The day of surgery
The surgery, which involves replacing the lens, is done on an outpatient basis. It is a quick and painless procedure. Before surgery, you will be asked to change into the patient gowns provided by the hospital.
For the surgery, the pupil must be dilated with a collyrium (ophthalmic eye drops) prescribed by your ophthalmologist or physician. The surgeon will disinfect the eye to be operated on and administer a local anaesthetic. The surgery takes between 10 and 15 minutes. Once completed, the eye will be covered with a protective dressing. After a short rest, you can return home. Since you cannot drive afterwards, someone has to accompany you on the day of surgery.
The day after the procedure, the operated eye will be checked. Your ophthalmologist will explain the post-operative medical treatment to you.
The types of anaesthesia
Usually, a local (topical) anaesthetic, consisting of eye drops, is used. In some cases, it can be combined with a mild sedative. Another option is general anaesthesia (recommended for children, very nervous people or people with specific pathologies).
The surgical technique
The purpose of the surgery is to replace the lens that has become opaque (cataract) or a clear lens (simple presbyopia) with a transparent artificial implant in the following manner:
- Keeping the eye open by immobilizing the eyelids.
- Making incisions to introduce the instruments into the eye. With modern micro-incision techniques (between 1.5 and 2.8 mm), the wound is self-sealing.
- Injecting a viscoelastic substance, a gelatinous material that helps protect the eye.
- Performing a capsulorhexis: making a round opening in the anterior lens capsule with a special instrument in order to introduce a probe, which will pulverize the lens core. The opening is made manually or with a laser.
- Lens fragmentation by ultrasound and its extraction (phacoemulsification).
- Inserting the intraocular implant in the capsular bag.
The results after surgery
Eyesight begins to recover from the first day after the surgery. Total recovery may take several weeks.
After the artificial lens is implanted, sometimes the distance refraction is not quite correct. A subsequent laser correction (Lasik) is required in such cases.
After the procedure, the patient may experience night-time halos around light sources or be disturbed by the headlights of approaching cars. These disturbances diminish significantly after a few months, in particular due to the phenomenon of brain neuroadaptation.
Procedure success rates
This surgery is the most common procedure performed in the world, and enjoys a complete success rate in 95% of cases. However, as with any intervention, one can never completely exclude a possible complication. The most severe complication that may occur during cataract surgery is an intraocular infection. The frequency of this type of complication is 1 in 2,500 cases. In 4 cases out of 1,000, difficulties can occur during surgery, causing retinal detachment. This then will require additional surgery.
In a third of patients, the lens capsule can become opaque again a few months or even years after surgery. This phenomenon is called a “secondary cataract” or “posterior capsule opacification”. The treatment involves making an opening in the opaque posterior capsule (capsulotomy) using a YAG laser. This will restore the eyesight by the next day after laser treatment.