Dr Ian Anderson's |
Cataract Surgery Overview
What is a cataract?
When the natural lens inside the eye becomes opaque the condition is called a cataract. This clouding of the lens causes a generalized blurring (mistiness) of vision. The effect on vision is very dependent on lighting and pupil size , often in the initial phases vision is reasonable except in glare situations such as night driving or bright sunlight. Progressively vision becomes duller and more blurred.
At present there is no medication that can reverse a cataract although several trials are underway looking for treatments which may slow the progression of the cataract.
Cataracts may develop very slowly , or progress over a few months to cause severe visual loss.
When is surgery performed ?
There is no absolute time to remove the cataract. Technically the cataract can be removed at any stage in its development, therefore the timing of surgery depends on your degree of visual handicap and your visual needs. The decision to proceed can only be made by you once you have an understanding of the operation (that is the success , risks and possible complications). The information supplied here can help you make this decision and during consultation I will be able to further assist you with more advice and information.
How common are cataracts?
Cataract surgery is the commonest surgical procedure performed in Australia. Cataracts can occur at any age , even being present at birth, but the incidence of cataract increases with age. At 60 years of age at least 60% of the population has some degree of cataract.
What are Intra Ocular Lenses?
An Intra Ocular Lens is a small lens inserted into the interior of the eye usually at the time of cataract removal to replace the focusing power of the natural lens which has been removed. Some Intra Ocular Lenses are now made to correct refractive errors without removal of the natural lens. They can be made from a variety of materials and are designed to remain in place forever.
After the cataract (the opaque lens) has been removed there is no lens to focus the vision so a corrective lens is needed. The choices are wearing special glasses after the operation, wearing contact lenses after the operation or inserting an intra ocular lenses (IOL) at the time of surgery.
If the special glasses are used they have to be extremely powerful and cause problems with distortion and magnification, also most patients find the weight and cosmetic appearance of these very thick glasses a problem.
Contact lenses overcome the distortion and magnification, but many patients have the problems with comfort and with insertion/removal of contact lenses.
The alternative (and best) choice is to insert an IOL at the time of surgery. The selection of the IOL is discussed separately (see IOL Types).
What is the Success rates and possible complications
While there have been (and still are) many techniques for removing a cataract the results of modern small incision cataract surgery are extremely good and should not be compared with older techniques.
If there is no other problem in the eye then small incision cataract surgery is extremely safe and predictable with Success rates in excess of 98% expected. Like all surgery there are some risks of failure but the risk of total loss of vision is less than 0.1%.( for more information see Small Incision Cataract Surgery)
What is involved in surgery
Modern small incision cataract surgery is performed using anesthetic drops so there is no need to spend more than a few hours in the hospital.
Because small self sealing (no stitch) incisions are used the eye need not be covered so there will be immediate vision. The vision will be a little blurred for the first few hours but will recover very rapidly.
The incision is secure so with very minor restrictions return to normal activities is immediate.
Minor discomfort can be expected for a few hours and slight irritation may be present for a few days with complete healing occurring by 3 weeks.( for more information see Operation Information Sheet )
Additional Information Pages