Your Cataract Treatment

Modern cataract surgery is a "day stay" procedure.  Most ambulatory surgicenters (ASCs) and hospitals allow the patient to remain in their clothes and merely wear a gown, cap and shoe covers in the operating room.  Typically, the patients are allowed to have a light breakfast.  On the day of treatment, you will be at the hospital or ASC for about three hours.  The procedure is usually performed under topical anesthesia, which means drops are applied to the eye for comfort, in addition to dilating drops.  The dilating drops increase the size of the pupil so the surgeon has easier access to the cataract.  In addition, an intravenous catheter is placed to facilitate the use of sedation during your procedure. 

You will then be brought into the treatment room where the anesthesiologist and circulating nurse will make sure you are comfortable and well-positioned appropriately the next member of our surgical team, the scrub nurse, will use an antiseptic solution to "prep" your eye.  The scrub nurse will then place a light drape around your eye so that there will be a sterile surgical field.  Alas! We can get to the actual process of removing the cataract and restoring your vision. (see video at http://www.northeastlaser.net/Special-id-85.html)

The surgical microscope will then be positioned about one foot above the operative eye.  The microscope has intense lighting and in combination with the dilation, the brightness can be very impressive.  The light intensity is notable only for a few moments, after which your eye will adapt to the brightness.  The surgeon then places a small eyelid supporting instrument so that you will not have to worry about blinking. 

Utilizing the microscope to magnify your eye, the surgeon creates a small peripheral corneal incision that allows controlled access to the internal structures of the eye.  The surgeon has micro instrument which enable him/her to address the cataract through the pupil.  The next step involves creating a small opening in the cataract capsule.  This opening is about 5 millimeters in diameter, and it is through this opening the surgeon applies ultrasonic energy to gently disassemble the cataract nucleus into tiny fragments.  The cataract fragments are suspended in the balanced saline solution which the surgeon gently rinses from your eye. 

Once the nucleus has been removed, the cortex of the cataract remains.  As the cortex is typically very soft, no energy is needed to disassemble it, and cortical removal is usually performed with a very low power vacuum delivered by an instrument called the irrigation/aspiration hand piece.  Cortical clean-up completes the process of cataract extraction, and the eye is now ready for intraocular lens implantation. 

Today's IOLs are made of very soft, flexible polymers, so they can be folded in order to be placed through the very small corneal incision directly into the capsular bag.  The lens is supported in the capsule by the flexible haptics. 

The surgeon does a final check to make sure the lens is in good position.  The wound is tested to ensure that it is watertight, and the lid supporting speculum is removed.  Immediately following the treatment, the patient is monitored in the post operative holding area and finally discharged.