What is a cataract?
A cataract develops when the natural lens inside the eye becomes cloudy. It commonly develops in people over the age of 55 years and is considered a normal part of the aging process. Rarely some people can be born with cataracts or develop them before that age. Many patients who develop cataracts have otherwise healthy eyes and removing the cataract will restore their previously good vision.
How do I know if I have a cataract?
Patients with cataracts usually find that their vision gradually becomes cloudy and blurred. They may also find that they experience glare when they are outside or looking at car headlights, which makes it difficult to see properly. Occasionally patients complain of seeing multiple images. Sometimes patients find that they need to change their glasses frequently. Cataracts are not painful.
The only effective treatment for cataracts is to operate to remove them. The latest technique for removing a cataract is called phacoemulsification surgery.
What does cataract surgery involve?
Modern cataract surgery is performed through a very small micro-incision, which usually does not require stitches at the end of the procedure. The incisions made in the eye seal themselves and heal completely within a few weeks, allowing normal activities to be resumed quickly after the surgery.
After making the incision, a small round opening is created in the lens capsule, which surrounds the cataract. An instrument called a phacoemulsification tip is then introduced into the eye and this uses high-speed ultrasound waves to break the cataract into small pieces, which can then be easily sucked out of the eye.
When the entire cataract has been removed, a lens implant (intraocular lens) is placed within the lens capsule to allow the eye to focus. Lens implants are very small and are made of highly durable materials that do not degrade over time within the eye, so do not need to be replaced.
Lens implants come in different powers and a lens is selected that best suits each individual patient. Additionally there are different types of lenses, such as multifocal lenses and accommodative lenses which can give greater freedom from glasses after the surgery. Not all lenses are suitable for all patients and your doctor will discuss the choice of lens with you before the surgery to ensure you receive the lens most suited to your needs.
Some patients may have astigmatism before their surgery, which can sometimes be reduced at the time of the operation with small incisions in the cornea.
What sort of anaesthesia can I have for my surgery?
It is possible to have cataract surgery with a local anaesthetic (topical or regional anaesthesia) or a general anaesthetic.
- Topical anaesthesia: This is a very popular method for surgery, which simply uses drops to numb the eye. Many patients prefer this method as there are no needles used.
- Regional anaesthesia: This involves gently injecting local anaesthetic around the eye. After the surgery a patch is placed on the eye, which is removed the following day.
Most patients prefer to have some mild sedation during their surgery and of course for some people who prefer to be completely asleep during the procedure, we can offer a full general anaesthetic if required.
Risks and benefits of Cataract Surgery
Benefits of Cataract Surgery
The most obvious benefit of cataract surgery is to provide greater clarity of vision. In addition most patient usually find that colours seem brighter and more vivid.
Studies have shown that people enjoy improved quality of life after successful cataract surgery. Many people can resume driving and activities such as reading and sewing. Golf and using a computer are generally easier after cataract surgery.
Risks of surgery
Modern cataract surgery is generally a safe and successful procedure to improve vision. However there is a small risk of developing a complication either during or following the procedure. Complications are usually treatable, sometimes requiring further surgery. Rarely people can develop serious complications such as infection or retinal detachment, which could result in visual loss. Your doctor will discuss the risks and benefits of the surgery fully with you before the procedure.
Frequently asked questions
Is the surgery painful?
No, cataract surgery is not painful and the vast majority of patients will have the operation as a day case procedure.
Will I see what is happening during my surgery?
If you are awake during your surgery your will notice a bright light and various shapes but you will not be able to see the instruments or what the doctor is doing.
What if I can’t keep still during the surgery?
Ideally you need to keep as still as possible during the surgery but if you need to cough or sneeze, as long as you give the doctor some warning there is usually no problem.
Will I need to wear glasses after my surgery?
Ideally, people are able to see clearly without glasses after surgery, although many patients find that glasses may be necessary for some activities such as reading or driving. Even people who still need to use glasses can usually use thinner lenses than they relied upon in the past. There are some newer types of lenses that have been developed to try and reduce the need for glasses completely following the surgery (Mutifocal and Accommodating lenses).
In patients with high levels of astigmatism it is possible to carry out additional incisions (LRI’s) to help change the shape of the eye, reducing astigmatism and decreasing reliance on spectacles.
What does the cost of my surgery include?
The cost of your surgery will depend on the type of intraocular lens you choose to have implanted and the type of anaesthesia.
When you have discussed fully the details of your surgery with the doctor, the price that you will be given for your surgery is all-inclusive for routine surgery, there are no hidden extras. The price includes the pre-operative assessment, the surgery itself, including the cost of the lens to go into the eye and the cost of the anaestheia. It will also include two routine post-operative visits to see the doctor. Please note that it does not include the cost of new glasses if required.