Cataract Surgery

By Renee Bovelle, MD

Modern cataract surgery makes use of an amazing array of high-tech equipment and techniques. Gone are the days when cataract surgery required a two-week stay in the hospital, with your head immobilized with sandbags until you healed. Todays cataract surgery is an outpatient procedure that takes a half-hour or less and lets you get back to your normal activity level within a few days.
One of the most dramatic advances in cataract surgery involves anesthesia for the procedure. Long ago, patients were put to sleep for cataract surgery. More recently, patients were given a shot behind the eye before surgery to numb it. But now, the vast majority of cataract surgeries are performed under topical anesthesia, with only a few numbing drops placed on your eye before the start of the procedure. This eliminates both the risks and discomforts of the shot. Also, the shot made the vision blurry for several hours after surgery with just the numbing drops, some patients notice improved vision within minutes after the surgery is completed.
The technique of cataract removal has also undergone major improvements. Once upon a time, the cataract was removed whole through an incision over a half-inch long. Modern cataract surgery is performed through an incision less than an eighth of an inch long. A small instrument is inserted through this tiny incision, and is used to break the cataract into many small pieces that are removed without the need for a large incision. There are many advantages to a smaller incision, including a faster recovery time, less need for glasses after surgery, and a smaller risk of infections after surgery. In addition, while the old incisions required many stitches to close up, modern cataract surgery can often be performed without any stitches, or with one stitch at most.
During cataract surgery, the cloudy lens of your eye is removed and replaced with a clear lens implant. In the old days, there were no implants, and patients had to wear thick glasses (“Coke-bottle glasses”) after surgery to see well. Now there are implants that are placed directly into the eye, reducing or eliminating the need for any glasses after surgery. The newest implants (called multifocal implants, or presbyopia-correcting implants) can even provide sharp vision at both distance and up close, reducing or eliminating the need for any kind of glasses, including reading glasses, after surgery.
Routine cataract surgery is so well tolerated that it has become the most common surgery performed on adults in the United States. As a result of these many high-tech developments in all aspects of cataract surgery, the operation is more successful and has a faster recovery time than ever before.