What is a cataract?
A cataract is a dense, cloudy region developing within the eye lens. A cataract occurs when proteins form and clump together in the eye, preventing the lens from transmitting clear images to the retina. The retina works by interpreting the light into signals which comes through the lens. These signals get sent through the optic nerve and gets carried to the brain.
Cataracts develop gradually and when fully formed interferes with your vision. It is not uncommon to find cataracts in both eyes, but they do not typically form at the same time.
Who is more at risk of getting cataracts?
Older people have a higher risk of getting cataracts, but those who smoke, heavily consume alcohol, are obese, have high blood pressure, are diabetic or in an environment that exposes them to too much sun, also pose a high risk to forming cataracts. It can also be down to genetics, those who have a family history of cataracts will be more.
Do you need surgery?
Cataracts generally get worse over time, and this makes your eyesight more impaired over time. Choosing to have cataract surgery is the only way to improve eyesight as it requires replacing the cloudy lens in the eye. Ultimately, the decision whether to opt for cataract surgery or not will be down to you, here at Clinica our fully qualified doctors will assess your individual situation and talk over the details of the surgery and whether it is suitable for you.
What happens before cataract surgery?
Before cataract surgery is scheduled, you will come in for an initial consultation to go over your medical history and for you to understand the process of the surgery. This initial assessment is an opportunity for your and the doctor to go over details for the surgery and outline your preferences for your lens type (near sight or long sight), the risks and benefits of surgery, downtime after surgery, and any additional questions or concerns you have.
What is cataract surgery?
The only way to treat a cataract is through surgery. The procedure is highly specialised and accurate, technically sophisticated and requires an ophthalmic surgeon with specific microsurgical skills using an operating microscope in order to visualise the tiny structures in the eye. Our consultant ophthalmologists perform cataract surgery regularly and are highly experienced with a plethora of good results to show.
Am I awake for cataract surgery?
At Clinical London, the consultant ophthalmic surgeons perform cataract surgery under local anaesthetic either with infiltrated local anaesthetic or topical anaesthetic eye drops. The surgery is done as a day case, and you do not have to stay in the hospital afterwards overnight.
The local anaesthetic is infiltrated around the eye to numb it so that you feel no discomfort, and it also prevents eye movements during the surgery. Sometimes patients elect also to have light intravenous medication to induce drowsiness and relaxation and prevent anxiety.
What happens during the cataract surgery?
During the operation, the surgeon makes a tiny incision at the edge of the cornea in order to get the microscopic instruments inside and removes the opaque lens from the eye using a special ultrasound machine (phacoemulsification). The surgeon replaces the cataract with an artificial intraocular lens.
The cataract surgeon places the intraocular lens (IOL) into the small capsule sac inside the eye, which was previously part of the capsule of the original lens and lends the IOL stability. Before the operation, this sac contains the lens, and afterwards, it will contain the IOL. In some cases, the surgeon needs to put a small stitch in the incision, which is removed a few days later at the clinic.
How does the cataract Surgeon choose the Intraocular lens?
Prior to surgery, your eye is measured (called eye biometry) to determine the specific intraocular lens implant size.
What happens after Cataract Surgery?
After the operation, you are recommended to wear an eye pad for 24 hours, followed by putting in eye drops for a few weeks. The first follow up is often on day one post-op for the Senior Clinica Nurse to check the wound, then the surgeon follow-up visit at one-week post-op to check the visual result and make sure everything is alright.
What results can I expect after cataract surgery?
Removing the cataract allows you to see more light and enables you to focus and have a clear vision again. The results are very good, with a complication rate of less than 0.1%. If before the surgery you used one eye to look at the distance and the other eye for reading (referred to as monovision), expect that this will stay the same as your lens will have been chosen in the consultation before the surgery to reflect this.
Is there any downtime after cataract surgery?
The outcome of the surgery vary in degree; some patients see very well the day after undergoing cataract surgery, while others require a few days or up to a full month to notice the full vision improvement.
As cataract surgery is usually only conducted on one eye at a time, your sight will not be completely impaired. This means that even a day after surgery, you can proceed to do day to day things and even return to work (depending on the nature of your work). Physically demanding work, bending with the head below the waist, straining, lifting, or anything which requires you to exert a small amount of pressure can cause the incision to open, so these activities should be avoided until your eye is completely healed.
It is also recommended that the patient keep their eye covered at all times, either with an eye shield, patch or eyeglasses, to protect it from being bumped, touched or rubbed.
What are the potential complications of cataract surgery?
Millions of people successfully undergo cataract surgery every year, and cataract surgery complications are relatively rare.
Potential cataract surgery complications include:
- Posterior capsule opacity (PCO)
- Intraocular lens dislocation
- Eye inflammation
- Light sensitivity
- Photopsia (perceived flashes of light)
- Macular oedema (swelling of the central retina)
- Ptosis (droopy eyelid)
- Ocular hypertension (elevated eye pressure)
When cataract surgery complications do occur, most are minor and can be successfully treated medically or with additional surgery.
What is an After Cataract?
Overtime (sometimes months, sometimes years), the surface of the capsule sac where the intraocular lens sits, can get cloudy as well, and blur vision again. This is called posterior capsule opacification (PCO). Although some people call PCO a “secondary cataract,” it really is not a cataract. Once a cataract is removed, it does not come back.
PCO is completely normal, and the treatment is simple using a laser in the clinic. It occurs in up to 20% of patients within six months of cataract surgery. The treatment is called a YAG laser posterior capsulotomy, which is done at Clinica London under topical local anaesthetic as an out-patient.
Cataract Product Range
Our product range includes:
• Normal lens which fixes the vision for near or distance clarity, a monofocal IOL
• The premium lens which can focus is called a multifocal IOP
• Cataract and glaucoma simultaneous surgical treatment with MIGS, microscopic glaucoma stent.
Can I have Laser Cataract Surgery?
Femtosecond laser-assisted cataract surgery automates some of the standard cataract surgery steps and is still being evaluated; therefore, is not routine.
If you are considering Cataract Surgery treatment, you can see our prices for treatment and consultation.