What Is Small Incision Cataract Surgery and Is It Right for Me? Cataract Awareness Month

Cataract surgery has come a long way over the years. Thanks to advances in technology and technique, cataract surgery has evolved from a relatively large incision with sutures and overnight stays in the hospital to much smaller incisions that usually don’t require sutures and same-day procedures that often require less than an hour of time from beginning to end. That’s terrific news, as cataract surgery is the most common ophthalmic procedure performed in the United States, with more than 3 million cataract surgeries performed each year. 

As cataract surgery has come such a long way and is so common, we’re taking a look at developments in cataract surgery, how cataract surgery is performed today, frequently asked questions about cataract surgery, and important things to know before surgery for this Cataract Awareness Month. 

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What Is Small Incision Cataract Surgery?

​​Small incision cataract surgery is the most common procedure used for cataract surgery today. Your eye surgeon will make a small incision in the cornea or, less often, the sclera, to access your cataract lens. The surgeon will then use a special ultrasonic device that emits ultrasound waves to break up the cataract lens into tiny pieces, which can then be gently suctioned out through the same incision. This is known as a phacoemulsification procedure, or phaco for short.  
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What Happens After the Cataract Lens Has Been Removed?

Once your cataract lens has been removed, your eye surgeon will replace it with an intraocular lens (IOL) implant. Your cataract surgeon will help you determine which IOL type best suits your vision needs prior to surgery. Depending upon your eye, vision, and lifestyle, your surgeon may recommend:

• Monofocal IOL, which provides excellent distance vision following cataract removal
• Presbyopia-Correcting IOL, which offers excellent distance vision, as well as presbyopia (age-related inability to see at arms length or close objects clearly) correction, and come in two types – accommodating lenses and multifocal lenses
• Toric IOL, which corrects astigmatism, the most common vision problem, causing blurry vision at all distances and usually caused by an irregularly shaped cornea

 
These clear, artificial lenses require no care and become a permanent part of your eye. With advances in technology and delivery, these lenses can usually be inserted through the same incision used to remove the cataract lens immediately following cataract removal. 
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Will I Feel the IOL?

Although the IOL becomes part of your eye, you will not be able to feel it!

If I Have Cataracts in Both Eyes, Do I Have to Get the Same IOL in Each Eye?

Not necessarily. Your cataract surgeon will discuss your options to help you achieve the best possible outcome based on your eyes and vision needs. That may mean the same type of IOL in each eye, or it may mean a specific combination of two different types of IOLs. Helping your eye surgeon understand your lifestyle will enable you to get the best possible IOLs for you. 

What Happens if the Phaco Procedure Is Not Able to Remove the Cataract Lens?

If the cataract has advanced to the point that it cannot be removed with phaco, your cataract surgeon will need to remove it in one piece through a slightly larger incision. This procedure is call extracapsular cataract extraction, and your eye surgeon will discuss this possibility with you prior to your procedure. 

If I Have Cataracts in Both Eyes, Will They Be Removed at the Same Time?

No, cataracts are removed one at a time in order to achieve the best possible result. 

Are There Risks Associated with Small Incision Cataract Surgery?

As with any surgical procedure, there are always risks. Thankfully, cataract surgery is one of the safest and most effective surgical procedures performed. Complications of cataract surgery include:

• Infection
• Bleeding within the eye
• Retinal detachment
• Increased pressure within the eye (glaucoma)
• Swelling of the cornea or retina
• Partial or complete loss of vision

 
These conditions are usually treated successfully with medications or additional surgery. Your cataract surgeon will discuss these risks with you and answer any questions you have prior to surgery. 
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How Long Does Cataract Surgery Take?

Thanks again to advances in technology and technique, cataract surgery to remove the cataract lens and implant the IOL should take about 10 minutes. In most cases, you will be done and able to go home in under two (2) hours – sometimes less. 

Does Cataract Surgery Hurt?

Your cataract surgery should not be painful. You may experience mild discomfort, but generally, your experience should be comfortable. Your eye will be numbed for the procedure, and you will receive a mild sedative to help you relax.

How Long Does It Take to Recover from Cataract Surgery?

Modern cataract surgery is performed as an outpatient procedure, and you should be able to go home within a couple of hours of your procedure. You should be able to resume normal activities the day after your cataract surgery.

Will I Need to Wear an Eye Patch After Cataract Surgery?

No, your eye should recover without the need for an eye patch.  

Can I Drive After Cataract Surgery?

You will not be allowed to drive after your cataract surgery, but you should be able to resume normal activities by the following day. 

How Long Until I Can See Well After Cataract Surgery?

You should notice a marked improvement in vision immediately after cataract surgery thanks to your new IOL. However, it may take up to a week after surgery for your vision to stabilize. 

How Will My Eyes Feel After Cataract Surgery?

Your eyes may be itchy for a few days after surgery, and you may experience some mild discomfort. If you notice a crusty residue on your eyes, you can use a clean, damp facecloth to very gently remove it. Avoid rubbing or pressing on your eyes while recovering from cataract surgery. 

Should I Contact My Eye Surgeon After Cataract Surgery?

Your cataract surgeon will schedule you for a post-operative visit after your cataract surgery. You should contact your eye surgeon immediately though if you experience any of the following:

• Severe or increasing pain that does not get better with over-the-counter medication
• Sudden onset of floaters or flashes in your eye

 
These could be signs of a more severe eye problem and should be considered an eye emergency.
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Am I at Risk of Developing a “Secondary Cataract” After Cataract Surgery?

The term secondary cataract is a common name for a posterior capsule opacity and means that a hazy membrane has developed in the capsule behind the new lens. This is not actually a cataract; once a cataract is removed, it cannot recur. Because the symptoms are similar to a cataract and a posterior capsule opacity causes blurry vision like a cataract would, secondary cataract is often used to describe this condition.
 
Thankfully, if you experience a posterior capsule opacity or “secondary cataract” following cataract surgery, it can be easily treated with a procedure called a YAG laser capsulotomy. A YAG procedure opens the membrane behind the lens and allows light to flow directly to your retina once again. 
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More Information on Cataract Surgery

We hope this answers many of your questions about cataract surgery. If you would like to know more, we have a lot of information on our website on the following pages:

• Cataract Surgery
• Intraocular Lens Implants
• YAG Capsulotomy

 
You can also visit the following cataract and cataract surgery resources provided by:

• American Academy of Ophthalmology (AAO) EyeSmart
• PreventBindness.org

 
Finally, if you have questions about cataracts or cataract surgery and would like to schedule an appointment with our cataract surgeon, Dr. Richard Strecker, please contact us.