Cataracts Treatment

This is rather lengthy, I copied it from webmd.com, after you read this go to http://www.webmd.com and type in the search line cataract implant lenses, then click on Extracapsular surgery for cataracts. Then you can also click on the pictures to see how it is done etc., the article below gives good information regarding what to expect after surgery etc. Good luck!!!!

The lens of the eye is enclosed in a lining called the lens capsule. Extracapsular surgery, also called extracapsular cataract extraction (ECCE), involves removing the lens with the cataract from the lens capsule. In most cases, the lens will be replaced with an intraocular lens implant (IOL). If an IOL cannot be used, contact lenses or eyeglasses must be worn to compensate for the lack of a natural lens.

See an illustration of the lens.

Extracapsular surgery with or without phacoemulsification involves removing the lens as well as the front portion of the lens capsule (anterior capsule). The back of the lens capsule (posterior capsule) is left inside the eye to keep the vitreous gel in the back of the eye from oozing forward through the pupil and causing complications.

Extracapsular surgery using phacoemulsification has become the most commonly used procedure for cataract removal. This is a special type of extracapsular surgery that involves removing the lens through the front portion of the lens capsule.

Cataract
Incision into the cornea and insertion of instrument for phacoemulsification
Removal of the cataract by phacoemulsification
Insertion of the intraocular lens implant (IOL)
IOL in place
Extracapsular surgery without phacoemulsification involves:

An 8 mm to 10 mm incision is made in the eye where the clear, front covering of the eye (cornea) meets the white of the eye (sclera).
Another small incision is made into the front portion of the lens capsule, and the lens is removed, along with any remaining lens material.
An intraocular lens implant (IOL) may then be placed inside the lens capsule, and the incision is closed.
Anesthesia
Most cataract surgery is now done using a topical anesthetic (eyedrops) or a local anesthetic. Local anesthetic may involve a sedative for relaxation followed by an injection beside, under, or inside the eye to deaden nerves and prevent blinking or eye movement during surgery.

General anesthetic may be necessary for:

People with extreme anxiety that cannot be controlled with simple sedation or counseling.
People who are unable to follow instructions during surgery.
People who are allergic to certain local anesthetics.
People with other medical conditions that require the use of a general anesthetic.
Children.
What To Expect After Surgery
Before you leave the outpatient center, you will receive the immediate eye care that is needed after surgery. The surgeon reviews the symptoms of possible complications, eye protection, activities, medications, required visits (see below), and what to do for emergency care if needed. Portions of the follow-up may be done by another health professional, such as an optometrist or community health nurse.

The eye that was operated on may be bandaged for one night after surgery. You will wear a protective shield over the eye at night for about a week. There is normally no pain after surgery.

You will usually need to see the doctor for checkups within 2 days after surgery, and after 1 to 4 weeks. Visits should occur sooner and more frequently if any complications occur.

Checkups following cataract surgery include:

Ophthalmoscopy, to evaluate the inside of the eye.
Measurement of visual acuity and eye pressure (tonometry).
A slit lamp exam, to check for lens clarity.
Eyeglasses may be prescribed within 3 to 8 weeks after surgery. An average of 3 months is required for healing after cataract surgery.

Contact your doctor promptly if you notice any signs of complications following cataract surgery, such as:

Decreasing vision.
Increasing pain.
Increasing redness.
Swelling around the eye.
Any discharge from the eye.
Any new floaters, flashes of light, or changes in your field of vision.
Why It Is Done
Cataract surgery may be done when:

Your work or lifestyle is affected by vision problems caused by the cataract.
Glare caused by bright lights is a problem.
You cannot pass a vision test required for a driver’s license.
You have double vision.
The difference in vision between the two eyes is significant.
You have another vision-threatening eye disease, such as diabetic retinopathy or macular degeneration.
Reasons not to have surgery (contraindications)
Cataract surgery will not be done if:

You do not want surgery.
Glasses or visual aids provide adequate vision.
Your lifestyle is not affected by the cataract.
Surgery is not possible because of another medical condition.
You have vision loss that has been caused by another eye disease. Removal of a cataract may not improve vision loss caused by another eye disease.
Extracapsular surgery using phacoemulsification may not be used if the cataract is too hard to be broken up by sound waves (ultrasound).

How Well It Works
Cataract surgery has a 90% to 95% success rate in older adults whose only eye problem is cataracts. Overall, an increase in well-being and quality of life can be expected after surgery in 90% of all people who are bothered by their cataracts.1

Extracapsular surgery with or without phacoemulsification restores the same amount of vision. However, recovery of sight occurs sooner after surgery with phacoemulsification.

People who have surgery for cataracts usually have:

Improved vision.
Increased mobility and independence.
Relief from the fear of going blind.
Surgery may also improve vision in infants who have cataracts.

Risks
Up to 3% of people have complications from cataract surgery that may threaten their sight or require further surgery. The rate of complications increases in people who have other eye diseases in addition to the cataract.1

Though the risk is low, surgery for cataracts does involve the risk of some vision loss if the surgery is not successful or if there are complications. Potential complications that may occur with cataract surgery include:

Infection in the eye (endophthalmitis).
Swelling and fluid in the center of the nerve layer (cystoid macular edema).
Swelling of the clear covering of the eye (corneal edema).
Bleeding in the front of the eye (hyphema).
Bursting (rupture) of the capsule and loss of fluid (vitreous gel) in the eye.
Detachment of the nerve layer at the back of the eye (retinal detachment).
Complications that may occur some time after surgery include:

Problems with glare.
Dislocated intraocular lens.
Clouding of the portion of the lens covering (capsule) that remains after surgery, often called second membrane or aftercataract (posterior capsular opacification). This is usually not a significant problem and can easily be treated with laser surgery if necessary.
Infants have the highest risk (almost 100%) for cloudiness in the back portion of the lens capsule following cataract surgery. If posterior capsule opacification develops after cataract surgery, a laser procedure or a vitrectomy that removes the posterior capsule may be needed. Removing a small part of the posterior capsule during cataract surgery may allow better sight and reduce the need for laser surgery.
Lenses made of polyacrylic material decrease the chance of posterior capsular opacification more than lenses made of polymethyl methacrylate or silicone.2
Retinal detachment.
Glaucoma.
Astigmatism or strabismus.
Sagging of the upper eyelid (ptosis).
What To Think About
Today, extracapsular surgery using phacoemulsification is used more often than standard extracapsular surgery, even though they are similar procedures. The major difference is that phacoemulsification uses sound waves (ultrasound) to break the lens into small pieces that can then be removed through a smaller incision. In standard extracapsular surgery, the lens is removed in one piece, which requires a larger incision. The improvement of vision is the same for both procedures, but the healing process is quicker for phacoemulsification.

Removing cataracts by extracapsular surgery using phacoemulsification is preferred over standard extracapsular surgery because:

The surgery can be done more quickly.
There is less astigmatism after surgery.
Recovery of sight after surgery is faster.
The risk of complications after surgery is less.
People usually need reading glasses (glasses for near vision) after cataract surgery. However, some people may choose to have different lens implants in their eyes so that one eye can be used for distance vision and the other for near vision (monovision). For more information, see replacing the lens of the eye during cataract surgery.

Intraocular lens implants (IOLs) are available that allow you to see both distance and near vision. However, these lens are usually not covered by insurance and may be very expensive.

The vast majority of patients require an implant to replace the natural lens or cataract. Only in very rare cases of extreme nearsightedness is are implants unnecessary.

When the cataract, the cloudy lens, is removed, the haze is eliminated. However, the focus of the eye must be restored. Intraocular lens implants are made of a type of plastic or silicone. Since the intraocular lens is not human tissue, your body cannot reject it.

There are three materials presently used for intraocular lenses, polymethylmethacrylate (PMMA), silicone, and acrylic, with other materials under development. None of these materials is clearly superior to the others. Each has advantages and disadvantages.

PMMA has been used the longest, by far, and thus has the best safety record. It must be implanted through a larger incision than the other materials. Silicone and acrylic can each be placed through a smaller incision than PMMA. Acrylics afford a very controlled unfolding of the lens, but silicone can go through a smaller incision than acrylic. Today’s intraocular lenses are very safe and effective. All of the available lens materials perform admirably.

The lens implants can be folded to permit placement inside the eye through the tiny incision already made for cataract removal. The power of the lens implant is calculated to give the best distance vision possible without glasses. Bifocal lens implants may be necessary to sharpen vision for fine near tasks.

A new lens implant, the Array lens, has multiple focus points so the need for glasses is lessened