What might be a reason to do cataract surgery before the cataracts are "ripe"?
Many years ago it was said: You have to wait until cataracts are "ripe" to do surgery. What that meant was that the discolored natural lens (which is the "cataract") needed to reach such a state of complete density that it could be manually pushed out of the eye in one piece (through a very big wound -about 10-15 mm long) without it crumbling into small pieces. Retained lens fragments could often create a severe inflammatory reaction in the eye that would complicate the outcome.
Given the relatively unsophisticated technology used then, that was an entirely appropriate standard. But that was before the introduction of small incision (2-3mm) phacoemulsification and the use of intraocular lens implants (IOLs). As ophthalmic technology advanced, cataract surgery became quicker, safer, and provided much better optical outcomes.
_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic