Cataract Surgery

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Cataract Surgery

A cataract is a cloudy area in the lens of the eye. A normal lens is clear. It lets light pass to the back of the eye. A cataract forms in the lens and blocks some of the light. As a cataract develops, it becomes harder for a person to see.

This video provides an overview of traditional Cataract Surgery.

Cataracts are a normal part of aging. About half of Australians aged between, 65 to 74 have some cataract. About 70 percent of those 75 and over have this condition. Factors like sunlight exposure, genetics and medication can influence the condition.

Most people with cataracts have a cataract in both eyes. However, one eye may be worse than the other because each cataract develops at a different rate. Some people with cataract don't even know it. Their cataract may be small, or the changes in their vision may not bother them very much. Other people who have cataracts cannot see well enough to do the things they need or want to do.

What Are the Symptoms of a Cataract?

  • Cloudy, fuzzy, foggy, or filmy vision.
  • Changes in the way you see colors.
  • Problems driving at night because of glare from car headlights.
  • Problems with glare from lamps or the sun.
  • Frequent changes in your glasses prescription (increasing shortsightedness).
  • Double vision

These symptoms also can be signs of other eye problems.

How is a Cataract treated

A change in your glasses, stronger bifocals, or the use of magnifying lenses may temporarily help improve your vision. Usually though surgery is eventually necessary to remove the lens and replace it with an artificial lens implant. This is one of the most common surgeries performed in Australia today.

Just because you have a cataract does not mean it must be removed immediately. Cataract surgery can almost always be put off until you are unhappy with the way you see. If you do have cataracts and do not wish to wear glasses, your surgeon will advise cataract surgery over Laser surgery as it provides the best long term solution for you.

How do I decide whether to have surgery

Most people have plenty of time to decide about cataract surgery. Your doctor cannot make your decision for you, but talking with your doctor can help you decide.

Does your cataract affect your vision and your life. Circle the statements below that apply to you

  • I need to drive, but there is too much glare from the sun or headlights.
  • I do not see well enough to do my best at work.
  • I do not see well enough to do the things I need to do at home.
  • I do not see well enough to do things I like to do (for example, read, watch TV, sew, hike, play cards, go out with friends.
  • I am afraid I will bump into something or fall.
  • Because of my cataract, I am not as independent as I would like to be.
  • My glasses do not help me see well enough.
  • My eyesight bothers me a lot.
  • I do not wish to wear my glasses or contacts anymore.

What should I know about surgery?

Your Ophthalmologist will choose the best kind of lens replacement for you, to help optimise your vision. The Nurse will also explain how you can prepare for surgery and how to care for your eyes post procedure.

You do not need to stay overnight in a hospital to have cataract surgery. Cataract surgery can be performed at a Day Surgery hospital where you will have your cataract removed. Most typically leave within 2-4 hours post-op. As your eyes need to recover, you will need a friend or family member to take you home. You will also need someone to stay with you overnight due to the sedation used during the procedure.

Painless Cataract surgery

Thanks to recent developments in Anaesthesia, cataract surgery is a painless experience. People stay awake during their surgeries, although you will be drowsy. Two kinds of Anaesthetic are used:- Monitored local Anaesthetic and regional Anaesthetic and IV sedation.

An Anaesthetist administers IV sedation via a cannula inserted into the back of your hand. Local Anaesthetic eye drops are used to numb the eye. No eye patches are needed, and people usually notice improved vision immediately after surgery.

Removing the lens

Phaco-emulsification (pronounced FAY-co-ee-mul-sih-fih-CAY-shun). is the technique used to remove your natural lens. The lens technique is used to remove your natural lens. The lens is gently soften by ultrasound and then irrigated and aspirated out of your eye in approximately 2 minutes. During this time you just see colourful light. No discomfort is experienced.

The natural lens has a “capsular bag” which remain in the eye and is where your new artificial lens is held in place. Once this has been done antibiotics are introduced to the eye to reduce risk of infection. There is no need for stitches as the wounds heal naturally.

Can a Cataract Return?

A cataract cannot return because the lens has been removed. However, in about 10% of all people who have phaco-emulsification, the capsular bag later becomes cloudy. This cloudiness of the capsular bag, if it occurs, usually develops 3 months or more after surgery. It causes the same vision problems as a cataract does. The treatment for this condition is a procedure called a YAG Capsulotomy. The doctor uses a laser (light) beam to make a tiny hole in the capsule to let light pass. This procedure is painless and is done very easily in our rooms during a consultation.

Is Cataract surgery right for me?

Most people who have a cataract recover from surgery with no problems and improved vision. In fact, serious complications are not common with modern cataract surgery. This type of surgery has a success rate of 98 percent in patients with otherwise healthy eyes. But no surgery is risk free. Although serious complications are not common, when they occur they could result in loss of vision.

If you have a cataract in both eyes, it is best to wait for a minimum of 1 week before having surgery on the second eye. If the eye that has a cataract is your only good eye, your doctor will weigh very carefully the benefits and risks of cataract surgery.

You will be able to make the right decision for yourself if you know the facts. Ask your doctor to explain anything you do not understand. There is no such thing as a "silly" question when it comes to your health.

Benefits and Risks of Cataract Surgery

Improvements in Activities

  • Everyday activities
  • Driving
  • Reading
  • Working
  • Moving around
  • Social activities
  • Hobbies
  • Safety
  • Self-confidence
  • Independence

Risks: Possible Complications (all very rare)

  • High pressure in the eye
  • Artificial lens damage or dislocation
  • Drooping eyelid
  • Infection inside the eye (can cause loss of vision in about 1 in 5000 cases, and (may require further surgery)
  • Retinal detachment or swelling (may require further surgery)
  • Severe bleeding inside the eye (may require further surgery)
  • Swelling or clouding of the cornea (may require further surgery)
  • Blindness (very very rare)
  • Loss of the eye (extremely rare but possible)

Cataract Surgery – The Operation

Revolutionary no-stitch surgery.

Our doctors uses phacoemulsification, an advanced technique that allows the cataract to be removed through a tiny, secure opening 2 mm long. The lens is removed by a small ultrasonic probe, inserted through the incision. They also use intraocular lenses which can be folded to fit through the same small incision. The lens then unfolds during insertion within the eye. Once the lens is inside the eye it stays in position permanently.

This type of surgery means your recovery period is dramatically shortened and your eye recovers much earlier than previously. Normal activities such as driving, walking and sports can usually be resumed the next day. Before surgery the eye is precisely measured so an individual lens implant can be chosen for you. The latest technology is used to determine the implant strength needed to give you the best possible vision.

What to Do Before the Operation

  1. Shower the morning of surgery. Wash your hair at this time as it is not recommended to wash your hair again until 2 days after your surgery.
  2. Don’t wear make up, perfume, talc or take jewelry with you to the day Hospital
  3. Contact lenses should not be worn for 48 hours prior to cataract surgery.
  4. Take all your usual medications, and bring them along with you to the hospital.
  5. Your fasting times before surgery will be advised at the time of booking.
  6. You may be asked to use some eye drops for a day or two before surgery.

At the hospital

  • Drops will be put into your eye to dilate the pupil.
  • When you arrive in the operative suite, you will meet your Anaesthetist who will collect a history of previous anasethetics, listen to your heart and take your blood pressure.
  • A painless anaesthetic will be administered.
  • The skin around the eye will be cleaned.
  • Sterile drapes will be placed around your head and face. You will be aware of voices during the procedure, and you will feel Doctor’s hands on your face. But for the most part you will be drowsy because of the sedation.
  • Your Specialist Anaesthetist will monitor you continuously to ensure your safety and comfort.
  • The doctors will talk to you during the surgery to tell you what is going on. There should be no discomfort throughout the procedure, but you will feel pressure occasionally.
  • After surgery you rest for a while in a reclining chair and have a cup of tea or coffee. Most patients are able to leave within an hour or 2.

What To Do After Surgery

  • Dark glasses should be worn on the day after surgery.
  • A protective shield may need to be worn on the operated eye for one or two nights.
  • You will need to put eye drops in your eye for 4 weeks.
  • Pain is not expected, although the eye may feel gritty for a few days.
  • It is quite safe to read or watch television.
  • Light is not harmful, but glare should be controlled in the interests of comfort; sunglasses often help.
  • You can have a bath or shower, but you MUST keep water out of the eye, and pressure on the eye should be avoided. You can wash your hair two days after surgery if required.
  • You must be consistently aware of your hands. They should be washed well with soap and water (and dried well) prior to touching your eye area or administering eye drops.
  • Physical activity may be resumed immediately, but strenuous exertion should be restricted for about a week. Moderate stooping will do no harm.
  • Pain symptoms that cause anxiety should be reported promptly to your doctor

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