How is a Cataract Removed?

Your ophthalmologist performs this delicate surgery using a microscope, miniature instruments and other modern technology.

Anesthesia is a necessary part of having a cataract removed. Two types of anesthesia, local or topical are used in most cases.

• Local anesthesia is administered by placing a needle over and under the eye. This eliminates any sensation of pain and prevents movement of the eye during surgery.
   
• Topical anesthesia is administered by placing drops on your eye. It eliminates any sensation of pain but does not prevent your eye from moving around.

Both types of anesthesia leave you fully awake and aware during the operation. The type of anesthesia that the surgeon will choose for you will depend on the technique your surgeon chooses and the condition of the eye.

In order to remove the cataract and replace it with a new lens, your doctor will make an incision in your eye. Incisions can be made in either of two places in your eye, clear cornea or the sclera. The cornea is the transparent area of your eye over the iris and pupil. The sclera is often referred to as the white part of your eye.

Where the incision is made and how large it will be depends on the technique your surgeon chooses for you. Your doctor can help you understand the differences and determine which technique is best for you.

There are two primary techniques to remove a cataract:

• Extracapsular cataract extraction (ECCE)
  technique requires a large incision
  (up to 10-12 mm in length) in the sclera
  and removes the hard center of the cloudy
  lens in one piece.
   
• Phacoemulsification, or phaco technique
  requires a smaller incision in either the
  sclera or clear cornea (5.5 - 3.2 mm or less)
  on the side of the cornea. The surgeon then inserts a small probe into the eye. This device emits ultrasonic waves that soften and break up the cloudy center of the lens so it can be removed by suction.

Most cataract surgery today is done by phacoemulsification, which is also called small incision cataract surgery. In most cataract surgeries, the removed
lens is replaced by an intraocular lens (IOL).

An IOL is a clear, artificial lens that requires no care and becomes a permanent part of your eye. With an IOL, you'll have improved vision because light will be able to pass through it to the retina. Also, you won't feel or see the new lens.

Some people cannot have an IOL. They may have problems during surgery, or maybe they have another eye disease. For these people, a soft contact lens may be suggested. For others, glasses that provide powerful magnification may be better.