Through a new surgical technique, Salt Lake ophthalmologists are removing a cataract and replacing it with a soft lens - through only a 3.2-millimeter incision.
This major advance in ophthalmic surgery is allowing patients to become active sooner."It's the most exciting development in cataract surgery to date," said Dr. W. Andrew Lyle, director of the Salt Lake-based Eye Institute of Utah, where the implant is performed.
Small-incision lenses are also being implanted by two ophthalmologists at the University of Utah Medical Center, and the procedure will likely be performed soon by other medical eye specialists throughout the valley.
Ophthalmologists doing the surgery use a tiny diamond scalpel to make an incision in the eye. Through phacoemulsification (use of a mini surgical drill), the cataract, or cloudy lens, is broken up and aspirated by suction.
A lens implant is inserted without any further enlargement of the incision.
This, Lyle said, has been made possible by the new silicone, foldable lens implant that goes into the eye through an injector tube. In its folded configuration, it looks like a taco; it unfolds inside the eye to fit within the capsular bag.
"The new procedure allows patients to be fully active one day after surgery - including playing golf and tennis," Lyle said. "Results from the surgery are equally remarkable, often requiring little or no additional correction.
"The unaided vision is typically between 20/20 and 20/40 without glasses. A whiter, stronger eye results and patient discomfort is usually minimal."
Dr. Alan S. Crandall, the first Utah ophthalmologist to perform the small-incision procedure, isn't convinced it's a panacea, however.
In fact, he said said there's no data to show improved speed of recovery time and stabilization of visual acuity in the 3.2-millimeter incision procedure, as opposed to the typical 6-millimeter one.
"However, I have a gut feeling that by making a small incision you should, in fact, have more rapid recovery time," said Crandall, an associate professor of ophthalmology at the U. Medical Center. "But that has never been shown."
Some 18 to 20 percent of Utah ophthalmologists perform phacoemulsification, while the remainder continue to use the large-incision "planned extracapsular" extraction procedure.
Lyle said phacoemulsification is far preferable to the commonly performed extacapsular operation, which requires a 12-millimeter incision and can result in more bleeding, astigmatism, prolonged healing time, discomfort and other complications.