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Cataract removal
Definition Cataract removal is a procedure to remove the clouded lens ( cataract ) of the eye to improve vision. Today, it almost always includes the implantation of an artificial lens.
Alternative Names Cataract extraction; Cataract surgery
Description The normal lens of the eye is transparent. It focuses light onto the inner surface of the eye (the retina ) to create an image. As cataracts develop, the lens gets cloudier and blocks the normal path of light entering the eye. Vision becomes obscured. The purpose of cataract surgery is to remove the clouded lens and replace it with an artificial lens, thereby restoring clear vision. Cataracts are seen most commonly in the elderly as a result of the normal aging process. However, children may be born with clouded lenses (congenital cataracts ) due to infections they acquire before birth. Surgery is usually recommended for people who have loss of vision or visual abnormalities caused by cataracts. Cataract removal surgery is for people who are not satisfied with their current vision or whose cataracts disrupt their life. PREPARATION: An ophthalmologist will take several measurements to assess the type of surgery needed. These tests will include an ultrasound of the eye to measure length and a measurement of the curvature of the front surface of the eye. Together, these tests help the surgeon choose the power of the artificial lens to be implanted in the eye at the time of surgery. Routine pre-operative testing is often done to assess overall general health prior to the operation. Since cataract surgery is usually done with local anesthesia (numbing), most patients are able to undergo cataract extraction regardless of other illnesses they may have. PROCEDURE: The surgery is performed in a hospital or in an outpatient setting. Children are typically given general anesthesia to keep them deep asleep and pain-free; adults usually are awake but sedated and pain-free with local anesthesia. With the help of a special microscope, a small incision is made at the junction of the clear and white outer parts of the eye. The lens can be removed in several ways depending upon the type of cataract:
  • With surgical instruments and suction
  • With an instrument and machine that uses high frequency sound waves (ultrasonic energy) to break up the lens and suction it out (phacoemulsification)
  • An artificial intraocular lens (IOL) is usually inserted to help the eye focus in the absence of the removed lens. The incision may be closed with fine stitches (sutures) or in some cases may be self sealing (sutureless). If sutures are placed, they may need to be removed at a later date. The surgery typically lasts less than an hour. This operation is most often performed on an outpatient basis and the patient returns home the same day. A patch is placed over the operated eye and is removed prior to examination the next day. Antibiotic and anti-inflammatory eye drops will be prescribed for several weeks to assist the healing process. Expect complete healing in about 10 weeks. Glasses or contact lenses may then be fitted if the clarity of your vision needs to be refined. Close follow-up with the surgeon is essential.
    Indications Cataract surgery is usually recommended for people who have loss of vision or vision abnormalities caused by clouding of the lens.
    Risks Complications of cataract surgery are not common, and serious complications are rare. Most patients have better vision after cataract surgery. FREQUENTLY ASKED QUESTIONS: Q: Will a laser be used to remove my cataract? A: No. Lasers currently are not used to remove cataracts, though their application in the future is likely. Several months after the surgery, a laser can be used to break apart remaining old lens fragments sitting behind the new artificial lens if necessary. Q: Will it harm my eye to wait to remove the cataract? A: No. Cataracts do not harm the eye. You should have your cataract out if you are unhappy with your vision and when it is convenient for you. Q: If I have a cataract in each eye, can I have them both done at the same time? A: No. Usually one eye is allowed to heal before the operation is repeated on the other eye. Most surgeons wait one to two months between operations.
    Expectations after surgery The outcome of cataract surgery is usually excellent. The operation has low risk, the pain is minimal and recovery time is short, and improvement in sight occurs in most cases. Ninety-five percent or more of all cataract surgeries result in improved vision.
    Convalescence Since this operation is often performed in the ophthalmologist's office or an outpatient basis, the patient returns home the same day. Expect complete healing in about 10 weeks.

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