UW Department of Ophthalmology: CATARACT SURGERY

Cataract Surgery at the University of Washington

A cataract is a clouding of the normally clear crystalline lens inside the eye. Cataracts are associated with aging but may also be caused by diseases such as diabetes, from medications, or from trauma. There are many different types of cataracts.

The three most common types of age-related cataracts are: nuclear sclerosis, cortical, and posterior subcapsular. Nuclear cataracts tend to progress slowly while cortical and posterior subcapsular cataracts vary in their rate of progression. While most cataracts progress slowly, they are unpredictable in their rate of progression. Some cataracts will get significantly worse within a few weeks
while other cataracts remain unchanged for many years.

Signs of cataract formation may be blurring of vision, glare from headlights of oncoming cars, difficulty reading, or distortion of vision. The initial treatment for cataracts is usually a change in glasses prescription. With advancing cataracts, however, a change in glasses is no longer helpful and surgery may be needed. The decision about whether or not to proceed with cataract surgery should be based on whether one is having trouble performing daily activities because of vision. Since every person has their own unique needs and medical history, the decision to proceed with surgery is made only after a thorough eye exam and discussion of the risks and benefits of surgery with the surgeon.

Modern cataract surgery can be done through a small incision (less than 1/4"). The image to the right represents phacoemulsification. The advantage of a small incision is improved safety and faster recovery of vision after surgery. To perform the small-incision surgery, an ultrasound-tipped probe (phacoemulsification) is used to break apart the cataract and vacuum it out of the eye.

The normal function of the lens is to focus light onto the retina. Since removing the cataract leaves the eye without a lens to focus light, an artificial (intraocular) lens is placed inside the eye. Intraocular lenses are made of plastic, silicone, or acrylic compounds; have no moving parts; and last for the remainder of a person's life.

Some intraocular lenses can be folded (see above image) so as to be inserted through a smaller incision. Once inside the eye, these lenses unfold into a full-sized optical intraocular lens (see image to the right). Before surgery measurements of the eye are done, and calculations are performed to determine what power of lens is needed for each particular patient.

The intraocular lens implant is held in place inside the eye by a thin membrane called the posterior capsule. The posterior capsule is part of the covering of the lens that is intentionally left behind for this purpose. In about 25% of patients who have undergone cataract surgery, this membrane or posterior capsule becomes cloudy. This is not to be confused with the cataract coming back. The cloudy posterior capsule is much thinner than the original cataract and can be opened up with a laser beam. This procedure is termed laser posterior capsulotomy and is done in the eye clinic after surgery at a follow-up visit.

Cataract surgery is performed on an outpatient basis. That is, patients may go home the same day of their surgery. A typical follow-up after surgery is to be seen by the surgeon after 1 day, 1 week, and again in 3 to 4 weeks. This may vary depending on individual circumstances.

The University of Washington Eye Center provides high quality care in conjunction with state-of-the-art technology to treat patients with cataracts. The eye surgeons who perform cataract surgery at the University of Washington are Philip P. Chen, M.D., Rahgu Mudumbai, M.D., and Tueng Shen , M.D., Ph.D., and Michael Wu, M.D. Depending on your situation, small-incision/no-stitch surgery with foldable intraocular lenses and a choice of local, topical, or general anesthesia may be appropriate for you.

To schedule an appointment with one of our cataract surgeons, call the University of Washington Eye Center at (206) 598-4011. Bring your list of questions, and we will do our best to answer them.

				UW Eye Center Patient Care Clinical Trials
	Cataract Surgery at the University of Washington A cataract is a clouding of the normally clear crystalline lens inside the eye. Cataracts are associated with aging but may also be caused by diseases such as diabetes, from medications, or from trauma. There are many different types of cataracts. The three most common types of age-related cataracts are: nuclear sclerosis, cortical, and posterior subcapsular. Nuclear cataracts tend to progress slowly while cortical and posterior subcapsular cataracts vary in their rate of progression. While most cataracts progress slowly, they are unpredictable in their rate of progression. Some cataracts will get significantly worse within a few weeks while other cataracts remain unchanged for many years. Signs of cataract formation may be blurring of vision, glare from headlights of oncoming cars, difficulty reading, or distortion of vision. The initial treatment for cataracts is usually a change in glasses prescription. With advancing cataracts, however, a change in glasses is no longer helpful and surgery may be needed. The decision about whether or not to proceed with cataract surgery should be based on whether one is having trouble performing daily activities because of vision. Since every person has their own unique needs and medical history, the decision to proceed with surgery is made only after a thorough eye exam and discussion of the risks and benefits of surgery with the surgeon. Modern cataract surgery can be done through a small incision (less than 1/4"). The image to the right represents phacoemulsification. The advantage of a small incision is improved safety and faster recovery of vision after surgery. To perform the small-incision surgery, an ultrasound-tipped probe (phacoemulsification) is used to break apart the cataract and vacuum it out of the eye. The normal function of the lens is to focus light onto the retina. Since removing the cataract leaves the eye without a lens to focus light, an artificial (intraocular) lens is placed inside the eye. Intraocular lenses are made of plastic, silicone, or acrylic compounds; have no moving parts; and last for the remainder of a person's life. Some intraocular lenses can be folded (see above image) so as to be inserted through a smaller incision. Once inside the eye, these lenses unfold into a full-sized optical intraocular lens (see image to the right). Before surgery measurements of the eye are done, and calculations are performed to determine what power of lens is needed for each particular patient. The intraocular lens implant is held in place inside the eye by a thin membrane called the posterior capsule. The posterior capsule is part of the covering of the lens that is intentionally left behind for this purpose. In about 25% of patients who have undergone cataract surgery, this membrane or posterior capsule becomes cloudy. This is not to be confused with the cataract coming back. The cloudy posterior capsule is much thinner than the original cataract and can be opened up with a laser beam. This procedure is termed laser posterior capsulotomy and is done in the eye clinic after surgery at a follow-up visit. Cataract surgery is performed on an outpatient basis. That is, patients may go home the same day of their surgery. A typical follow-up after surgery is to be seen by the surgeon after 1 day, 1 week, and again in 3 to 4 weeks. This may vary depending on individual circumstances. The University of Washington Eye Center provides high quality care in conjunction with state-of-the-art technology to treat patients with cataracts. The eye surgeons who perform cataract surgery at the University of Washington are Philip P. Chen, M.D., Rahgu Mudumbai, M.D., and Tueng Shen , M.D., Ph.D., and Michael Wu, M.D. Depending on your situation, small-incision/no-stitch surgery with foldable intraocular lenses and a choice of local, topical, or general anesthesia may be appropriate for you. To schedule an appointment with one of our cataract surgeons, call the University of Washington Eye Center at (206) 598-4011. Bring your list of questions, and we will do our best to answer them.