Phacoemulsification (Phaco) is a surgical method used to remove a cataract, which is a clouding of the eye’s naturally clear lens. A cloudy lens interferes with light passing through to the retina, the light-sensing layer of cells at the back of the eye. Having a cataract can be compared to looking at the world through a foggy window.
In phacoemulsification, an ultrasonic oscillating probe is inserted into the eye through a very small incision, which usually does not require suturing. The probe breaks up the center of the lens. The fragments are suctioned from the eye at the same time. Most of the lens capsule is left behind and a foldable intraocular lens (IOL) is implanted permanently inside to help focus light onto the retina. Vision returns quickly and one can resume normal activities within a short period of time.
When you have a cataract, the lens of your eye becomes cloudy. Light cannot pass through the lens easily, and your vision becomes blurred. Cataract and implant surgery takes about 15 minutes and is an outpatient procedure. It is usually done with topical anesthesia (drops to numb the eye) and mild intravenous sedation (medicine to help the patient relax). The surgeon makes a few small incisions close to the edge of the cornea and then inserts a small, ultrasonic instrument to break up the center of the eye’s natural lens, which is then vacuumed out through one of the incisions. The surgeon folds and inserts the intraocular lens implant (IOL) through the same incision. These incisions are usually self-sealing, requiring no stitches.
The most common type of IOL is the monofocal or fixed-focus IOL. The monofocal lens helps you attain clearer vision at one distance. Note that eyeglasses and contact lenses are still required in order for you to see clearly at all ranges of distance.
Another type of IOL is the multifocal IOL. The multifocal lens has several rings of different powers built into the lens. This type of implant allows the individual to see at a range of distances.
The third type of IOL is the accommodative IOL. The accommodative lens has a hinge designed to work with your eye muscles, allowing the lens to move forward as the eye focuses on near objects and backward as the eye focuses on distant objects. This movement allows you to focus at different distances.
A posterior capsulotomy is a laser procedure that sometimes is necessary after cataract surgery.
During cataract surgery, part of the front (anterior) capsule of the eye’s natural lens is removed to gain access to and remove the lens. The clear, back (posterior) capsule remains intact and supports an intraocular lens (IOL), a plastic or silicone disc that is implanted in the eye and replaces the natural lens. As long as that capsule stays clear, you will experience good vision. But in about 10% to 20% of cases, the posterior capsule may lose some of its clarity. When this happens, the doctor can create an opening in the capsule using a laser, thereby restoring normal vision. This procedure is called a posterior capsulotomy.
Before the laser procedure, the doctor will have done a thorough eye examination to make sure there is no other reason for vision loss.
The posterior capsulotomy is painless and takes approximately five minutes. Eye pressure is measured 30 minutes after the operation to make sure it is not elevated. Vision usually improves within the next 24 hours.