phacoemulsification

Phacoemulsification is a common cataract surgery where ultrasound is used to break the lens of the eye into small fragments, which are then suctioned out of the eye. The lens is replaced with an intraocular lens implant.

Phacoemulsification restores vision in patients with cataracts, a clouding of the eye’s lens.

How Is Phacoemulsification Performed?

During phacoemulsification, a surgeon makes a small incision at the edge of the cornea and then creates an opening in the membrane that surrounds the lens. A small ultrasonic probe is then inserted, breaking up the cloudy lens into tiny fragments. The instrument vibrates at ultrasonic speed to chop and almost dissolve the lens material into tiny fragments. The fragments are then suctioned out of the capsule by an attachment on the probe tip. 

After the lens particles are removed, an intraocular lens implant, commonly referred to as an IOL, is implanted and positioned into the lenses natural capsule. It is inserted through the tiny corneal incision through a hollowed out tube. Once the lens is pushed through, it unfolds and is positioned in place. 

Phacoemulsification is typically performed in an outpatient surgery center and normally does not require a hospital stay. The cataract surgery procedure is performed under local anesthesia (an anesthetic injected around the eye) or topical anesthesia (numbing drops inserted into the eye).

What Is the Recovery Time for Phacoemulsification?

The incision made in the cornea usually requires no stitches and is self-sealing. Within a few days, the incision heals completely. Post-operative eye drops are prescribed and usually consist of antibiotics, steroids, and a non-steroidal anti-inflammatory medication. These drops reduce inflammation and prevent infection. The antibiotic is usually discontinued within 7-10 days. The steroid and non-steroidal anti-inflammatory are taped over 3-6 weeks depending on the surgery. Most patients have vision improvement almost immediately and vision tends to steadily improve over 4-5 weeks.

Phacoemulsification revolutionized cataract surgery. Before phacoemulsification was developed, surgeons would remove the entire lens and capsule. This made it difficult to insert an intraocular lens. The lens of the eye contributes a lot of focusing power to the eye. As a result, if you remove the cataract, which is the lens, the patient is left with a very high “plus,” farsighted prescription. This is why, many years ago, when patients had cataracts removed, they typically wore “cataract glasses.” Cataract glasses were thick, heavy and magnified the eyes. It was not long before surgeons realized that they needed a better process in which to insert a lens implant so that patients would not have to wear such heavy, thick post-cataract surgery glasses. Patients were happy to have the cataract removed, but not so happy that they had to now wear thick, heavy glasses.