If the lens becomes cloudy, the light reaching the retina is blurred and distorted, and your vision is affected. This clouded lens is called a cataract, and it must be removed before vision can be restored. A clouded lens can be
compared to a window that is frosted or “fogged” with steam. Cataracts are not cancerous. They can be treated with a
surgical procedure that has become a fairly common procedure in the United States.
The two most common types of cataracts are: the cortical cataract and a posterior subcapsular cataract. Depending on the type of cataract, a patient will experience different vision problems, but the most common cataract symptoms include:
• blurring vision
• sensitivity to light or glare
• double vision in one eye
• poor night vision
• needing brighter light to read
• experiencing fading or yellowing of colors.
If the cloudiness is not near the center of the lens, you may not be aware that you have a cataract.
Cataracts can be removed at any age. You no longer have to wait until the cataract “ripens” or until you lose your sight before surgery can be performed. In fact, the placement of an intraocular lens (IOL) implant to restore vision is best done in an eye when the cataract interferes with your daily activities or causes a decrease in vision.
In removing cataracts, the clouded lens (cataract) must be removed surgically. Cataracts cannot be removed via laser.
A common surgical procedure used today is extracapsular cataract extraction. The surgeon makes an incision in the eye and the front (anterior) capsule of the lens to remove the clouded lens. The lens tissue within the capsule is removed. The sac-like capsule that surrounds the lens remains in place. This capsule is left intact for two reasons: to avoid disturbing the gel, or vitreous, that fills most of the eye, and to support an intraocular lens.
After the cataract has been removed, the incision is closed. Often the sutures, which are finer than human hair, do not need to be removed. Some patients, in fact, don’t even need sutures, and the “no suture” surgery is popular today.
Another common type of extracapsular cataract extraction is phacoemulsification (often just called “phaco”), where the surgeon removes the cataract through an even smaller incision than the one used in conventional surgery. In this procedure, the surgeon uses a
computerized instrument consisting of a needle about the size of a ballpoint pen tip which vibrates at about 40,000 times a second.
This ultrasonic vibration dissolves the cataract into fine particles, which are then vacuumed through an opening in the instrument.
The benefits of the phaco approach include an early restoration of vision and return to normal activities. Phaco is well suited for patients with a less-advanced cataract, when an earlier return to activity is required or when increased physical activity is part of the
convalescent period.
