Treatment Options for Cataracts: Surgery

If your vision impairment from cataracts is advanced or if lifestyle changes made as a result of early detection are unable to improve your vision, surgery may be necessary. After you have chosen a surgeon, which can be a particularly important decision depending on which type of intraocular lens (IOL) you would like, the surgeon will discuss the procedures that are available and make recommendations as to what would be best for you. All procedures will (a) remove your current lens and (b) replace it with the IOL of your choosing.

No Stitches and Low-rate of Complications  

The most frequently performed procedure in the U.S., phacoemulsification begins with a tiny incision on the edge of the cornea. The surgeon breaks up the patient’s natural lens with ultrasonic oscillations, and an irrigation-aspiration tool is used to remove remnants of the lens. The IOL is then inserted. A major benefit of this procedure is the small incision does not require stitches and, in fact, increases the speed of recovery. The procedure is associated with a low rate of complications.

Stitches Required and Slow Healing Time

This less common method is primarily used if a patient’s cataracts are hard, if phacoemulsification is not possible, or if the IOL will be dense or rigid. This procedure requires a larger incision in the eye (about 10-12 mm), which necessitates stitches and prolongs healing time. Unlike phacoemulsification, in this procedure, the surgeon removes the patient’s lens manually.

A Surgery Rarely Performed

In intracapsular surgery, both the lens and lens capsule are simultaneously removed. Because of the high rate of potential complications that is associated with this procedure (e.g. increased pressure on the eye), it is infrequently performed nowadays. 

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