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  • Writer's pictureAtanas Bogoev M.D. and Maria Cholakova

Best Cataract Surgery Options in 2024

Advancements in procedures and medical tech offer patients a range of cataract surgery options in 2024. In this guide you will learn about these treatments, their benefits and considerations. This way you can make an informed decision in consultation with your ophthalmologist.


Overview of Cataracts


What are Cataracts?


The eye lens assists in focusing light and producing clear images. Cataracts is clouding of the lens, it happens as a natural part of aging. Cataracts progressively decrease vision and, if left untreated, may cause blindness.


Causes and Risk Factors


Aging is the primary cause of cataract development. Other contributing factors are diabetes, excessive exposure to sunlight, smoking, and certain medications. In some cases, genetic predisposition may also play a role in how early cataracts start to form.


Symptoms and Diagnosis


The symptoms of cataracts are:


  • Blurred vision

  • Difficulty seeing at night

  • Sensitivity to light and glare

  • Seeing ‘halos’ around lights

  • Faded or yellowed colors


An ophthalmologist can diagnose cataracts through an eye exam by assessing visual acuity and eye health.


Cataracts Treatments


There are two types of treatments for cataracts:


  • Non-surgical management

  • Cataract surgery


In the early stages of cataract development, non-surgical methods such as adjusting the power of your eyeglasses, magnifying lenses, or using anti-glare sunglasses can manage the symptoms. The problem is, those are temporary measures and do not halt cataract progression.


Once cataracts interfere with daily activities like reading, driving, or facing difficulty in low-light conditions, consider surgery. The decision to proceed with surgery depends on the patient’s visual needs and the impact on their quality of life. Rather than just the presence of cataracts.

eye with cataract example infographic

Selected List of Cataract Surgery Options in 2024


Cataract surgery is a procedure to remove the clouded lens and replace it with an artificial one - intraocular lens (IOL). In 2024, patients have several cataract surgical options available, each with its advantages:


  1. Phacoemulsification

  2. Laser-assisted cataract surgery

  3. Extracapsular cataract extraction (ECCE)

  4. Small Incision Cataract Surgery (SICS)


1. Phacoemulsification


Phacoemulsification is the most common procedure for treating cataracts right now.


During phacoemulsification, the clouded lens is emulsified with an ultrasonic handpiece. Then it's removed from the eye.


As a final step, the doctor inserts an intraocular lens into the eye.


2. Femtosecond Laser-Assisted Cataract Surgery (FLACS)


This modern technique uses a femtosecond laser to assist or replace several aspects of manual cataract surgery. It provides precision and potentially reduces recovery time.

Learn in detail about the surgical procedures in our extensive guide to cataract removal surgery.

3. Extracapsular Cataract Extraction (ECCE)


In the ECCE method, the cloudy lens is removed in one piece.


The surgery requires a larger incision compared to phacoemulsification. The extraction of the cataractous lens is manual.


This traditional method is no longer in practice, except in some severe cases of cataracts where other methods are not an option.


4. Small Incision Cataract Surgery (SICS)


SICS is an effective ECCE alternative but with a way smaller incision. Thus allowing for quicker recovery and fewer complications.


The procedure includes manual breaking up of the cataractous lens and suctioning out the pieces before implanting a new artificial lens in the eye.


Small incision cataract surgery is useful in settings with limited access to advanced technology. As well as for treating dense cataracts.



Advanced Technology Intraocular Lenses (IOLs)


As for the types of intraocular lenses in cataract surgery, here are the most common ones:


  • Monofocal IOLs provide clear vision at one distance, usually set for far vision with glasses for near tasks.

  • Monofocal Plus IOLs provide clear vision at one distance, similar to monofocal lenses, but have enhanced intermediate distance vision (when working on a computer).

  • Multifocal IOLs provide clear vision at many distances, reducing the need for glasses.

  • EDOF IOLs  provide an extended depth of field and a good vision in far and intermediate distance

  • Toric lenses are best for patients with astigmatism to correct the irregular shape of the cornea.

  • Light adjustable IOLs are monofocal lenses with special polymers that allow the lens diopter to be adjusted postoperatively, giving you the most precise correction with the IOL possible

  • Pinhole IOLs use small opening to filter out unfocused light, improving the quality of vision for patients with corneal problems


intraocular lens

Choosing the Right Surgery Option


Factors influencing the choice of cataract surgery are:


  • Age and general health

  • Severity and type of cataracts

  • Lifestyle and daily activities

  • Visual needs and preferences

  • Expectations from the surgery


Patients should discuss these factors with their ophthalmologist to determine the most suitable surgical option for cataracts.


Understanding the patient’s lifestyle and visual needs is essential. For instance, a patient who drives at night may benefit from a different IOL compared to someone who spends more time reading or using digital devices.


Each surgical option comes with its own set of potential risks and benefits. While modern cataract surgeries are generally safe and effective, patients have to understand the possible complications and the expected surgery outcomes.



Preparing for Cataract Surgery


Pre-operative Assessment


Before cataract surgery, a patient undergoes pre-operative assessment:


  • Detailed eye examination to determine the health of the eye and the best IOL power.

  • Medical history review to identify any conditions that may affect the surgery or recovery.

  • Medication review because some medications may need adjusting before surgery.


The Night Before Cataract Surgery


Here are preparation tips for the night before your surgery:


  • Do NOT eat or drink anything after midnight, including water. Unless your surgeon instructs you otherwise. Fasting before surgery helps prevent complications during anesthesia.

  • Do NOT take blood thinners. Take your other medications according to your doctor's instructions.

  • If pre-operative eye drops have been prescribed, use them as directed.

  • Get a good night’s sleep to ensure you are well-rested for the surgery.


What to Expect on the Day of Surgery


Patients should be informed about the surgery day procedures, including:


  • Arrival time: Patients should arrive at a scheduled time to complete any last-minute paperwork and pre-surgery preparations.

  • Sedation: While cataract surgery is usually under local anesthesia, some patients may need sedation.

  • Post-surgery: Patients spend a short time in recovery before they go home, accompanied by a friend or family member.

  • Arrange transportation: You will not be able to drive after the surgery. Arrange for someone to take you home.


Cataract Surgery Postoperative Care


Immediate Postoperative Period


  • Eye Protection: Patients get a protective shield or eyeglasses immediately after surgery to safeguard the eye.

  • Rest: It’s important to go home and rest for the remainder of the day.

  • Follow-Up Appointments: Patients should attend all scheduled postoperative appointments to ensure proper healing.


Long-Term Outcomes


  • Vision Improvement: Most patients notice an improvement in their vision within a few days following surgery.

  • Activity Resumption: Patients can go back to normal activities after a few days, but should avoid strenuous activities until the eye has fully healed.


When to Seek Help


While rare, if patients experience severe pain, vision loss, or flashing lights, these symptoms may be a red flag. Seek medical help if you have any complications a few days after the procedure.


Conclusion


The advancements in ophthalmology provide patients with many cataract surgery options. As technology continues to evolve, the future of cataract treatment looks promising, with the potential for even better surgical outcomes and patient satisfaction.


Resources:



Checked by Atanas Bogoev, MD.

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