PCL07 - Cataract Surgery Myat

Cataract surgery, usually an outpatient procedure, takes an hour or less to perform. Eyedrops placed in your eye dilate your pupil. You'll have local anesthetics to numb the area, and you may be given a sedative to help you relax. If you're given a sedative, you may be awake but groggy during surgery. Rarely does anyone require general anesthesia for cataract surgery.

Typically, two things happen during cataract surgery

• The clouded lens is removed


• A clear artificial lens is implanted

In some cases however a cataract may be removed without implanting artificial lens.

Surgical methods used to remove cataracts include:

Phacoemulsification:

In phacoemulsification, your surgeon removes the cataract but leaves most of the back layer of the lens (lens capsule) in place. To do this, your surgeon makes a small incision — about 1/8 inch, or 3 millimeters (mm), long — where the cornea meets the conjunctiva and inserts a needle-thin probe. Your surgeon then uses the probe, which transmits ultrasound waves, to break up (emulsify) the cataract and suction out the fragments. The lens capsule remains in place to provide support for the lens implant.

Extracapsular cataract extraction:

If your cataract has advanced to the point where phacoemulsification can't break up the clouded lens, your surgeon may do an extracapsular cataract extraction. This procedure requires a larger incision, about 2/10 inch (10 mm), where the cornea and sclera meet. Through this incision your surgeon opens the lens capsule, removes the center (nucleus) of the lens in one piece and vacuums out the softer outer lens, leaving the capsule in place. Once the cataract has been removed by either phacoemulsification or extracapsular extraction, a clear artificial lens is implanted into the empty lens capsule. This implant, known as an intraocular lens.

Intraocular Lens (IOL)

IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close. However, many IOLs are flexible, allowing a smaller incision that requires no stitches. The surgeon folds this type of lens and inserts it into the empty capsule where the natural lens used to be. Once in place the lens unfolds to about 1/4 inch (6 mm) in diameter. Recent advances in IOLs include blue-blocking lenses, which filter out ultraviolet light. Other types of IOLs provide multifocal vision — being able to see things both near and at a distance. Multifocal lenses offer reasonably good near and distance vision. However, vision at the intermediate range is sometimes less than satisfactory. Glare is reportedly a problem with multifocal lenses, but design improvements are ongoing.

Results
Cataract surgery successfully restores vision in the majority of people who have the procedure done.
Months to years after cataract surgery, you have a 25 percent risk of developing a condition known as posterior capsule opacification (PCO), or second cataract. This happens when the back of the lens capsule — the part of the lens that wasn't removed during surgery and that now supports the lens implant — becomes cloudy and impairs your vision. The gradual clouding is the result of cell growth on the back of the capsule.
To treat PCO, you need a painless, five-minute outpatient procedure called YAG (yttrium-aluminum-garnet) laser capsulotomy. In YAG laser capsulotomy, a laser beam is used to make a small opening in the clouded capsule to let light pass through.
After the procedure, you typically stay in the doctor's office for about an hour to make sure your eye pressure doesn't increase — a potential complication if you have glaucoma or are extremely nearsighted. Other complications are rare but can include swelling of the macula and retinal detachment.


http://www.mayoclinic.com/health/cataract-surgery/EY00014