What is a cataract?
The lens inside the eye sits just behind the coloured part (the iris) and helps to focus light onto the back of the eye (the retina) in order for vision to be clear. However, with aging and occasionally with trauma, steroid use, inflammation or previous surgery, the lens changes from a clear structure to an opaque one, not unlike frosted glass (see diagrams below). This results in blurred vision either for distance, near or both. It can also result in halos, glare and colour desaturation.
What happens at the consultation?
During the consultation, a thorough history will be taken and an eye examination will be performed. It is advised that you bring your recent optician’s report with your spectacle prescription to the consultation. The risks and benefits of the surgery will be explained and you’ll have time to ask any questions you may have. Further investigations e.g. biometry will be done. This helps to determine the power required of the new artificial lens, which will be inserted into the eye during the operation.
What are The benefits of the surgery?
The main benefit is to have improved clear vision – as occurs in around 97% of patients. Although the measurements taken during the biometry investigations to determine the power of the artificial lens will be as good as they can be – they are not always 100% accurate. Patients who use a contact lens may have to avoid using their lens for a period of time prior to having the biometry investigation, in order to improve accuracy of the biometry readings. The general aim is to improve distance vision for such activities as driving, walking and navigating safely in your environment; however your own particular visual requirements will be discussed during the consultation.
What are The potential complications?
In most patients, the risk of problems arising is relatively low. There is a risk of not getting the vision you wish for. The risk of a nasty infection, which may even result in blindness, is very low. Occasionally there is a risk of inflammation which may require intensive use of eye drops; other complications include retinal detachment, corneal swelling/decompensation, lack of integrity of the bag in which the new lens is inserted into, swelling of the macula and increased astigmatism. These risks will be discussed with you…
What happens during the surgery?
Small incisions are made on the surface of the eye and the opaque lens is removed using ultrasound waves to break it down. This is referred to as phacoemulsification. The new artificial lens is then inserted into the space where the old lens originally was and the wounds are closed, usually without the need for any sutures (stitches). This operation is usually performed under topical (numbing eye drops) or local anaesthesia as a day case.
What is The aftercare?
In the majority of procedures, daily administration of topical drops will be required, usually four times a day for four weeks. It is advised to wear a hard-plastic shield over the eye every night for the first week to protect it while sleeping. The speed of visual improvement following the surgery depends on the level of post-operative inflammation – some patients get very little inflammation with rapid improvement in vision and others get some inflammation which may take a few weeks to clear before the vision improves. Each patient is different and even each eye can be different with regards to healing. A follow-up appointment will be arranged at the time of your surgery; however if you have concerns before the follow-up appointment, you can use the contact details given to you at the time of the surgery for us to answer your concerns.
Mr Paul Cannon, consultant Ophthalmic & Oculoplastic Surgeon