During cataract surgery, a variety of very technical, precise instruments are used to restore your vision. (Learn more) That equipment is designed to help your surgeon do the best job possible, but your doctor is more than a simple machine driver.
Doctors with more experience tend to have lower complication rates than those with lesser amounts of experience. (Learn more) The machines used do matter, but researchers aren't sure about the role they play in reducing complications. (Learn more) The type of surgery you have also plays a role in how well you can see after surgery, and your doctor chooses your surgery approach. (Learn more)
Our doctors can help you understand the risks, and our experience could help to ease any concerns you may have about eye surgery. (Learn more)
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How Cataract Surgery Works
Prior to cataract surgery, you may have noticed that your vision became blurred and cloudy. Driving at night became difficult, as lights from oncoming cars seemed to blind you. Reading in low light was a struggle due to an inability to pick out individual letters. Bright colors may have faded in intensity, leaving you with a world that seemed vaguely yellow or brown.
The clouding of the lens inside the eye is responsible for those symptoms. When it becomes hard for you to do the things you once loved, a surgical correction can restore your vision.
According to the American Optometric Association, cataract removal is one of the most frequently performed surgeries worldwide. During a cataract surgery, your doctor:
- Makes a small incision in your eye.
- Breaks your cataract into pieces (in most cases). Some surgeries do not require this step.
- Removes your cataract.
- Places a new lens in your eye.
To perform this surgery, your doctor might use a computer, camera, and laser machine. This technology can allow your doctor to map your eye, plan your incisions, and carefully manage your surgery.
Other doctors use lights and cameras, rather than computers and lasers, to perform their surgeries. They may also use ultrasound equipment and vacuum equipment to get the work done.
Experience Helps Reduce Complication Rates
The technology used in a cataract surgery is advanced. As is the case with most types of technology, abilities tend to improve with repeated use. Doctors need to learn the quirks of each individual piece of equipment used during a surgery, and they need to develop a form of muscle memory while using the machine, so they can focus on anatomy and not on technology.
Research suggests that doctors who perform a large number of cataract surgeries on a regular basis develop muscle memory. As a result, they have fewer complications that arise after surgery.
For example, in a study published in the journal Current Opinion in Ophthalmology, researchers found that the odds of a so-called "adverse event" were 70 percent lower when surgeries were done by doctors who performed between 501 and 1,000 surgeries per year when compared to doctors who performed between 50 and 250 surgeries per year. If the surgery was conducted by a surgeon who performed more than 1,000 surgeries per year, odds were 86 percent lower.
In a second study published in the journal Investigative Ophthalmology and Visual Science, researchers examined the difference in performance between residents (students) and attending surgeons (experienced professionals). Residents had an error rate of 10.4 percent, while residents had an error rate of 2.7 percent.
Studies like this demonstrate that skill with surgery takes time to develop, and surgeons who are new to the practice may not have the experience required to perform a surgery in the perfect way every single time.
In another assessment of the issue, performed by the Institute for Clinical Evaluative Services, researchers found that, when compared to professionals in their tenth year of practice, surgeons in their first year were more than nine times as likely to make an error. This makes the importance of experience more than clear. The more your surgeon knows, the less likely it is that you will have an issue appear after surgery.
Machines Help, but Doctors Drive Them
It is reasonable to think that better machines would help to reduce complication rates. A machine that is easy to learn and use would reasonably help a doctor to perform even complicated surgeries with a low risk of something going wrong. Laser technology, which helps your doctor to plan and execute your surgery with the support of a computer, should offer that level of help. Unfortunately, the research suggests that machines alone cannot reduce error rates.
As an article in Cataract and Refractive Surgery Today points out, laser machines do give surgeons support as they perform delicate surgeries, but the research does not suggest that these machines have a huge impact on safety and complication rates. The research that could prove the machines make a difference just has not been performed quite yet. At the moment, all experts can say is that the machines have the potential to reduce surgical harm.
But we do know, from the studies cited above, that the person running the machine has an impact on safety. For now, that is a certainty.
Surgical Type May Also Play a Role
Your surgeon does more than simply work on your eyes during the procedure. Your surgeon also examines your eye before the surgery and decides what surgical approach to take to amend your eye issue. The type of surgery your doctor chooses can have a deep impact on your eye health after surgery.
For example, in a study published in the Journal of Cataract and Refractive Surgery, researchers found that the complication rate for manual eye lens removal was 1.01 percent, while the complication rate for cataract breakup and vacuuming was 1.11 percent.
These two different types of surgeries are right for different types of eyes and cataracts. If your doctor chooses the right approach for your eye, it is reasonable to think your complication rate would be lower. If your doctor chooses another approach, your complication risk might grow.
Again, experience matters here. Your doctor uses a machine to do the work, but your doctor's experience in choosing the surgery that is right for your eyes matters too.
How We Help Our Patients
At NVISION, we take eye health seriously. All of our surgeries begin with a comprehensive examination performed by an expert. We support our surgeons with advanced equipment, so they have the tools they need to take care of your eyes. Our surgeons are trained and experienced in advanced surgical techniques, and they have the experience your eyes can trust.
Ask our doctors about their experience. You're sure to be impressed with the number of procedures they handle each and every year. We have surgeons available in your area now. Contact us to find out more.
What Is a Cataract? American Optometric Association.
Serious Adverse Events After Cataract Surgery. (September 2013). Current Opinion in Ophthalmology.
Does Case Order Affect Cataract Surgery Complication Rates and Case Time?(June 2013). Investigative Ophthalmology and Visual Science.
New Surgeons More Likely to Have High Complication Rates for Cataract Surgery. (January 2017). Institute for Clinical Evaluative Services.
Cataract Surgery Complication Rates: How Are We Doing?(February 2012). Cataract and Refractive Surgery Today.
Complication Rates of Phacoemulsification and Manual Small-Incision Cataract Surgery at Aravind Eye Hospital. (August 2012). Journal of Cataract and Refractive Surgery.