Older people commonly experience cataracts, which are a clouding of the eye's lens. According to Mitchell Scheiman, Maxine Scheiman and Stephen G. Whittaker, authors of "Low Vision Rehabilitation", age-related cataracts are caused by clumps of protein that reduce the sharpness of images and by the slow yellowing of the lens. Cataract removal is considered very safe, although risks include infection and retinal detachment. There are three types of extraction procedures: intracapsular, phacoemulsification and extracapsular.
Intracapsular Cataract Extraction
According to Gary H. Cassel, M.D., Michael D. Billig, O.D. and Harry G. Randall, M.D. authors of "The Eye Book", intracapsular cataract extraction (ICCE) is rarely performed these days since modern microsurgical techniques are superior. The technique was developed in the 1980's and involved removing not only the entire lens, but also the capsule that holds it in place. The authors of the website VisionRx describe how the surgeon makes a large opening in the eyeball and injects medicine that causes the fibers that hold the lens to dissolve. After the natural lens is removed, an intraocular lens is implanted in front of the iris. This type of surgery requires several stitches, has a recovery period as long as six or more weeks and carries a greater risk of retinal detachment and swelling than other types of cataract surgery.
Phacoemulsification Cataract Extraction
According to eye surgeon Chris Heaven, author of the website Cataract Care, phacoemulsification has been the most popular type of cataract surgery in the United Kingdom since the mid 1990's. Incisions made during this procedure can be as small as 3 millimeters or 1/8th of an inch. Phacoemulsification involves using ultrasound waves to break the cataract into pieces that are vacuumed up by a special surgical instrument. After the cataract is removed, the leftover fragments are further cleaned with use of irrigation and aspiration. A surgeon may either enlarge the opening before inserting the new lens or use a folding lens implant that fits through the tiny opening and is then manipulated to fit into place. This procedure requires only one or two stitches to close the wound and recovery time is only two to three weeks.
Extracapsular Cataract Extraction
Scheiman, Scheiman and Whittaker report that extracapsular surgery is generally used if the cataract has advanced beyond the point where phacoemulsification can successfully break up the clouded lens. Extracapsular (ECCE) surgery involves opening the capsular lens bag in order to extract the inner lens from the eye in one piece. Cassel, Billig and Randall report that a surgeon may choose this technique if he or she is more skilled in this procedure.
YAK Laser Surgery
Although lasers are not commonly used in cataract surgeries, they are used to treat conditions in which the intraocular implant lenses become cloudy. Cassel, Billig and Randall call this a "secondary cataract" or a opacified posterior capsule that can cause decrease in vision. Lasers called "YAG lasers" removes the hazy capsule from the line of sight without actually touching the eye or making an incision. According to authors on the website All About Vision, this procedure takes only a few minutes, is entirely painless and is followed up with anti-inflammatory eye drops.
References
- All About Vision: Cataract Surgery Complications
- Cataract Care: The Cataract Operation
- Vision Rx: Intracapsular Cataract Extraction
- "The Eye Book"; Gary H. Cassel, M.D., Michael D. Billig, O.D. and Harry G. Randall, M.D.; 1998
- "Low Vision Rehabilitation"; Mitchell Scheiman, Maxine Scheiman and Stephen G. Whittaker; 2007
