What exactly happens during cataract surgery?

Doctor's Answers 1

Photo of Dr Harold Choi
Dr Harold Choi

Ophthalmologist

The first step would be to numb the eye, in various ways, like eye drops or injection around the eye to make sure the surgery is painless.

One of the most important steps is cleaning, I'm sure any eye doctor will clean the eye with a lot of cleaning solution.

After that, a small incision will be made to access the eye.

Then we will make an incision in the anterior capsule, the front part of the lens, usually making a circular opening to access the lens.

Then we use something called an ultrasound machine to go into the lens before activating it to smash the lens into small bits.

then we will use suction to vacuum the bits up.

Once we have done a thorough cleaning, we will put in lens implants and close it.

The most you will feel is some pressure at times, but it isn’t painful.

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Is it best for the cataract surgery to be done with or without anesthesia?

I prefer to perform cataract surgery with my patients under monitored sedation (this is different from general anaesthesia or GA). Monitored sedation is when patients are completely asleep (without the need for GA) and under the close monitoring of an anaesthetist. Monitored sedation (unlike GA) is very safe, even for patients who have pre-existing medical conditions. I believe that patients have the best experience and are most comfortable when they are completely unaware of the ongoings of the surgery.

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When should a cataract surgery be avoided?

Cataract surgery has evolved in recent years into a highly successful eye surgery, capable of removing a hardened lens and even improving one's eyesight free of power like myopia, hyperopia, astigmatism and even presbyopia. For that, it is really a type of refractive surgery, when a customized lens implant is chosen. When there is minimal cataract, one should weigh the pros and cons of the surgery before deciding for or against it. There may be benefit in a cataract surgery even when there is no cataract, such as when there is a threat of narrow angle glaucoma.

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