Cataract Surgery

Over half the people over the age of 65 have some degree of cataract development and most cases can be treated with cataract eye surgery. So, if you are alarmed because your doctor told you that you have a cataract, don’t be. A cataract is a clouding of a part of your eye called the lens. Your vision becomes blurry or dim because light cannot pass through the clouded lens to the back of the eye. Cataracts can develop over periods ranging from a few months to many years. Sometimes the cataract stops developing in its early stages and vision is only slightly impaired. But if it continues to develop, it will interfere with vision. The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the centre of the lens, you may not be aware that a cataract is present.

Common Symptoms

• A painless blurring or dimming of your vision.
• Glare, or light sensitivity.
• Frequent eyeglass prescription changes.
• Double vision in one eye.
• Needing brighter light to read.
• Poor night vision.
• Fading or yellowing of colours.

Misconceptions about Cataracts:

• It is not a growth or film over the eye.
• It is not caused by overusing the eyes.
• It is not a cancer, tumour or infection.
• It is not spread from one eye to the other.
• It is not a cause of irreversible blindness.

What causes Cataracts to develop?

Cataracts will usually develop as part of the ageing process, but can also result from:

• Eye injuries
• Certain chronic diseases such as diabetes
• Medications
• Genetic inheritance
• Long-term, unprotected exposure to sunlight
• Previous eye surgery

How are Cataracts diagnosed?

A thorough eye examination with an instrument called a slit lamp microscope can detect the presence and extent of a cataract, as well as any other conditions that may be causing blurred vision or discomfort.

How can Cataracts be treated?

The cataract may need no treatment at all if the vision is only a little blurry. A change in your prescription may improve vision for a while.

There are no medications, eye drops, exercises or glasses that will cause cataracts to disappear once they have formed. When you are not able to see well enough to do the things you like to do, cataract surgery should be considered. Surgery is the only way to remove a cataract.

Your eye will be measured to determine the correct power of the intra-ocular lens that will be placed in your eye during cataract surgery.

When should Cataract surgery be done?

Cataract eye surgery should be considered when cataracts cause enough loss of vision to interfere with your daily activities. It is not true that cataracts need to be "ripe" before they can be removed. Surgery can be performed when your visual needs require it. You must decide if you can see well enough to do your job and drive safely and if you can read and watch television in comfort. Also, ask yourself if you can perform daily tasks, such as cooking, shopping or taking medications without difficulty.

Cataract Procedure

Surgery is done under topical anaesthetic, which makes the operation almost painless. The surgeon uses only eye drops to numb the eye completely, no injection or general anaesthesia is necessary.

The eye procedure used for cataracts extraction is micro-incision phaco-emulsification, which involves a sub-2.2mm incision in the side of the cornea, through which the surgeon applies a tiny, high-frequency ultrasound instrument. High-energy sound waves break up the centre of the lens into microscopic particles, which are then gently suctioned out through the incision. Until recently we have been using "White Star" technology, but we have now upgraded to the new "Zil Torsional" ultrasound system. The general consensus amongst leading cataract surgeons from around the world is that the OZil system provides better post-operative vision and quicker recovery due to clearer corneas.

Once cataracts extraction has been successful (after the cloudy lens has been removed), a replacement silicon or alternative intra-ocular lens (IOL) implant, through a 3.2mm incision is added. This new lens allows light to pass through and focus clearly on the retina. The IOL becomes a permanent part of your eye. There are many different IOL's available to address the patient’s specific needs, for e.g. Multifocal IOL's, Toric IOL's, Accommodative IOL's and Anterior Chamber lenses. The surgeon will determine which type of IOL is best suited to the patients needs. After using this special small incision, you will not receive any stitches. The incision is self-sealing, stronger, heals faster and remains tightly sealed as a result of the natural outward pressure from your eye. Surgery does not require an overnight stay in hospital. You will be given eye drops to use for six weeks after the operation to prevent infection and reduce swelling of the cornea.

Complications can occur during and after the surgery and as with any surgery, a good result cannot be guaranteed. Infection, bleeding and swelling or detachment of the retina are some of the more serious complications that may affect your vision, but these are rare. Many patients report immediate improvement in their vision. Most patients return to their normal work and lifestyle routines within a day or two.

What to expect in the long term

In some cases, the posterior capsule that supports the IOL becomes cloudy several months or years after the initial cataract removal. This is called an "after cataract" or Capsular Sclerosis. If this occurs and blurs your vision, an opening in the centre of the membrane will be made with the Yag laser. This procedure, called a posterior capsulotomy, is painless and takes about 15 minutes and requires no recuperation. Most people who wear bifocals or reading glasses for near vision before cataract surgery will still need to wear glasses after surgery.