Cataract Surgery
Cataract
Our natural human lens ages and can become cloudy with a lifetime of absorbing blue to UV light. If we live long enough, we all develop cataract and those who spend time outdoors commonly at a much younger age. A cataract causes the vision to become cloudy and often there is glare in bright light and at night with oncoming lights. Cataract affects your quality of life, reading or driving.
Cataract surgery is the only way to remove a cloudy lens and restore vision. The cloudy lens is replaced with a precision engineered lens implant, which, for most people, is expected to last a lifetime, though occasionally people change implant where there is a need.
The decisions with cataract surgery include the choice of lens implant and understanding the benefits, expectations, as well as potential risks and side effects. Having poor vision itself entails risk due to the increased frequency of injury and falls, which is reduced when vision is restored by cataract surgery.
What is cataract surgery?
Cataract surgery is removal of a cataractous lens from within the eye and replacing it with an intraocular lens implant. Cataract causes loss of the ability to change focus from distance to near, a change in the spectacle prescription, especially with loss of near vision and finally loss of contrast, glare and difficulties with your daily activities, such as work, reading and driving.
Laser assisted cataract surgery
Miss. Khanam uses a state-of-the-art femtosecond laser cataract surgery with greater precision than any human surgeon. In the past, all of the steps of cataract surgery had to be performed by hand with the attendant variation in the result.
What are the symptoms of cataracts?
Cataracts cause blurry or hazy vision, or the vision eventually becomes dim when the cataract is fully opaque. People normally nowadays do not wait for this stage to be reached. People often change glasses prescription more often due to the changing refractive index of the cataractous lens, but glasses eventually cannot correct the vision.
What causes cataracts?
Age, UV damage often from childhood exposure as children in the past did not use sunglasses when out playing, genetics, use of steroids, inflammation, trauma, diabetes, smoking and gout.
Delaying onset of cataracts
You may be able to slow down cataract formation by not smoking, using protective sunglasses in bright light, good control of diabetes and healthy eating. However, cataracts will still progress but at a lesser rate.
Cataracts & driving
Regular eye checks ensure that your vision is compliant with driving and also for safety. Surgery is commonly required when the vision affects driving.
Cataract treatment
Cataract surgery is one of the most commonly performed surgical procedures, with over 400,000 cataract surgeries being performed in the UK each year. The surgery takes approximately 30 minutes in a day case setting, with the vast majority performed under local anaesthetic. It can be a basic procedure with a basic lens implant or can be a precision refractive cataract procedure with attention to managing astigmatism, using a premium advanced lens implant and engineering the vision aiming to minimise or eliminate the need for glasses after surgery.
An incision is made in the clear cornea and the cataractous lens is broken up into segments by laser. Then the surgeon completes the procedure removing the pre-prepared segments. A lens implant is then placed into the exact position where the original human lens was sited within the eye, or in some circumstances very close to this. This lens remains inside for life, though rarely it can be exchanged for a different lens if circumstances require.
Risks of cataract surgery
As with all surgery, cataract surgery has risks and complications. These include:
- Tearing of the lens capsule
- Infection or chororidal bleeding. This rare, serious complication, though very rare, can
happen and can be serious - Complete loss of vision 1 in 4000 in international trials
- Retinal detachment. The manipulations of cataract surgery create an increased risk of
retinal detachment, which may occur months, or years, later. This is especially the case
for those who have myopia (near-sightedness) and may increase risk by up to 5 times in
those who are young. It is thought that, when older and the vitreous gel is liquid where
floaters are seen in the vision, this risk is significantly reduced. - After cataract surgery, it is common to develop lens capsule opacification. This occurs in
20% to 50% long-term and is easily treatable using a laser in the clinic. This is termed
YAG laser capsulotomy.
When do you need cataract surgery? The decision is yours.
We all get cataract if we live long enough, and cataract surgery is the only way to restore vision. It is part of our aging process and, along with age, exposure to UV light is an important risk factor.
Some people will get lens dysfunction with reducing quality of vision earlier, due to other risk factors, such as previous steroid medication, diabetes, exposure to sun and UV light and gout.
People choose to undergo cataract surgery or refractive cataract surgery when the vision affects daily life or occupation. Not having surgery does no harm inside the eye but having poor vision is associated with increased risk of falls and fracture. If left long enough, cataract can lead to blindness.
For a personal driving license, the DVLA in the UK requires that vision should be above a minimum level using glasses or contact lenses if required.
Choose your vision correction
There are various options for replacement lenses and Miss. Khanam will guide you to choose lenses that best suits your eyes, your visual needs and also will advise you about the long- term future.