This Is How The New Lens Stays In The Eye After Cataract Surgery

During cataract surgery, the old cataract is removed and replaced with a new artificial lens. This is an important step.

The cataract develops from the natural lens inside the eye. This natural lens serves an important purpose. It focuses light into the back of our eye. In fact, 1/3 of the eye’s ability to focus light comes from this natural lens.

So if we didn’t put an artificial cataract lens in after cataract surgery, vision would be VERY blurry. You would require large thick glasses in order to see. (and was how cataract surgery was done before the invention of artificial cataract lenses).

So that’s the purpose of the artificial lens, do what that old lens used to do (and then some, since frequently cataract surgery is able to correct vision and with advanced lenses reduce the need or even eliminate glasses).

Where Does This Lens Go?

The simple answer is this lens sits exactly where the cataract used to be.

This is very advantageous. By placing the new artificial cataract lens where the old cataract used to be, it compartmentalizes the lens away from any delicate structures in the eye. Making artificial lenses very safe and effective for the whole lifetime after cataract surgery.

The cataract is suspended in the eye within a bag - called the capsule. This capsule is then attached to the walls of the eye through special ligaments called suspensory ligaments or zonules. This allows a smooth spherical object such as the lens remain in the same position within the eye.

Cataract surgery is actually designed to preserve this capsule bag for the new artificial lens.

To access the cataract, a circular open is made through this capsule bag. The cataract is then broken up into pieces, dissolved and removed through a micro-vacuum. So all we are left with is the capsule bag.

Placing The New Lens

The new artificial lens is rolled up to fit through the tiny cataract surgery incision. Once inside the capsule bag, it unfolds and expands to fill the space.

But the new lens isn’t just a circle like the old one. The new lens actually has two “arms” (called haptics) on opposite sides of the lens. These haptics expand even further out into the edges of the bag. This keeps the lens centered within the eye as well as prevents the lens from rotating around.

Because the lens is larger than the circular opening of the bag, it isn’t going anywhere. It stays secured within the bag.

Over time, the capsule bag shrink wraps over the new lens - further securing the lens in place.

Alternative Places For The New Lens

In the past, artificial cataract lenses used to be placed between the capsule bag and the iris. Various reasons including cataract surgery technique as well as how lenses were made at that time necessitated placement in this location - called the sulcus.

One main issue with placing a lens in this location is that the lens can potentially rub up against the iris and cause some additional inflammation. Thus, this location fell out of favor as cataract surgery techniques developed to allow placement in the capsule bag instead.

However, an artificial lens may still be placed in the sulcus if there are any issues with the capsule bag during surgery such as a break in the back of the bag preventing safe placement of a lens.

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