Fig.1-The Normal Eye

Inside the front part of the eye is a lens, much like the lens of a camera. (Fig. 1). Its function is to focus light rays onto the retina (the film in the camera) at the back of the eye which then transmits "pictures" of what you see to the brain. This lens must remain clear for the light to pass through and reach the retina. When all or part of the lens becomes cloudy, like a "white-washed" window, the vision becomes blurred. This clouding is referred to as a cataract. The cataract is a part of the lens.. It is not a film or growth over the lens or eye.

Fig.2. Cataract Removal by Phacoemulsification 

There are several methods used to remove cataracts. Each has its advantages and disadvantages. Each patient is evaluated individually for the type of surgery best suited for their particular cataract and their particular eye.

The most commonly used advanced technique is the PHACOEMULSIFICATION TECHNIQUE (Fig.2). This procedure is normally done on an out-patient basis under local anesthesia. The operation takes 20-30 minutes and is painless during and usually after the surgery. You will recall from the first few pages of this booklet, that the lens of the eye is like an orange with a "peel" or capsule around the outside and a central core (Fig.1). In the phacoemulsification technique, the front capsule (or peel ) is removed. The central cataract is then broken into many small particles by an ultrasound probe and suctioned out of the eye, leaving the posterior capsule (peel) behind (Fig.2). A Hard plastic or soft silicone len implant (Fig.3) is then placed where the natural lens was, resting on the posterior capsule (peel). .INTRAOCULAR LENS IMPLANTS (Fig.3) are the most natural way to restore your vision after cataract surgery  and are used in almost all cases.

Fig.3- Placing an intraocular lens implant.

The main limitation of these implanted lenses is that they cannot change their focusing power like the natural lens, so ordinary corrective glasses will probably be required to give the sharpest distance vision and reading glasses will be needed even if none were necessary prior to surgery. The surgery can be performed using normal incision or small incision technique and the wound may be stitched or stichless depending on the doctor’s evaluation.

IN ADDITION YOU SHOULD:
1) WEAR GLASSES OR METAL SHIELD AT ALL TIMES FOR PROTECTION.
2) DO NOT LIFT ANY HEAVY OBJECTS OVER 5-10 POUNDS , INCLUDING GRANDCHILDREN, for 1-2 WEEKS.
3) DO NOT DO ANY STRAINING - INCLUDING DURING BOWEL MOVEMENTS.
4) IF BOWEL MOVEMENTS ARE DIFFICULT, LET THE DOCTOR KNOW AND A STOOL SOFTENER WILL BE ORDERED.
5) DO NOT BEND BELOW WAIST LEVEL FOR MORE THAN 10 MINUTES.
6) DO NOT WASH HAIR for one day, THEN limit the water getting into the eye with washing hair, showering etc.
7) You may bend to put on your shoes, pick something up off the floor, read, go to movies, be up and around, in general. The key is common sense. Just take everything easy for a week or so.
8) We do not recommend driving for one week after surgery as you are likely to be blamed for any accident which occurs shortly after your eye surgery.
9) NO SEXUAL ACTIVITIES FOR 3 DAYS.
10) YOU MAY READ FOR SHORT PERIODS, UP TO TEN MINUTES, FOR TWO WEEKS.
11) IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO LET US KNOW.
12) IF THERE IS A QUESTION, DO NOT DO IT; CALL AND ASK FIRST.

COMPLICATIONS:
As with any surgical procedure, the possibility of complications always exists. In spite of advances which have increased the safety of cataract surgery and in spite of the best efforts of expert surgeons, complications can still arise. Possible complications range from minor irritations of the eye to total, irreversible loss of vision. It is important to know that the chances of having an excellent result after surgery is over 95%. Fortunately, the more serious complications are the rarest ones. The more common problems are usually treated with drops.

HOWEVER, GLAUCOMA, RETINAL DETACHMENT, INFECTION, MACULAR EDEMA, HEMORRHAGE INSIDE OR BEHIND THE EYE, MALPOSITION OR INABILITY TO PLACE AN INTRAOCULAR LENS, LOSS OF THE NUCLEUS, VITREOUS, OR CAPSULE, ABNORMAL PUPIL OR LID, DOUBLE VISION, ACCELERATION OF DIABETIC CHANGES IN DIABETIC PATIENTS ONLY, AND OTHER KNOWN OR UNKNOWN PROBLEMS WHICH CAN OCCUR AT SURGERY OR ANYTIME AFTER SURGERY AND CAN LEAD TO LOSS OF VISION OR LOSS OF AN EYE. IF YOU HAVE ANY OF THE PROBLEMS BELOW, PLEASE CALL US AS SOON AS POSSIBLE. DO NOT WAIT!

1) INCREASED REDNESS OR IRRITATION.
2) INCREASED PAIN.
3) INCREASED BLURRING OF VISION.
4) FLASHING LIGHTS, FLOATING OBJECTS, OR LOSS OF PART OR ALL OF YOUR VISION.
5) ANY UNUSUAL CHANGE IN VISION OR NEW OR UNUSUAL SYMPTOMS - PLEASE CALL US!