No Stitch/Small Incision Surgery Although the formation of a cataract can make activities such as reading and driving difficult, good vision can be safely restored with outpatient cataract surgery. Today, with the development of no stitch/small incision cataract surgery, many patients are experiencing a faster recovery and a quicker return to good vision. What is a cataract? A cataract is the clouding of the lens of the eye. Normally, light passes through the clear lens and is focused onto the retina. However, as a result of the natural aging process, the lens gradually becomes cloudy. The cataract or cloudy lens blocks the passage of light through the eye and causes distored or blurred vision. Normal vision (left) compared to simulated vision through a cataract (right). What are no-stitch/small incision surgery techniques? No-stitch/small incision surgery are techniques used to restore vision loss due to cataracts. The cloudy lens is removed and replaced with a plastic lens (IOL) implant. Ultrasound technology (phacoemulsification) is often used to remove the cataract. A special lens can then be implanted through a smaller incision than is required in traditional cataract surgery. Ultrasound is used to gently break the cloudy lens into tiny pieces. The lens fragments are removed through the tip of the probe before a plastic lens is implanted. What is phacoemulsification? Phacoemulsification (phaco) is a surgical technique which uses ultrasound technology. In "phaco" or small incision surgery, a small probe is inserted into the capsular membrane which surrounds the cloudy lens. Ultrasound is used to gently break-up (or emulsify) the cloudy lens into tiny pieces which can be removed through the tip of the probe. In comparision, traditional surgery techniques require the lens to be removed in one piece through a relatively large incision. Traditional cataract surgery requires an incision that spans a third of the circumference of the cornea and needs as many as eight stitches to close. In contrast, the phaco technique allows the cloudy lens to be removed through an incision as small as 1/6 of an inch wide. No-stitch self sealing incision In many cases the incision can be closed with just one stitch. In cases where the surgeon can use a technique that does not require sutures, the natural pressure inside the eye is used to keep the incision closed while the eye heals. What are the advantages of no-stitch/small incision surgery? Faster recovery of good vision Faster return to normal activities Good vision in a matter of days instead of weeks or even months Return home within hours of the procedure Reduces the chance of surgically induced astigmatism or ruptured sutures No-stitch/small incision surgery not only speeds the healing and recovery process but also reduces the risk of possible complications. In traditional surgery, tying the sutures too tightly may create astigmatism or a distortion of vision. The patient may experience blurred vision until natural healing corrects the astigmatism or the sutures are removed. However, if tied too loosely, the incision may leak or rupture. A no-stitch/small incision can be closed very securely without causing astigmatism. In addition, there is less chance of leakage and ruptured sutures. How is no-stitch/small incision surgery performed? No-stitch/small incision cataract surgery is performed on an outpatient basis. Before surgery, the patient is given an anesthetic to numb the eye and keep them comfortable during surgery. Most patients return home a few hours after the procedure, with little or no need for pain medication. After the cataract is removed, an artificial lens is implanted to restore good vision. What results can be expected after no-stitch/small incision surgery? Most patients can expect a rapid return to good vision following no-stitch/small incision cataract surgery. In many cases, patients are able to see relatively well the day after surgery witout glasses. However, some patients will need to wear glasses for reading and other activities following the procedure. Quickly returning to an active lifestyle is one of the primary benefits of no stitch/small incision cataract surgery. "Secondary" cataracts may develop following cataract surgery. If this occurs, an outpatient laser procedure will quickly restore good vision. Is no-stitch/small incision cataract surgery for everyone? With the no-stitch/small incision techniques, fewer or no stitches are needed than with traditional techniques. However, the size of the incision and the number of stitches used varies from patient to patient. Some patients, because of their eye structure or other health factors, are not good candidates for no-stitch/small incision surgery. In these cases, patients can have traditional surgery and expect to do well. Sight loss can be prevented Although there is no way to prevent the development of cataracts, loss of sight from the disease is largely preventable. With modern technology, cataracts can be removed and good vision restored. Cataract surgery can be performed when a loss of vision begins interfering with daily activities. If you are experiencing the symptoms of cataracts or other vision problems, you should obtain a complete eye examination. CLOSE WINDOW