What is Cataract Surgery?

Dr Foram Bhuta

Dr Foram Bhuta

BDS (Bachelor of Dental Surgery), 10 years of experience

November 19, 2021 Lifestyle Diseases 568 Views

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What is the meaning of Cataract Surgery? 

Cataract surgery, also known as lens replacement surgery, is a procedure of removal of the lens of the eye and replacing it with an artificial lens. The human eye is comparable to a camera. Just like the lens in the camera helps to focus the image on the film, the lens in the human eye helps to focus the image on the retina (a thin tissue layer lining the back of the eye on the inside). The lens is a transparent structure that allows light to pass through it.

A cataract is a condition that causes the lens to lose its transparency, become opaque, and interfere with the vision of the patient. Cataract surgery is one of the easiest and most widely performed procedures used to treat this condition. 

Let us explain in detail about cataract surgery in today’s article.

  • What is the purpose of Cataract Surgery?
  • What is the diagnostic procedure before Cataract Surgery?
  • What is the preparation for Cataract Surgery?
  • What is the procedure of Cataract Surgery?
  • What are the different types of artificial lens used in Cataract Surgery?
  • How to care after Cataract Surgery?
  • What are the risks of Cataract Surgery?
  • What is the cost of Cataract Surgery in India?

What is the purpose of Cataract Surgery?

The cataract surgery is done in the following conditions:

  • Reduced, blurry, or hazy vision due to the cataract condition
  • Presence of other eye conditions like diabetic retinopathy (damage to the blood vessels in the tissue at the back of the eye or retina due to diabetes), dislocated lens (a lens that moves out of position due to some or all of supportive ligaments breaking), or retinal detachment (an emergency condition when the retina pulls away from the supportive tissue) ( Know more about- What is a Corneal Transplant? Purpose, Procedure, Aftercare, Cost)
  • For cosmetic reasons

What is the diagnostic procedure before Cataract Surgery?

  • The ophthalmologist will first do an eye examination and note down the symptoms and medical history of the patient.
  • The doctor may conduct several tests like:
  • Visual acuity test: An eye chart is used to measure how well a person can read a series of letters.
  • Slit-lamp examination: A slit lamp is a kind of microscope that allows the eye doctor to visualize the structures at the front of the eyes under magnification to detect any kind of tiny abnormalities in the eye.
  • Retinal exam: The doctor first puts some eye drops to open the pupils (the black part at the center of the eye) wide. A slit lamp or an ophthalmoscope (a special device to view the back of the eye) is then used to examine the lens for any signs of a cataract.
  • Applanation tonometry: This is a test done for measuring the fluid pressure in the eye.
  • Eye and orbit ultrasound: High-frequency sound waves are used to measure and create clear images of the eye and the eye orbit (the socket in the skull that holds the eye). This helps in the determination of the correct type of lens implant or intraocular lens (IOL) that will be placed as a replacement to the lens of the eye.

What is the preparation for Cataract Surgery?

  • The patient should inform the doctor about any pre-existing medical conditions that he/she may be having.
  • The patient should inform the doctor of any medications, herbs, or supplements that he/she may be taking. ( Know more about- Home remedies to increase brightness of eyes )
  • The doctor may instruct the patient to stop taking any blood-thinning medications like aspirin or warfarin that he may be taking, a few days before the surgery.
  • The doctor may prescribe some medicated eye drops to begin using before the surgery.
  • The patient is advised to stop eating or drinking anything after midnight the day before the surgery.
  • Arrange for someone to drive you home after the surgery.
  • Stop smoking at least two weeks before the surgery.
  • Avoid the consumption of alcohol at least 24 hours before the surgery. 

What is the procedure of Cataract Surgery?

Cataract surgery is usually done under local anesthesia so that the patient does not experience any pain during the procedure.

The procedure is usually completed in fifteen to thirty minutes, and the patient is discharged within a couple of hours after surgery completion. There are 2 major types of surgeries done for treating a cataract. Your ophthalmologist will help you decide which surgery is best for you after proper examination and considering a wide array of factors. 

Let us read more about the surgeries here.

Extracapsular Cataract Surgery: 

In Extracapsular Cataract Surgery, the lens of the eye is removed keeping its posterior capsule (a barrier between the front and back part of the eyes) in place.

Extracapsular surgery can be performed in the following ways:

  • Small Incision Cataract Surgery: 
    • A small incision of 5.5 to 7.5mm is made on the white part of the eye. 
    • The lens is approached through the incision and manually broken down into pieces with the help of special instruments.
    • The broken part of the lens is suctioned out of the eye and the incision is sutured after placing the intraocular (artificial) lens in place. 
  • Phacoemulsification:
    • A small incision of 2.2-3.2 mm is made on the outer eye and a tiny probe is introduced into the eye to reach the lens. 
    • This tiny probe gives out ultrasound waves to break down the lens into tiny particles.
    • Another probe is used to carefully suction out this broken lens. 
    • Once the entire natural lens is extracted out, an artificial lens is inserted to take its place.
    • The incision is so tiny that it heals on its own without the need for any suture. This is the most commonly used technique of cataract surgery.
  • FLACS (Femtosecond Laser-Assisted Cataract Surgery):
    • This is the newest and best available laser-assisted surgery for cataracts. 
    • This is a microincision (extremely small incision) surgery that follows the same steps as any other extracapsular cataract surgery but with the help of a laser.
    • The use of a laser beam increases the precision of the surgery. 

Intracapsular Cataract Surgery:

In Intracapsular Cataract Surgery, the lens of the eye is removed as a whole.

  • For intracapsular cataract surgery, a larger incision of 8-10mm is made on the outer eye.
  • A tiny probe is introduced into the eye to reach the lens. 
  • The probe is used to extract the affected lens as a whole from the eye. 
  • After this, an artificial lens is carefully inserted in its place. 
  • The incision is closed with surgical sutures.  

What are the different types of artificial lens used in Cataract surgery?

There are a variety of lenses from which one can choose for treating a cataract. Your ophthalmologist will guide you to help you make an informed choice of which is best for you. 

Let’s look at the types of lenses categorized based on the focusing ability.

Monofocal or unifocal lens:

  • These are the most commonly used lenses.
  • They help to correct one distance vision of the patient, that is, either near vision or far vision is corrected but never both.
  • The patient usually requires a pair of spectacles for complete vision.

Multifocal lens: 

  • These lenses help the patient to gain both near as well as far vision.
  • These lenses reduce the dependence of the patient on additional spectacles.

Extended deep-of-focus lens:

  • These lenses are gaining a lot of popularity lately. 
  • They help the patient to gain near, intermediate, as well as far vision.

Special function lenses: 

  • Certain specific lenses are used for special conditions like astigmatism (blurry vision).

How to care after Cataract Surgery?

The ophthalmologist recommends some of the following precautions to the patient after cataract surgery:

  • Eye drops given after eye surgery should be regularly used by the patient.
  • Avoid soap or water getting directly in the eye.
  • After surgery, you should wear an eye shield or eye patch for protection, particularly during bedtime, to avoid touching your eyes.
  • Avoid pressing or rubbing your eye. The doctor may advise you to wear eyeglasses to protect your eyes.
  • The patient should not drive any vehicle after eye surgery unless your doctor permits you.
  • After cataract surgery, the patient should avoid swimming because, during swimming, water may enter your eyes and damage them.
  • The day after your cataract surgery, you should avoid lifting heavy things and doing any work or activity. 
  • After the surgery, the patient should rest for at least one to two weeks. Do not perform any activities unless your doctor allows them.

What are the risks of Cataract Surgery?

Risks for cataract surgery are minimal, but they are there. Some of the risks are,

  • Reduced eyesight
  • Seeing glare, halos, and dark shadows
  • Risk of glaucoma: A condition in which the nerve that connects the brain to the eye (optic nerve) is damaged and may cause blindness ( Know more about- What is Glaucoma Surgery? Purpose, Procedure, Aftercare, Cost )
  • Infection of the eye 
  • Retinal detachment: It is a condition of breaking away of a layer of tissue at the back of the eye that senses light
  • Bleeding
  • Swelling ( Know more about- What is Itchy Eyes? Causes, Symptoms, Treatment, Prevention )
  • Drooping of the eyelid
  • The artificial lens may displace from its position
  • Loss of vision ( Know more about- What is Blurred Vision? Causes, Symptoms, Treatment, Prevention )
  • After-Cataract or posterior capsular opacification: This is one of the common complications of cataract surgery. Every 3 of 10 people get a secondary cataract. In this, the lens forms a scar that blocks the entry of light and thus causes problems in the vision. 

A secondary cataract is treated very easily with a yttrium-aluminium-garnet (YAG) laser capsulotomy which is an outpatient procedure (overnight stay in the hospital is not required) that takes around 10 minutes in total. The laser beam is used to destroy the area of opacification inside the lens to allow the easy passage of light.

Although there is no major risk to the patient after cataract surgery, if there is any abnormality, you can talk to your doctor immediately.

What is the cost of Cataract Surgery in India?

The total cost of cataract surgery in India can range from around INR 50,000 to INR 1,00,000. However, the cost of surgery may vary across different hospitals. There are many big hospitals and specialized doctors in India for cataract surgery. But the cost varies across different hospitals. 

If you are coming from abroad, in addition to the expenses of cataract surgery, there will be a cost of staying in a hotel, cost of living, and cost of local travel. Apart from this, after the surgery, the patient is kept in the hotel for 7 days after the surgery for recovery. So, the total cost of cataract surgery comes to be around INR 80,000 to INR 1,20,000.

We hope that we could answer all your questions about cataract surgery through this article.

If you need more information about cataract surgery and treatment, then you can contact a good Ophthalmologist.

We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you the best advice and correct treatment plan.

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