The emphasis in cataract surgery has moved from a technique primarily concerned with the safe removal of the cataractous lens to refractive cataract surgery, a procedure refined to yield the best possible postoperative refractive result. Therefore, refractive cataract surgery allows the patient to dispense with glasses not only for distance vision but even – in the near future – for reading.
Today attention is directed both to eliminate pre-existing myopia and hyperopia and to treat astigmatism. Lens power calculations have been perfected and refined, and new means of correcting postoperative refractive surprises caused by lens power miscalculations are available.
Perhaps one of the more exciting prospects on the horizon of refractive cataract surgery will be the treatment of presbyopia during lens removal, with multifocal and accommodating intraocular lenses.
When cataract surgery is performed, the pre-existing spherical refractive error can be remedied by the choice of intraocular lens power. The astigmatic refractive error can be treated at the same time by appropriate astigmatic keratotomy incisions, performed either in the midperiphery or near the outer boundary of the cornea.
Dr. Massimo Lombardi, who heads the Lombardi Eye Clinic in Rome, Italy, is at the avant-garde for multiple types of eye surgeries. Consult his most recent research on Update on Keratoconus Microsurgery.
Read more about cataract surgery and other techniques for correction of visual defects: