What is a cataract?
A cataract is a clouding of the lens in your eye. It can affect one or both eyes. Cataracts are treated by surgery, where the cloudy lens is removed and replaced by a clear artificial lens.
When should I have my cataract surgery?
Cataracts can be removed at any stage. Making the decision to have your cataracts removed depends on a number of things, including how badly your sight is affected, whether you have any other eye conditions, if you only have sight in one eye and how you use your sight on a daily basis. Surgery should be carried out if the benefit of the operation outweighs the small risk attached to the surgery.
At your first consultation, I will assess your eye condition including taking measurements with optical laser biometry. I will discuss the surgery, optical options and the small risks of surgery. If you wear contact lenses, you will need to have the measurements done after a period (usually 1 to 3 weeks) of no-contact-lens wear. If you have had any previous surgery including laser surgery, it is important to get details about this with you, as it may affect the outcome of the surgery.
The vast majority of cataract surgery is performed by phacoemulsification. This means an instrument uses sound waves to break up the lens in the eye and remove it. This is done under local anaesthetic as a day-case procedure, and on average takes fifteen to twenty minutes. Sometimes the patient may prefer to have an injection (subTenon’s local anaesthesia) or general anaesthetic. This will be discussed at the outpatient appointment. In most cases, stitches are not required and the eye heals very quickly. You’ll have a course of drops to use. I will let you know what you need to do.
Complex Cataract Surgery
There are a number of situations where particular features of a person’s eye may increase the risk of complications. One of the complications is when the support structure that holds the lens in place (the capsule) tears or loses its attachment to the wall of the eye. This may lead to parts of the cataract to fall to the back of the eye and some of the jelly to come to the front of the eye. A number of additional steps may become necessary to complete the operation safely, and sometimes a second procedure is needed. This may include a vitrectomy operation.
Combined Cataract Surgery
When a patient needs a vitrectomy operation for a retinal condition, a cataract may also be present. In this select cases, I may offer a combined cataract and vitrectomy procedure, such that only one combined operation is done, instead of two separate procedures.
Posterior capsular opacification (misting up or scarring of the capsule behind the lens implant) may occur in a number of patients, and may happen within months or years of cataract surgery. I offer laser treatment for such a condition. It is done quickly, safely and painlessly as an outpatient, and rapidly restores the vision to its previous state.
If you would like to read more about cataract surgery, please refer to the booklet from the Royal College of Ophthalmologists below.