The cloudy lens of the eye (cataract) is removed most often by a process known as phacoemulsification, or “phaco.” This process was invented in the 1970s by Dr. Clark’s friend and colleague, Dr. Charles Kelman, but it was so ahead of its time that it took until the 1990s to become the standard procedure. A probe is inserted through a very small incision and used to simultaneously irrigate the inside of the eye, break up the cataract with ultrasound, and vacuum out the remaining pieces. Then an intraocular lens implant (or IOL) is placed where the cataract had been. This step is necessary because the eye needs an internal lens in order to focus, and the eye’s natural lens (the cataract) was just removed. The vast majority of patients receive a lens implant, whether or not they elect to receive one with additional features (such as astigmatism correction or multifocality). Today’s lens implants are made of extremely inert, biocompatible materials, and it is exceptionally rare to see any sort of rejection reaction. Any such reaction, even when it does rarely occur, is generally mild and can easily be controlled with eye drops. These lenses are flexible and are usually inserted, rolled up into a tube, through the same small incision through which the cataract was removed. The lens then unrolls into the proper configuration once inside the eye.
Cataract surgery is usually performed in an ambulatory (outpatient) surgery center, one eye at a time, on separate dates. Preoperative and postoperative treatment includes eye drops, but there are also “dropless” options available.