What Types Of Cataract Surgeries Exist?

Once a cataract has developed to a stage where normal vision can no longer be attained

, cataract surgery will become required. You should talk to your optometrist, who will refer you to an ophthalmologist, a surgeon who can perform the procedure. Bu what kind of surgery will it be? What procedures are available? Here's a brief summary on cataract surgery and what it involves.

Cataracts can develop in the eyes as a result of age, exposure to certain types of lights, or as a complication of diabetes or hypertension. Cataracts develop in the lens of the eye, a pouch of water and protein which is located directly behind the pupil and iris in the eye. They occur when the proteins in the lens start to clump together, causing a fuzziness of vision which can eventually worsen and cause blindness.

A little history. Cataract surgery actually goes all the way back to the sixth century BC, when an Indian physician described a process called couching, which does not replace the lens, but merely moves it to a different spot in the eye, removing it from the line of vision. Couching was practiced for centuries, and is still periodically practiced in some parts of the world today, but as it often does not fix the problem and sometimes can even make it worse, it is not the preferred method of treatment.

By the 1700s, cataract removal had been achieved and by the 1940s implants to replace the removed lens had been done. This is the type of cataract surgery that is performed today.

Types of surgery - There are three basic types of cataract surgery commonly in use today.

Conventional extracapsular cataract expansion (ECCE) involves the cutting of a 10- to 12-millimeter incision in the cornea and, through that incision, the removal of the natural lens. For years, this was the most common surgery performed.

In recent years, ECCE has been superseded by Phacoemulsification. Phacoemulsification surgery involves using a rapidly vibrating titanium tipped hand piece to emulsify the natural lens and then remove it in tiny chunks through a small incision. The advantage of this type of procedure is that the larger incision of ECCE is not needed and healing time is much quicker.

In parts of the world that don't have operating microscopes, a procedure known as Intracapsular cataract extraction is used. This involves the removal of the entire lens capsule. For years, this was the only procedure available, but it requires a very large incision and puts a great deal of pressure on the vitreous humour of the eye and isn't used where better technology is available.

After the cataract is removed, the natural lens is replaced with an implant known as an interocular lens. Although experimental versions of these IOLs have been around since the 1940s, they didn't come into common use until the 1960s and the first FDA approved model didn't appear until 1981. Prior to the development of IOLs, the lens was simply removed and the patient was required to wear thick glasses to replace the missing lens. Nowadays, IODs come in solid models for ECCE surgery, or foldable models for Phacoemulsification surgery.

by: Roger Ubik

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