FOR THE PATIENT:
CATARACT SURGERY WITHOUT INJECTIONS OR SUTURES
The latest technique in cataract surgery eliminates the need for
uncomfortable injection of anesthesia behind the eye and bothersome, sometimes troublesome
sutures.
This is an improvement over current methods, offering the patient
impressive benefits - safety, less time in surgery, relief from the usual discomfort and
stress, less risk of complications and improved likelihood of success for an operation
already known for its high success rate.
With this procedure, the eye is anesthetized by eye drops instead
of by injection. This approach not only eliminates the uncomfortable sensation associated
with injection, but also eliminates complications that can be induced by injection.
These complications are rare, but can be serious, such as
permanent loss of vision, bleeding or hemorrhage behind the eye and the temporary
cessation of breathing or heart beat. Omitting injection is more convenient for the
patient who may be on anti-coagulation medication, and spares the patient the unpleasant
experience of emerging from surgery with a "shiner".
The incision used in the latest technique is so small that no
sutures are required. Older techniques for extracapsular cataract extraction, with lens
implantation, require a comparatively larger incision. Then stabilizing sutures are
generally used under the muscles of the eye to hold it still for surgery.
Patients undergoing the newer procedure receive only half the
normal amount of tranquilizer prior to surgery because they must cooperate with the
surgeon to assure success. The patient is awake, but feels no pain when the
ophthalmologist makes a tiny incision into the white part of the eye usually covered by
the upper lid. Use of the eye drop therapy is possible only because of the small incision.
The cataract is removed, using ultrasound and suction, through
the very small incision. This incision is crafted in such a way that it becomes self
sealing, thereby requiring no sutures for closure. Then an intraocular lens is implanted
behind the iris in the back of the eye. After the lens is implanted, the eye is
repressurized with a special solution to make sure the wound is closed and leak proof.
This type of cataract surgery causes very little physiologic or
psychologic stress when compared with other forms of surgery. In fact, it is possible to
perform cataract surgery on people with severe, chronic ailments such as heart, lung and
kidney disease without producing complications.
The patient's usual medications need not be altered prior to
surgery. They can be taken with a swallow of water just before the operation.
Anti-coagulants are not stopped.
Diabetics are asked to not take their diabetic medication by
mouth or insulin injection the day of surgery. The insulin-dependent diabetic receives a
modified dose after surgery, prior to the first meal. The patient may then return to their
usual routine the next day.
Injectionless, sutureless cataract surgery is not appropriate for
the younger or anxious patient because the procedure does require good cooperation. It is
not recommended for the individual who is unable to cooperate, or the patient whose
surgery is likely to be complicated.
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