Cataract Surgery
What is a cataract?
In the diagram above, our natural lens sits where the orange oval is marked. This lens plays an important role in bending light rays to allow it to be focused onto the back of the eye, allowing us to see sharply. Our lens is clear and transparent when we are young.
As we get older, the lens proteins breakdown and it becomes cloudy. When this occurs, the lens then becomes a cataract. The cataract results in blurry vision and in some people cause glare and double vision. Cataracts can sometimes be in-born or congenital, and development may be sped up by certain medications and medical conditions such as diabetes and from previous eye injuries, surgeries or radiation treatments. In some patients, the first symptom of cataract is a progressive change in their spectacle prescription.
How are cataracts diagnosed & treated?
Cataracts can be diagnosed by examination after your pupils are dilated as they are located behind the iris (coloured part of your eye).
There are many factors affecting the decision about timing of surgery and this is discussed at your consult. In general, if your cataract symptoms are not bothering you very much, you don't have to remove the cataract until it worsens with age. You might just need new glasses to help you see better. Cataract surgery should be considered when your vision stops you from doing the things you want or need to do or when your reading or driving vision is compromised. In some cases, the cataract may be removed early to correct advanced refractive errors or if there are risks of increased eye pressure due to the shape of the eye. In general, it is advisable not to wait until cataracts become very advanced (brunescent or hypermature) as they become very difficult to remove surgically and can cause other eye problems.
Cataracts can be treated only with surgery. Cataract surgery is one of the most common surgical procedures performed. With new microincisional techniques, cataract surgery is quick, highly successful and often has dramatic effects on the patient’s vision. While any surgical procedure carries some risks, cataract surgery has a very low complication rate.
The operation involves removal of your cloudy lens from the eye and implanting an artificial plastic acrylic lens permanently in its place. In most patients, this is done under local anaesthetic and takes approximately 30 minutes from start to end. Please allocate at least 3 hours in the hospital, for admission procedures before the surgery and recovery time after surgery to ensure that you are well looked after.
What to expect with cataract surgery
Before surgery
Prior to the operation, careful measurements with swept source OCT Ascans and Macular Scans as well as cornea measurements with a Pentacam are performed to allow for tailored calculations for your eye. The intraocular lens (IOL) to be implanted is then chosen for you prior to your surgery. The type of lens is also discussed before surgery and options include:
Day of Surgery
You may not eat any solid foods or fluids at least 6 hours before your operation. You may take your morning medications with a sip of clear water. If you are diabetic, the surgery centre will advise you on how to take your diabetic medications. Follow the instructions given by the surgery centre as they are specific for you.
Your eye will be numbed with eye drops and some medications to help you relax is given through a line in your arm. You are awake during surgery and may see light and movement but you will not be able to see what is happening.
A small 2.4 mm micro incision is made in the clear part of your cornea and using small instruments, the cataract is broken up and removed carefully away. There is a small transparent bag that remains. This is where the new artificial IOL is inserted. As the incisions are small, no stitches are required.
After surgery
You will have to use eye drops regularly after surgery and this is very important. Be sure to follow the instructions. Do not get any tap water or other fluids apart from your eye drops in your eye. Do not rub or press on your eye. You will see me post operatively and instructions will be reiterated.
In most cases there is rapid visual recovery in the operated eye, with continuous improvement during the first days to weeks after surgery. Often there is some discomfort, with foreign body sensation, light sensitivity or tearing in the first few weeks, although in some patients, mild ocular discomfort persists for several months.
Prescription glasses usually for reading will usually have to be updated approximately 4 to 6 weeks after surgery.
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In the diagram above, our natural lens sits where the orange oval is marked. This lens plays an important role in bending light rays to allow it to be focused onto the back of the eye, allowing us to see sharply. Our lens is clear and transparent when we are young.
As we get older, the lens proteins breakdown and it becomes cloudy. When this occurs, the lens then becomes a cataract. The cataract results in blurry vision and in some people cause glare and double vision. Cataracts can sometimes be in-born or congenital, and development may be sped up by certain medications and medical conditions such as diabetes and from previous eye injuries, surgeries or radiation treatments. In some patients, the first symptom of cataract is a progressive change in their spectacle prescription.
How are cataracts diagnosed & treated?
Cataracts can be diagnosed by examination after your pupils are dilated as they are located behind the iris (coloured part of your eye).
There are many factors affecting the decision about timing of surgery and this is discussed at your consult. In general, if your cataract symptoms are not bothering you very much, you don't have to remove the cataract until it worsens with age. You might just need new glasses to help you see better. Cataract surgery should be considered when your vision stops you from doing the things you want or need to do or when your reading or driving vision is compromised. In some cases, the cataract may be removed early to correct advanced refractive errors or if there are risks of increased eye pressure due to the shape of the eye. In general, it is advisable not to wait until cataracts become very advanced (brunescent or hypermature) as they become very difficult to remove surgically and can cause other eye problems.
Cataracts can be treated only with surgery. Cataract surgery is one of the most common surgical procedures performed. With new microincisional techniques, cataract surgery is quick, highly successful and often has dramatic effects on the patient’s vision. While any surgical procedure carries some risks, cataract surgery has a very low complication rate.
The operation involves removal of your cloudy lens from the eye and implanting an artificial plastic acrylic lens permanently in its place. In most patients, this is done under local anaesthetic and takes approximately 30 minutes from start to end. Please allocate at least 3 hours in the hospital, for admission procedures before the surgery and recovery time after surgery to ensure that you are well looked after.
What to expect with cataract surgery
Before surgery
Prior to the operation, careful measurements with swept source OCT Ascans and Macular Scans as well as cornea measurements with a Pentacam are performed to allow for tailored calculations for your eye. The intraocular lens (IOL) to be implanted is then chosen for you prior to your surgery. The type of lens is also discussed before surgery and options include:
- Monofocal IOL for clear vision typically to see well in the distance with the need for reading glasses for near work,
- Toric IOL to correct astigmatism
- Multifocal / Extended Depth of Focus IOL for clear vision in the distance and near, but this is not suitable for everyone,
- Monovision where monofocal IOLs are inserted in both eyes, aiming to see well in the distance in your dominant eye and calculated for near vision in other eye. This is an option for those unsuitable for Multifocal IOLs.
Day of Surgery
You may not eat any solid foods or fluids at least 6 hours before your operation. You may take your morning medications with a sip of clear water. If you are diabetic, the surgery centre will advise you on how to take your diabetic medications. Follow the instructions given by the surgery centre as they are specific for you.
Your eye will be numbed with eye drops and some medications to help you relax is given through a line in your arm. You are awake during surgery and may see light and movement but you will not be able to see what is happening.
A small 2.4 mm micro incision is made in the clear part of your cornea and using small instruments, the cataract is broken up and removed carefully away. There is a small transparent bag that remains. This is where the new artificial IOL is inserted. As the incisions are small, no stitches are required.
After surgery
You will have to use eye drops regularly after surgery and this is very important. Be sure to follow the instructions. Do not get any tap water or other fluids apart from your eye drops in your eye. Do not rub or press on your eye. You will see me post operatively and instructions will be reiterated.
In most cases there is rapid visual recovery in the operated eye, with continuous improvement during the first days to weeks after surgery. Often there is some discomfort, with foreign body sensation, light sensitivity or tearing in the first few weeks, although in some patients, mild ocular discomfort persists for several months.
Prescription glasses usually for reading will usually have to be updated approximately 4 to 6 weeks after surgery.
Contact us