Cataracts can generally be left alone or be removed. The timing of removal is controversial. Generally, the earlier the lens is removed, the lower the complication rate. A crystalline lens (pre-cataract) can even be removed before a cataract forms. This is often done for vision correction purposes as the lens is replaced by an implant with a prescription customized for the patient’s eye. This is the among the best ways to reduce or eliminate the need for glasses or contact lenses. Certainly, there are risks of all surgery and the risks of removal must be balanced with the potential benefit. The risks can be minimized by selecting an excellent surgeon and excellent staff and excellent facility for the surgery. We are lucky to have very gifted surgeons and have our own facilility that has been accredited by AAAHC.The cataract (cloudy lens) is generally removed by breaking the whole lens into fragments with ultrasound and vacuuming (aspirating) the fragments through a very small incision located in the cornea. By entering the eye through a specially designed incision, there is generally no bleeding and limited inflammation and no stitches required.
Older techniques for removal have largely disappeared in the USA. These include intracapsular cataract extraction and manual expression by the extracapsular method.
Recently FDA approved is “laser” cataract surgery. This still needs to be supplemented by traditional ultrasound energy can double the time required for an efficient and skilled surgeon to care for the patient. It also adds dramatically to the cost. The benefits remain to be seen. The promise is for greater accuracy and standardizing surgery from the mediocre surgeon to the advanced surgeon for more predictable outcomes.
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