens capsule is held in place so that it can be placed where the lens used to be.
- Stitches are required because of the more significant cut.
- This method may be used if the patient has certain ocular complications.
If both eyes need to be operated on, usually one eye is done first. After a few days or even a couple of weeks after the recovery of the first eye, cataract surgery is performed on the second eye.
As indicated by Vistaláser and other major ophthalmology clinics, cataract surgery is one of the most commonly performed and safest operations in ophthalmology.
# Question 2: How Long Does Cataract Surgery Last?
According to many ophthalmology clinics, cataract surgery lasts approximately 20 minutes. This includes the duration of the surgery and the postoperative waiting time.
For Phacoemulsification surgery, the duration of the operation is about 15 minutes.
For extracapsular surgery, the duration is approximately 30 minutes.
# Question 3: What are the risks of cataract surgery?
As with any surgical intervention, cataracts, despite the progress of the technique, may also present some risks and complications, although these are becoming less and less frequent.
Let’s take a look at the risks that cataract surgery can have:
The opacification of the posterior capsule is the most common complication. The capsule where the crystalline lens was located, which remained in the eye to place the new lens, becomes opaque over time.
This happens because the cells of the capsule, which remain in the area after removing the lens, become larger over time and cause the capsule to become thicker.
Some of the other risks of cataract surgery are:
- the risk of infection, high eye pressure (ocular hypertension), problems with the lens,
- drooping eyelids (ptosis),
- inflammation of the cornea, clouding of the cornea,
- excessive blood loss,
- blindness and loss of the eye, in extreme cases, due to infection or bleeding inside the eye.
As indicated in All About Vision, some complications derived from cataract surgery may only appear later. Such is retinal detachment, which can occur months or even years after surgery.
However, they also tell us that patients with retinal detachment have, for the most part, a good prognosis if treated after the first symptoms are noticed.
It is important to pay attention to any symptoms we may have and go to the ophthalmologist as soon as possible, if necessary so that they can check the evolution after surgery.
# Question 4: When should cataract surgery be performed?
According to Clínica Baviera, cataract surgery should be performed as soon as possible, unlike what was recommended a few years ago when it was advised to wait for the cataract to be in an advanced stage before performing the surgery.
According to them, this change in criteria is due to: ‘The simplification of surgical techniques, coupled with the search for the best quality of life for patients.’
By performing the intervention earlier, the crystalline lens extraction is more manageable since, with time, the cataract will become more challenging, and its extraction will be more complicated.
Both Social Security and private health services agree that cataract surgery is recommended when visual acuity is below 40%.
In other words, cataracts, they say, should be operated on when they become a problem for vision.
At the same time, thanks to new designs in intraocular lenses, it is also possible to correct refractive defects such as myopia, hyperopia, astigmatism, or presbyopia. Since these lenses are multifocal.
In any case, the ophthalmologist will be the best person to advise us about cataract surgery and will guide us toward the best solution in our particular case.