Cataract Surgery

About Cataract Surgery

Cataract surgery removes the clouded natural lens of the eye and replaces it with an artificial intraocular lens. It is one of the most frequently performed surgical procedures in the world, and cataract remains a leading cause of blindness globally, particularly where access to surgery is limited. Cataracts are most often age related and become very common in older adults. The standard modern technique is phacoemulsification, introduced by the American ophthalmologist Charles Kelman in the late 1960s. Through a tiny incision in the cornea, a continuous circular opening is made in the front of the lens capsule, ultrasound energy is used to break up and aspirate the lens nucleus, the remaining cortex is removed and a folded artificial lens is inserted into the capsular bag. The British surgeon Harold Ridley implanted the first intraocular lens in 1949. Lens options include monofocal lenses, toric lenses that correct astigmatism, and multifocal and extended depth of focus lenses that reduce dependence on glasses but may cause glare or halos. Manual small incision cataract surgery is widely used in low resource settings. Surgery is usually performed as a day procedure under topical or local anesthesia, and vision often improves quickly. Complications are uncommon and include clouding of the capsule behind the lens, called posterior capsule opacification, which can be treated with a YAG laser, as well as swelling of the central retina, retinal detachment, rupture of the posterior capsule and, rarely, a serious infection called endophthalmitis. Femtosecond laser assisted surgery automates some steps but has not clearly improved outcomes.