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When we deal with your eye problems, you can expect to be treated with the same degree of care and commitment as if you were a member of our family.
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The decision to proceed with cataract surgery should be made with your doctor after he/she measures your vision, examines your eyes, and listens to your description of the visual problems you are experiencing. With modern medical technology, cataracts are routinely treated safely and effectively using microsurgical techniques. Today cataract extraction is one of the most successful surgical procedures – about 98% of all cataract surgery procedures result in improved vision.
Cataract surgery is performed through a microscope with the assistance of several highly trained operating room personnel in a suite with specialised eye surgery equipment. During the early stages of cataract development, more frequent changes in your glasses prescription may be sufficient to restore adequate vision. Surgery should be considered when the reduced vision caused by cataracts begins to interfere with normal daily activities such as reading and driving, even when corrective glasses are used. Although the potential risks of surgery must be weighed against its potential benefits, delaying surgery can lead to accidents when driving as well as personal injury such as falls. In addition surgical removal of advanced cataract is more difficult than the removal of less dense cataracts.
Cataract surgery restores quality vision for millions of patients each year. Good vision is vital to an enjoyable lifestyle. Numerous research studies show that cataract surgery restores quality-of-life functions including reading, working, moving around, hobbies, safety, self-confidence, independence, daytime and night-time driving, community and social activities, mental health and overall life satisfaction.
Cataract surgery is performed in a day surgery setting, and does not require an overnight admission. Over twenty years ago, thick glasses were prescribed so that people could see following cataract surgery. However now, small artificial lenses are implanted in the eye which can provide good distance vision with thin glasses, or sometimes no glasses at all.
While cataract surgery is a very safe procedure, there are risks and complications as with any surgery that your doctor will discuss with you. Most complications resolve in a matter of days to months. In rare cases patients lose some degree of vision permanently as a result of the surgery. Most risks of cataract surgery are well known and although procedures are designed to prevent them, they may occur even in the hands of an experienced surgeon who performs the procedure flawlessly.
The surgery is usually performed under local anaesthetic and with sedation. You may be aware of some vague movements but will see no details of the surgery. Some patients may have a general anaesthetic. The surgery is performed with the aid of a microscope through a tiny incision in the eye. The incision is so small that stitches are not usually present, making the post-operative period much more comfortable. The operation generally takes less than 20 minutes. During the operation the lens containing the cataract is removed and replaced with a plastic lens so that the eye can see clearly after the operation. This plastic lens is called an intraocular lens and remains permanently in your eye. A pad or shield will probably be placed over your eye to protect it from accidental rubbing and bumping after the operation. The operation cannot be performed by laser, although laser treatment is sometimes needed afterwards if the lens casing (the capsule), which is usually left in place, becomes cloudy. The eye is not taken out of its socket during surgery.
If a local anaesthetic injection was used to numb the eye for surgery, you may experience numbness of the forehead skin for several hours. Use of your clear plastic shield at night time for the first week is recommended to protect the eye while you sleep. You can remove the shield if it becomes very irritating, but it is important not to sleep on that side of your face. You should not have any pain other than mild discomfort or scratchiness for which you can take paracetamol. If the pain is not controlled by this, please call the clinic. Vision may be blurry for 24 to 48 hours after the surgery, and your pupil may be enlarged for some of this time. Your eye drops will start the day after surgery, and will be required 4 times a day initially. Please note that you should leave 1-2 minutes between the eye drops. The drops will continue as prescribed generally for 4 weeks.
You can do normal ‘light’ activities such as walking around, shopping, watching television and reading. It is alright to place your face under the shower but you should keep your eye closed. For at least 2 weeks, you should not do anything too vigorous, you should not do any heavy lifting, you should avoid bending your head low, and you should not rub your eyes. You should not swim in a swimming pool for several weeks. If you work, you should aim to have at least one week off work and more if you have a physically demanding job. Do not drive until you have been told it is safe to do so.
Glasses are usually prescribed approximately six weeks after surgery when the eye has healed. While you wait it is perfectly safe for your eye to choose what is most comfortable for you in terms of wearing your old glasses, not wearing any glasses at all, or using some hobby/reading glasses for reading. Generally after surgery, we aim to have you seeing clearly in the distance, although you may still need glasses to see perfectly in the distance.
However you will usually need glasses to read and see objects up close. If you wish to see up close and read without glasses, you will need glasses to see clearly in the distance or drive. Occasionally patients will opt to have one eye focused for distance and another focused for near (monovision), and so alternate between eyes depending on what they are doing.
However not every patient is able to achieve this comfortably. If you have lots of pre-existing astigmatism, discuss the possibility of decreasing this with your surgeon. Some patients with very strong glasses with find their eyes very “unbalanced” after their operation, which can be very disorientating and difficult to manage. These patients will generally need to have their second eye operated on fairly quickly in order to balance the two eyes once more.
A cataract cannot return because the entire lens has been removed. However in approximately 20% of people who have cataract surgery, the lens capsule (the tissue bag that supports the replacement lens) becomes cloudy. This cloudiness can develop months or years after surgery. It can cause the same vision problems as the original cataract. The treatment for this condition is a procedure called a YAG laser capsulotomy, which is named for the material used to generate the laser energy (yttrium-aluminium-garnet). The doctor uses a laser (light) beam to make a small opening in the the capsule through which light can pass unimpeded. This surgery is painless and is performed in the Clinic. Most people see well after their YAG capsulotomy. Your doctor will discuss any risks with you.
(See Cataract and Laser capsulotomy)
When we deal with your eye problems, you can expect to be treated with the same degree of care and commitment as if you were a member of our family.