Modern cataract surgery involves a small incision in the cornea followed by fragmentation of the cloudy lens (cataract) with the use of ultrasound (phacoemulsification) and removal by aspiration. Once the lens has been removed, a permanently implanted artificial intraocular lens (IOL) is inserted into the eye through the small incision. The small incision usually seals itself or it may be closed with sutures which are then removed in the post-operative phase. Cataract surgery is commonly performed under monitored local anaesthesia as a day surgery procedure.
How do I decide whether to have cataract surgery?
Cataract formation is a slow process and it may take years for the cataract to start interfering with vision. However if left untreated, vision may continue to worsen as the cloudy lens can not recover its normal clarity. When deciding whether to undergo cataract surgery, one should consider the degree of vision impairment on your daily activities such as reading and driving, and the level of symptoms such as glare.
We will examine your eyes and determine how much the cataract is contributing to your reduced vision and discuss the benefits and risks in removing your cataract.
Pre-operative care for patients with cataract includes an assessment of your general health, medications, and allergies as these factors will affect the decision to proceed with surgery, the type of anaesthesia required, and the recovery process. Prior to surgery, biometry with the IOL Master will be performed to calculate the required power of the artificial lens to be inserted during the operation. The aim is to achieve clear vision for the desired distance. Prior to surgery, it is also important to advise the doctor regarding the use of anticoagulation drugs such as aspirin, Warfarin, Eliquis, Pradaxa, Plavix and prostate medications such as Duodart and Tamsulosin may interfere with pupil dilation during surgery.
Following surgery, it is important to follow the post-operative instructions to maximize the visual recovery. The eyes should be kept clean and dry and dry and take care while showering to avoid getting water in the eye for the first two weeks. A plastic eye shield should be worn at night for at least the first week following surgery to prevent any trauma to the eye.
Activities such as swimming, bending, heavy lifting and high impact exercise should be avoided for at least 6 weeks. You may perform your usual daily activities after a few days as long as care and hygiene is maintained. Eye drops will be required during the post-operative period to minimize risks of infection, reduce inflammation, and/or control the intraocular pressure. In some cases, tablets may be required to control the pressure. Ocular lubricants such as Systane, Optive, Hyloforte may be used. Referral for refraction is usually at two months post-op.
Cataract surgery is a safe procedure and complications are rare. Symptoms of reduced vision, redness or pain require urgent attention as they may indicate complications such as infection, inflammation or development of retinal problems such as retinal detachment.