How is Lens or Cataract Surgery Performed?

1:30

Video Transcript

How is cataract or lens surgery performed?
Hi, I’m Dr. Rylan Hay, ophthalmologist and specialist cataract and refractive surgeon here on the Sunshine Coast. Modern cataract surgery is a microsurgical procedure performed through tiny self-sealing incision. We’re talking roughly one to two millimeters in size, and no stitches are typically needed. Once the eye is numbed and you’ve been made comfortable with sedation, I make a small entry into the eye and then use a technique called phacoemulsification, using ultrasound energy to break up the cataract into tiny pieces, which are then gently suctioned out. Once the natural lens is removed, the empty lens capsule acts as a pocket where I carefully insert the chosen intraocular lens, where it unfolds and centers itself in the eye. The incision is self-sealing, and in most cases, no sutures are needed. The whole procedure typically takes 10 minutes, and we aim to keep you comfortably and sedated throughout. You go home the same day, and many patients are already noticing an improvement in their vision the very next morning. So if you might require lens or cataract surgery, come and have a discussion with me.

How is Lens or Cataract Surgery Performed?

Modern cataract surgery is one of the most refined and successful microsurgical procedures in medicine. The technique — phacoemulsification — has evolved significantly over the past three decades and is now performed through a tiny self-sealing incision with no stitches required in routine cases.

Anaesthesia and preparation

Cataract surgery is performed under intravenous twilight sedation administered by an anaesthetist and either numbing drops or a numbing injection. You are sedated throughout the
procedure but not to the point of needing breathing tubes, we will ensure you are relaxed and free from pain or significant discomfort. The eye and surrounding area are cleaned, and a sterile drape is placed around the eye. A small device keeps the eyelid gently open during surgery.

Step 1: Corneal incision

One or two small, self-sealing incision — typically between 1- 2.5 mm in width — is made at the periphery of the cornea. This micro￾incision is the entry point for the surgical instruments and is designed to seal without sutures at the end of the procedure.

Step 2: Capsulorhexis

A circular opening is created in the front of the lens capsule — the thin bag that holds the natural lens. This precise step is critical, as the capsule will ultimately support the intraocular lens implant.

Step 3: Phacoemulsification

A fine ultrasound probe is inserted through the incision and used to break the crystalline lens (which may have become the cataract) into microscopic fragments using high-frequency ultrasound energy. The fragments are simultaneously aspirated (suctioned) out of the eye. This is the phacoemulsification step — and it is what makes modern cataract surgery so minimally invasive.

Step 4: IOL insertion

The chosen intraocular lens is folded and inserted through the same small incision into the now-empty lens capsule. As it enters the eye, it unfolds and positions itself within the capsule like a ship in a bottle. The IOL is permanent and does not need to be replaced.

Step 5: Wound seal and completion

After cleaning up and using antibiotic injections, the self-sealing incision closes naturally with the restoration of intraocular pressure. Sutures are not typically required. The eye is padded and shielded for protection.

Duration and recovery

The procedure typically takes 15 minutes per eye. You are monitored briefly in recovery and given snacks and a drink before discharge on the same day. Most patients notice meaningful visual improvement within 24 hours.

Key Takeaways

• Modern cataract surgery uses phacoemulsification — ultrasound to break and remove the lens through a tiny self-sealing incision
• No stitches are required in the vast majority of cases
• The procedure takes 15–30 minutes and is performed under twilight sedation with local anaesthetic drops or injection
• Most patients notice significant visual improvement within 24 hours

Interested in cataract or lens surgery?

Book a consultation with Dr Rylan Hayes at The Vision Surgeon, Maroochydore.

References

• American Academy of Ophthalmology. Cataract in the Adult Eye — Preferred Practice Pattern. aao.org
• Linebarger EJ, et al. Phacoemulsification and modern cataract surgery. Surv Ophthalmol. 1999.