What is Cataract Surgery?

At some point in everyone’s life, vision begins to decline due to cataracts. It is very likely you have already encountered the term cataract from someone raving about their vision after cataract surgery. (after all, something about cataracts brought you to this page)

The cool part about cataracts (the only cool part) is that cataracts are curable! And cataract surgery (the procedure that cures them) is one of the most common surgeries performed in the world!

Cataract surgery involves… removing the cataract. Simple Enough. While it is labeled a “surgery”, cataract surgery is really more of an outpatient procedure. It’s painless! Sedation isn't necessary. It really takes no time at all and also recovery is really quick! All in all, cataract surgery is highly safe and effective. What's there not to love?

Dissolving Cataracts

An almost magical technology is used during cataract surgery to dissolve cataracts. This technology is called phacoemulsification. What a jumble of a word! But what exactly does it do? In short, phacoemulsification uses ultrasound energy to break up or emulsify cataracts.

A tiny cataract instrument called a phaco probe has a tip that vibrates in a linear direction at a fixed microscopic speed. This intensive vibration creates ultrasonic waves. When this tip is applied to the cataract, two things happen. When the tip of the probe hits the cataract it creates a micro impact and compression breaking up a microscopic part of the cataract. In addition, the ultrasonic waves generated from the vibration of the tip release its energy into the cataract continuing the emulsification process.

At this point, only a small amount of the cataract has actually been broken up (remember these are all microscopic movements). But that process is repeated again and again to break up more small parts of the cataract. All of these steps happen incredibly fast (each second has thousands and thousands of cycles!) allowing the cataract instrument to create clean grooves into the cataract.

_{Clean Grooves; image by Gb11111, CC0, via Wikimedia Commons}

Once the cataract is broken up, a tiny vacuum is used to remove the remainder. The remaining debris is then gently washed away. Because cataracts develop from the natural lens inside the eye, this lens must then be replaced with a completely new artificial lens. This new clear lens provides great clear vision for the rest of your life!

A very controlled microscopic process.

Lasers Can Also Break Up Cataracts

Lasers have had an amazing effect on refractive surgery. Lasers have made revolutionary procedures such as lasik possible. One laser in particular, called the femtosecond laser, has been so versatile that it has spread from lasik into many different procedures including cataract surgery. This laser has caused a large change into how cataract surgery is performed.

Laser cataract surgery does a remarkable job at making cataract surgery safer and more efficient. While cataracts can be and still are broken up by the manual method, lasers just make it easier.

The femtosecond laser works by placing very precise laser pulses. By placing these pulses next to each other, the laser is able to "cut" different structures.

• One major use of the femtosecond laser in cataract surgery is with astigmatism correction. In the most simple explanation of astigmatism, one side of the cornea is steeper than the other side. The femtosecond laser can be used to flatten out the steep side of the cornea to make all sides equal. This corrects astigmatism! However, the fun doesn’t end there.

There are a few steps which can benefit from the controlled reproducibility that a laser provides. Now, cataract surgeons are typically quite skilled but there isn’t any harm of utilizing advanced technology to make things even better.

• During cataract surgery, ultrasound energy is used to break up and dissolve the cataract. Before this happens, however, a window to the cataract must be created. This is called the capsulorhexis. Lasers create perfect capsulorhexises! These windows are perfectly round and centered. This allows the new intraocular lens to sit in the perfect position within the eye. That means improved accuracy in getting the best vision.
• Finally, these same lasers are used to divide up dense cataracts. The typical way of removing a cataract is by using ultrasound energy in a process called phacoemulsification. By using a laser to divide up dense cataracts, less energy is used within the eye. Less energy improves outcomes and recovery. The laser energy is applied to the cataract to divide it up like a pizza pie into quadrants, sextants or in some cases even tiny little cubes.

_{Dividing a cataract like slices of a pizza; image by Eric Chan, CC BY 2.0, via Wikimedia Commons}

After the laser does its work, the cataract surgeon must still go and finish separating what the laser started. But, however, as the cataract is already pre-divided, this process goes quicker and uses less energy than what would have been required manually. Making a safe surgery even safer!

Lasers have really changed the world of ophthalmology and cataract surgery is no exception. The femtosecond laser has made cataract surgery safer and more accurate to provide your best vision.

See also Your Comprehensive Handbook To Learn What Are Cataracts on EyeMountain.com to learn more

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