By Dr. William Lee, Charleston Eye Care
As the population matures, cataract surgery will continue to be one of the most common, safest and most beneficial surgeries performed. It is now a routine 30 minute procedure done in an outpatient facility.
Usually an anesthesia is given intravenously to alleviate anxiety, and numbing eye drops are administered to the eye. Typically there is no pain during or after cataract surgery and most daily activities such as driving can be resumed the day after surgery. Full activities, including vigorous exercise can be resumed after one week.
A cataract is just the clouding of our natural lens inside the eye. In humans, the lens starts out clear in youth and usually begins to turn cloudy, brown and hard in our sixth or seventh decade. Symptoms include blurriness, glare, starburst appearance of headlights at night, or a general feeling of dulled vision. When new glasses do not help and symptoms become bothersome on a daily functional level, then cataract surgery is recommended.
The entire surgery is done under the microscope. The pupil is dilated before surgery with drops. This gives access to the cataract, which lies behind the pupil. A tiny incision is made on the outside corner of the eye where the white of the eye meets the clear cornea. A specialized probe uses ultrasound energy to delicately soften the hard cloudy lens and vacuum it out.
After removing the cloudy natural lens, an artificial lens implant is chosen to replace it based on prior measurements. The artificial lens is made out of a clear flexible material that essentially lasts forever. The lens implant is rolled up like a carpet so that it can get through the tiny incision. Once placed back behind the iris and within the capsule of the former lens, the artificial lens is unfolded and centered into place just where the natural lens had been. Most often, the tiny incision is self-sealing and no stitches are needed. A clear protective shield or patch is placed over the eye just overnight. The patient is seen in the office the next day, one week later and one month later. Typically, the second eye is ready to be done around that time.
Medicare and most insurance companies pay for the surgery and the basic lens implant. Most patients with the basic implant experience good vision without glasses much of the time, and great vision with thin glasses the rest of the time. Premium implants can offer greater spectacle independence for some select patients, but are not covered by insurance. Thanks to the lens implant, the big thick cataract glasses of yesteryear are history. Often drug store glasses are all that is needed.
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