Lens Replacement During Cataract Surgery
Yes, lens replacement is the fundamental procedure performed during cataract surgery—the clouded natural crystalline lens is removed and replaced with an artificial intraocular lens (IOL). 1, 2
The Standard Surgical Procedure
Cataract surgery involves removing the patient's opacified natural lens and implanting an artificial IOL to restore vision. 1, 3 This is not optional—it is the defining characteristic of modern cataract surgery. 4
Technical Approach
- The predominant method is sutureless, small-incision phacoemulsification with foldable IOL implantation performed on an outpatient basis. 1, 2
- Phacoemulsification uses ultrasound to break up and remove the clouded lens, followed immediately by IOL implantation. 1, 4
- This technique produces better uncorrected distance visual acuity and lower surgical complication rates compared to manual extraction methods. 1, 2
Why Lens Replacement Is Necessary
The natural lens cannot be left in place after cataract removal because the eye would be aphakic (without a lens), resulting in severe visual impairment. 4 The IOL serves to:
- Correct the aphakia created by lens removal 4
- Restore focusing power to the eye 1
- Provide predictable refractive outcomes 1
- Enable rapid visual rehabilitation 1
Alternative Scenarios
While standard cataract surgery always involves lens replacement, there are related procedures worth distinguishing:
- Refractive lens exchange removes a clear (non-cataractous) lens and replaces it with an IOL to correct refractive errors—the surgical technique is functionally indistinguishable from cataract surgery. 1
- Phakic IOLs are implanted in eyes that retain their natural lens, used for refractive correction without removing the crystalline lens. 1
Common Pitfall to Avoid
Do not confuse cataract surgery with procedures that preserve the natural lens. 1 In true cataract surgery, the diseased lens is always removed and replaced—this is the only effective treatment for cataracts, as no pharmacological treatments exist to eliminate existing cataracts. 2, 5