Inside the eye, a cataract is a clouded area of the lens that interferes with the passage of light and can cause sight loss. Subcapsular cataracts form on the rear part of the capsule that encloses the lens, and may develop more quickly than other types of cataract. If sight loss begins to interfere with everyday activities, subcapsular cataract surgery may be necessary. In the most common type of operation, known as phacoemulsification, an opening is made in the lens capsule and ultrasound waves are directed at the clouded lens to shatter it. Next, suction is used to remove the lens fragments and an artificial lens may be inserted.
The phacoemulsification method of subcapsular cataract surgery takes under half an hour and does not require a general anesthetic, although painkilling drops are placed in the eye. A tiny cut is made in the eye’s surface and a special needle is inserted, which emits ultrasound waves to break up the lens. Pieces of the shattered lens are then sucked up through the same needle.
If a replacement lens is to be used, it is placed inside the rear part of the capsule. Some patients have other eye conditions, which mean they are not able to have artificial lenses implanted. Patients without artificial lenses normally have spectacles or contact lenses fitted to correct their sight.
After subcapsular cataract surgery, patients are given eye drops to use for a number of weeks. No stitches are required following the procedure, and it is not necessary to wear an eye patch. It is normal to experience some discomfort, but a doctor should be consulted if there is a lot of pain or loss of vision, as this is not typical and could be a sign that complications have occurred. Possible complications include eye infections and bleeding, and subcapsular cataract surgery also carries a risk of detachment of the retina.
In some cases, it is not possible to shatter the lens and an alternative type of eye surgery is used, known as extracapsular cataract surgery. Here, the eye surgeon makes a larger cut in the eye to remove the whole of the lens. A replacement lens can be inserted if necessary. As the incision is wider, stitches are needed to close it, and an injection of anesthetic may be required at the start of the procedure. Recovery is longer after this type of subcapsular cataract surgery and it may be necessary to wear an eye patch following the operation.