Cataract is the term used to describe opacification (or clouding) of the eyes natural lens. As it blocks the light path entering your eye, some common symptoms include: blurred vision, glare, halo and difficulty reading. It is a process which comes with time, and surgery is currently the most effectively form of treatment for this.
Cataract removal and Lens Replacement Surgery by Cataract Surgeon in Sydney
What are Cataracts?
What causes cataracts?
Cataract forms with age and is common amongst elderly. Some other causes include medications( steroids), retinal surgery, previous eye trauma, and other genetic/ congenital causes.
How is cataract treated?
Cataract surgery is a safe and highly developed treatment for removing the cloudy cataract and replacing it with an artificial lens. The operation is usually done in a day surgery setting without the need to stay in hospital. Your anaesthetist will numb the area around the eye with either topical, sub-tenon or peribulbar local anaesthesia. The surgery is done through a very small incision through the side of the cornea. The incision is so small it usually self-seals and doesn’t require sutures.
You can imagine the cataractous lens like an M&M chocolate in concept: when surgery is performed, the surgeon peels a rounded hole on the capsular bag (outer sugar coating), then the cortex and nucleus (chocolate and central peanut) is removed through this hole by the instruments. The capsular bag is meticulously kept intact and becomes the space where a new artificial lens is inserted.
The vast majority of patients who have cataract surgery experience no complications during or following the surgery. A full recovery from surgery can range from a short few days to a few months. Most patients will see clearly the next day after surgery.
How can surgery help?
Vision impairment due to cataracts can be improved through surgery. The benefits of surgery include:
- Improving your vision.
- Improves the 3D perception when both eye achieves good vision.
- Improve the symptoms caused by cataracts such as glare and halo.
- In some patients, cataract surgery is required to control eye pressure.
How to prepare for your cataract surgery?
During your comprehensive consultation, our doctors will explain in more detail regarding the condition and what the surgery involves. You will also under precise measurement of the dimensions of your eye. This allows us to determine the best lens to replace the natural lens.
If you wear contact lenses, please ensure you stop using them for 2 weeks (soft lenses) to 4 weeks (hard lenses) before to the eye measurements for the operated eye are made.
If you have had previous laser eye surgery (PRK / LASIK / SMILE) please advise our doctors as this will affect the measurement method and calculations required to select your artificial lens.
Preparing for the surgery?
On the day of surgery, you will first attend the CBD eye clinic to check in and have eye drops in the eye. The eyedrops will dilate the pupil of the eye planned for surgery. When the dilating drops have worked, we will guide you to the operating theaters of Sydney Eye Hospital. Which is just a short walk away.
What happens during the surgery?
The cataract surgery is done under local anaesthesia. It will involve that you relax and lie flat on your back during the operation. Vast majority of the surgery will take about 10mins, however more complex cases may take longer depending on the condition of the cataract.
After the surgery, there will be an eye patch covering the operated eye. Please ensure that you have friend or family who will be able to take you home and look after you
What to expect after cataract surgery?
Here are some points to be mindful of following surgery:
You will have an eye patch over-night and will be prescribed medication eyedrops for about a week.
These are rarely required, Your dcotor will inform you when it is time for removal.
Returning home after surgery
It would be ideal to have someone (friend or family) to take you home or arrange a taxi.
Vision may seem a bit smeary following surgery or from the ointment prescribed.
Please take care not to rub on or near the surgical wound for at least 2 weeks.
Please use Chlorsig eyedrops to use 3 times during the day and ointment at night. The ointment can also be applied to the skin wound.
This is used for 1-2 weeks following surgery
Can I wash and bath normally?
It is okay to bath and shower, however, please try and keep the surgical wound dry at until the sutures are removed. During healing phase, it is best to keep the wound dry.
Exercise and swimming?
While gentle exercises are okay following surgery, it is best to avoid any strenuous exercise, sports, or heavily lifting for at least 2 weeks until the wound heals.
Swimming should be avoided until the wound heals and stitches removed.
Can I drive after the surgery?
You should be able to continue to drive few days after cataract surgery if vision has improved and the eye isn’t irritated. However residual swelling of the eye may make the vision blurry, thus please do take great care, or stop driving if the vision is not clear.
Can I still use makeup after cataract surgery?
Avoid using make in the immediate few days following cataract surgery. At least allow 3-5 days for the wound to seal before using make up following surgery.
Is it okay to watch television or use the computer as usual?
Yes, these can continue as usual.
If you are searching for an experienced cataract surgeon near me and are based in the Sydney area, please contact us: Sydney CBD Eye Surgery 02 9233 6688
Interesting Facts about Cataract Surgery
In cataract surgery, a variety of surgical procedures are employed:
Phacoemulsification (or “phaco” in short) is the most widely used method. It includes using a device with an ultrasonic handpiece that has a steel or titanium tip. The lens material is emulsified by the ultrasonic frequency (40,000 Hz) vibration of the tip. To make it easier to break or chop the nucleus into smaller bits, a second fine instrument, may be utilized from a side port. Emulsification is made simpler by fragmentation into smaller pieces and by aspirating cortical material (the soft part of the lens around the nucleus). A dual irrigation-aspiration (I-A) probe or a bimanual I-A device is used to aspirate out the residual peripheral cortical material after the lens nucleus and cortical material have been phacoemulsified.
Small-incision cataract surgery (MSICS): The entire lens is taken out of the eye with this method, a modification of ECCE (see below). The sclera is the white part of the eye This surgery involves creating a self-sealing tunnel through this part of the eye to access the cataract.
Extracapsular cataract extraction (ECCE) Involves making a larger excision through the cornea (measuring 10 to 12 mm), which allows access to the front part of the eye and allows complete removal of the lens leaving behind the lens capsule only. While this is not commonly done in countries where phaco is available, it remains a very useful procedure for patients who have extremely dense cataracts that are not suitable for phacoemulsification.
Intracapsular cataract extraction (ICCE) is a procedure where the lens and lens capsule are both removed simultaneously. This procedure is not usually performed these days given the higher complications associated with it.
Laser-assisted cataract surgery using femtosecond laser is a relatively new technology. It utilizes a laser to replace certain steps of the cataract surgery, however, there is not enough evidence to support that this offers visual or refractive advantages over traditional phacoemulsification.
There are various types of intraocular lenses that are available to be inserted into the eye following cataract surgery. The selection of the appropriate lens often depends on your visual requirements. The type of lenses can include:
Mono-focal intraocular lenses. These are traditional lenses that provide sharp, clear vision at a set focal length and distance. If both eyes are set to distance for focal length there is a very high chance the patient will need glasses after the operation for reading. The advantage of doing this is that the patient will have the sharpest image clarity with good 3D stereo suspicion.
Extended-range intraocular lenses are one of the latest developments in lens technology where the new designs offer similar sharpness to mono-focal lenses however allow the extended focal length to accommodate for both distance vision and some degree of near vision.
Multifocal lenses are lenses that are designed to focus both at a distance and near vision. The lenses have special designs on them which changes the light entering the eye to allow for this. While it is often considered a premium lens and does offer convenience, however, this is done so at a compromise Where the vision is not as sharp as a mono-focal lens at a comparable focal length and may have risks of glare and halos following surgery.
Cataract surgery is perhaps one of the oldest forms of surgery. A procedure known as “couching” was described in ancient Indian literature where a needle was used to push out the opaque matter in the eye. The same process was perhaps also used in ancient Egypt