Cataract surgery is a procedure that removes a clouded natural lens from the eye (called a cataract) and replaces it with a crystal-clear lens. This allows the eye to see properly again by letting a normal amount of light to enter the eye and focus properly.
This procedure is done using gentle sedation and anesthetic eye drops and is virtually pain-free. Over 19 million cataract surgeries take place every year worldwide, making this is one of the most popular and safest eye procedures done today.
Briefly explained, the surgeon makes a small incision through which the cloudy natural lens is removed from inside a lens capsule where it resides within your eye. Next, an artificial, crystal clear new lens is carefully placed into the lens capsule and, almost magically, the patient's clear vision is restored.
Traditional cataract surgery involves using a blade to make an incision that gives the surgeon access to the clouded-over lens. The lens is then carefully broken into fragments before it is gently suctioned out of the eye. Once the old lens is gone, the artificial clear lens is inserted in the lens capsule.
Today, there's a new approach to cataract surgery that uses a Femtosecond laser to create a 2-millimeter incision through which the entire surgery is performed.
The laser is then used to access and soften the natural lens so that it can be easily broken up using gentle ultrasound energy. After the lens fragments are gently suctioned out, the laser is used once more to precise position the artificial lens for optimal vision.
In the event that a patient has astigmatism, the Femtosecond laser can also be used to correct his or her astigmatism.
Basically, there are three important advantages to the laser-assisted approach to cataract surgery:
If you're wondering about cataract surgery, here's a typical patient experience when undergoing cataract surgery at AGEI.
Our cataract procedures are performed as outpatient surgical procedures in our own surgery center. The entire process takes less than two hours, after which the patient is taken home by whoever has accompanied them that day.
After the patient is comfortably seated in a reclining treatment chair, an experienced anesthesiologist administers a gentle sedative by vein to help the patient relax. Next, the eye surgeon inserts anesthetic eye drops.
Once the anesthesia takes hold, a 2mm wide incision is made through the cornea at the border of the iris and the white of the eye using a very precise LensAR Femtosecond Laser. The laser then opens the capsule surrounding the hard cloudy natural lens and softens it, making it easier to remove.
Next, a tiny probe is introduced through the incision and, using gentle ultrasound energy, breaks down the cataract (a process called phacoemulsification). Once the cataract is in tiny pieces, the probe gently sweeps them up like a vacuum. The posterior lens capsule is left intact to serve as a pocket to hold the new artificial lens.
If the patient has chosen to replace his or her natural lens with a premium intraocular lens (IOL for short) then once the hazy natural lens is removed, we use the ORA System TM to measure the patient´s eyeglass prescription without interference. These measurements help us to accurately select the new lens to correct for near vision or distance vision, or both (if using multifocal lenses).
The new lens is then inserted in the eye through a pen-like instrument that contains the lens rolled up like a cigar inside of its barrel. Once the lens is released into the eye, it unfurls into a round disc and is tucked into the proper place within the lens capsule.
After the new lens is in place in the back of the eye, we use the ORA System a second time to verify that the implant provides a crisp focus throughout the entire visual field. This assures us that the patient is receiving the correct strength replacement lens before leaving the operating suite.
Once the surgeon has verified that the patient has received the best correction possible, surgery is over. If the patient has astigmatism, the Femtosecond laser can be used to correct astigmatism on the spot.
Because the surgery takes place through a tiny incision, no stitches are required to close the incision. The cornea will heal on its own in a few days.
If you undergo cataract surgery, you may be given prescriptions for eye drops to prevent infection, control inflammation, and perhaps even control eye pressure. These drops are usually prescribed for several weeks. In some cases, your surgeon might place medications into the eye at the time of surgery to control post-op inflammation.
You may experience a couple of days of mild discomfort and perhaps itchiness in your operated eye. You will experience blurry vision at first, but you will start improving within a few days of surgery as your eye heals. Colors will seem brighter and your distance vision will seem more clear.
You will return to our clinic for your first follow-up on the day after surgery. Your next visit to check your healing progress will be one week after surgery, then four weeks post-op, and eight weeks post-op. Your eye will be fully healed within eight weeks.
In a small percentage of patients who undergo cataract surgery, a condition known as Posterior Capsular Opacification (PCO) can occur. It is a clouding of the capsule that holds your artificial lens. When PCO occurs, looking through the cloudy capsule can feel just like your vision before your cataract surgery.
PCO occurs when a few cells from your native lens remain within the lens capsule after it is removed and replaced by the artificial lens. These native cells multiply and form a thin layer over the back of the lens capsule, causing it to become cloudy. This can result in blurred vision and excessive glare.
Luckily, PCO is easily treated by a laser treatment that is performed in a few minutes during an office visit. This treatment is known as a YAG laser capsulotomy and involves removing the cloudy portion of the posterior lens capsule affecting your vision. See how the YAG procedure is performed:
Most folks need reading glasses or contact lenses, for at least some time, following cataract surgery. Your doctor will let you know when your eyes have stabilized enough for you to get a final prescription for glasses or lenses. This is usually from one to three months post-op.
If you opt to have a premium intraocular lens (IOL for short), then you will have the benefit of crisp vision at various ranges from near through far distances. Your eye surgeon can recommend which lenses will best fit your lifestyle and visual demands.
Learn more about cataract lens options
When you select Assil Gaur Eye Institute for your cataract removal, you will benefit not only from our state-of-the-art technology and our physicians’ extensive experience treating cataracts and a wide range of eye problems but also from our commitment to:
Medicare generally does not pay for vision care but will cover certain medically necessary services, such as cataract surgery. Specifically, Medicare covers the following:
At AEI, the actual surgery takes about 10 minutes per eye. Immediately following your surgery, you'll be asked to rest in the recovery area for 30 minutes until your eye drop anesthesia wears off.
Cataract removal surgery involves removing the cataract-damaged lens from the eye and replacing it with an artificial lens, called an intraocular lens implant. This new artificial lens cannot develop a cataract, meaning the patient will never have a cataract in that eye again.
At AEI, we use a combination of gentle sedation and anesthetic eye drops, which results in virtually pain-free surgery.
A very small percentage of patients who undergo cataract surgery develop a condition known as Posterior Capsular Opacification (PCO).. Luckily, PCO is easily treated by a laser treatment performed in a few minutes during an office visit.
Based on the results of all published studies to date, genetics may play a role in 50% of age-related cataracts, with the remainder due to aging, systemic factors, and environmental factors.
For the vast majority, cataract surgery is not urgent and can be safely delayed until the person wishes to pursue surgery. However, there are some drawbacks to postponing cataract surgery. Patients who wait for surgery may experience more vision loss, reduced quality of life, and an increased risk of falls.
Patients report seeing the light or movement but don't see what's happening to their eyes.
There comes the point in time when cataract surgery is more difficult to perform than it would have been if left untreated. When left alone, cataracts become denser and further impair one's vision. When the cataract has become denser, it becomes more difficult to remove and has a higher chance of causing complications during surgery.
Once your cataract surgery is completed, a clear plastic shield will be placed over your eye for protection. It's important to wear the shield as instructed by your doctor - the shield is more protective than a standard eye patch and will help prevent any dust or potential injury from occurring as you heal. You may be instructed to sleep with the shield for at least one week after surgery.
Dr. Gaur's training and work experience at renowned ophthalmic institutions, including Tufts Medical Center and Boston-Mass Eye and Ear Infirmary, have given her extensive experience in state-of-the-art medical, laser and surgical management of glaucoma and cataracts. It is no exaggeration to report that she has performed thousands of sucessful cataract, glaucoma and LASIK surgeries.