Cataract Surgery

Lens replacement through micro incision

Overview

Cataract surgery removes the clouded natural lens of the eye and, in almost all cases, replaces it with an artificial intraocular lens. The dominant modern technique is phacoemulsification, introduced by the American ophthalmologist Charles Kelman in 1967, in which a small incision is made at the edge of the cornea, the front of the lens capsule is opened, and an ultrasonic probe breaks up and aspirates the lens. A foldable implant is then inserted into the remaining capsular bag. Manual small incision cataract surgery is widely used in low resource settings. The British surgeon Harold Ridley implanted the first intraocular lens in 1949, after observing that fragments of acrylic canopy material were tolerated in the eyes of wartime pilots. The operation is usually performed under local or topical anesthesia as a day procedure and is among the most commonly performed surgeries worldwide. Implant options include monofocal, toric, multifocal, and extended depth of focus lenses. Complications are uncommon but include posterior capsule rupture, endophthalmitis, cystoid macular edema, and retinal detachment, while posterior capsule opacification is a frequent later development treated with YAG laser capsulotomy.