Cataract Surgery | Types, Complications, Recovery, Costs & More

Treatment options for cataract

There are many cataract surgeries, but almost all of them involve removing the hazy lens and replacing it with an artificial one. Many patients may get concerned about having surgery on such a sensitive area. However, it is a quite safe operation in which you will be given a local anesthetic to numb your eye. During the operation, patients are awake but feel no pain. Moreover, cataract surgeries have a very high success rate estimated to be more than 94%.

Cataract surgery normally takes 15 to 20 minutes according to the ophthalmologist’s competence, experience, and how complicated the operation went. Cataract surgery isn’t considered a major surgery as patients don’t even have to stay in the hospital overnight. If you have cataracts in both eyes, your doctor will do surgery on the second eye when the first fully recovers. More than 95% of patients who underwent cataract surgery have experienced a significant improvement in their vision.

Phacoemulsification which is abbreviated as “phaco” is the most common cataract surgery nowadays. On the side of the cornea, the transparent, dome-shaped layer that covers the front of the eye, a tiny incision is created. A small probe is inserted into the eye by an ophthalmologist after applying topical anesthesia. This apparatus delivers ultrasonic waves that soften and break up the lens, allowing it to be suctioned out. The majority of cataract surgery is performed with phacoemulsification due it its high success rate and low invasiveness. Most phacoemulsifications don’t require suturing because its incision is so minimal.

Extracapsular Cataract Extraction (ECCE) is another type of cataract surgery in which the core of and the anterior capsule of the natural lenses of the eye are removed but the posterior capsule that holds the lens in place is left in place. This method involves a small incision, yet bigger than the incision of phacoemulsification. Therefore extracapsular cataract surgery is less common than phacoemulsification, especially in developed countries.

The surgeon creates a little incision in the outer border of the cornea or the sclera (white of the eye)  towards the outer borders of the cornea during this surgery. The size of this is determined by whether the nucleus’s lens is to be removed in one piece or dissolved into smaller pieces and sucked away. After entering the eye through this incision, the surgeon delicately opens the anterior capsule of the lens and removes the nucleus of the lens. The doctor may need to suture the site of the incision if it wasn’t small enough to heal by itself.

Intracapsular cataract extraction (ICCE) is the least common cataract surgery performed nowadays. ICCE simply involves extraction of both lens nucleus and posterior capsule. Since the development of modern extracapsular techniques in the late 70s, the intracapsular cataract extraction method of lens removal has not been the procedure of choice in developed countries, owing to lower rates of postoperative complications such as retinal detachment, neovascular glaucoma, and cystoid macular edema. After intracapsular surgery, the incidence of neovascular glaucoma has been reported to be as high as 9%.