The Lens and Cataract Surgery

The lens is a round object located immediately behind the pupil and iris. It’s architecture is much like a cyst. It is made of many thousands of cells, which are contained in a very thin bag, called the lens capsule. The capsule is very similar to cellophane or "handi-wrap" and can be likened to a cocoon which the cells make for themselves to live in. When cataract surgery is done, two small incisions (about 1/8th of an inch and 1/16th of an inch wide respectively) are made at the edge of the clear cornea. With the pupil already dilated, a round piece of the cellophane-like lens capsule is removed from the front of the lens (cataract) and the lens tissue (cataract cells) are broken into pieces using high-frequency sound waves and then suctioned out of the capsular bag. Next, an artificial lens implant (IOL, intraocular lens) is placed into the now empty capsular bag. Often no stitches are necessary, although they can be placed when indicated.

YAG Laser Posterior Capsulotomy

During Cataract Surgery, the lens cells (cataract tissue) are removed from the lens’ capsule (see above) and a sterile artificial lens is placed inside the empty capsule. However, not every single microscopic lens cell can be removed. Sometimes, any remaining cells will attach themselves to the capsule and form a wrinkle or an opaque membrane on the inside of the capsule. When this occurs on the capsule immediately behind the new artificial lens implant, it may blur or obstruct the view seen by the retina. When this happens, a simple laser procedure can be done in the office, opening the capsule and clearing the opacity which has formed behind the lens implant. This is painless, and both easier and less-risky than cataract surgery. It is done sitting up like one is having an eye examination. There is no need to skip breakfast or to get an IV (in the vein).