Cataract Surgery

Cataract

Our natural human lens as we get older can become cloudy with a lifetime of absorbing blue to UV light. If we live long enough we are guaranteed to get cataracts. Cataract is part of aging, like grey hairs or wrinkles of the skin. A cataract causes the vision to become cloudy and often glare in bright light. Cataract affects your quality of life and reading or driving, especially at night, becomes difficult.
Cataract surgery is the only way to remove a cloudy lens and restore vision. The cloudy lens is replaced with a clear acrylic lens implant, which for most people is expected to last a lifetime.
The journey to cataract surgery includes the important choice of lens implant and understanding the benefits, expectations, 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 a miniature intraocular lens implant, commonly made from clear soft acrylic material that is biocompatible.
If you have developed cataract, you may experience blurred vision, loss of contrast, glare, double vision, change in spectacle prescription and difficulties with your daily activities, such as work, reading and driving. Some people, who are very conservative or fearful, wait too long and then driving has to cease.

 

 

Laser assisted cataract surgery

Miss Khanam uses a state-of-the-art femtosecond laser, to perform some of the steps of the cataract procedure with greater precision than a human surgeon. In the past all of the steps of cataract surgery had to be performed by hand with the attendant variation in result.

 

 

What are the symptoms of cataracts?

Cataracts cause blurry or hazy vision or the vision becomes dim. More light is needed to see. You may experience new symptoms of glare and sensitivity to light, particularly while driving at night or in bright sunlight. You may also appreciate a yellowing tinge in the vision and the colours are less vivid, being desaturated. You may also find that you are needing to change your glasses prescription more often due to the changing refractive index of the cataractous lens.

 

 

What causes cataracts?

Age is a major risk factor of developing cataracts. Other risk factors are UV damage, familial genetics, previous steroid use, inflammation, trauma, diabetes, smoking and gout.

 

 

Delaying onset of cataracts

You may be able to slow down cataract formation by giving up smoking, using protective sunglasses in bright light, good control of diabetes and healthy eating. However cataracts can still progress in spite of all efforts.

 

 

Cataracts & driving?

Regular eye checks ensure that your vision is compliant with driving. Cataract progresses over time so to continue driving it is expected that surgery is commonly required when cataracts have been diagnosed.

 

 

 

Cataract treatment?

Cataract is treated by removal and implantation of a replacement intraocular lens implant. It is the most commonly performed surgery, 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.
An incision is made in the clear cornea and a window is created in the front of the cataractous lens. Then a miniature ultrasound probe break ups and removes the cloudy lens. A lens implant is then placed where the original cataract was sited within the eye. 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 (national rate of 1.4%, my rate 0.8%) • Infection or chororidal bleeding. This rare serious complication though very rare can happen • 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 an aging process and along with age, exposure to UV light is an important risk factor.
Some people will get lens dysfunction 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 at least 6/12 Snellen chart visual acuity with both eyes open, using glasses or contact lenses if required.
Those who undergo cataract surgery when younger commonly have surgery which is technically easier, hence less risk.

 

 

Choose your vision correction

There are various options for replacement lenses. Miss Khanam will help you choose the one that best suits your needs and gets you closer to your goal of achieving the best vision.