Understanding Cataracts and Cataract Surgery

The natural lens in our eyes, which is normally transparent, can turn yellow or white and become what is known as a cataract. Cataracts are not just an inconvenience; they can significantly affect quality of life if left untreated. Cataract treatment typically involves surgical intervention to restore clear vision.

Early symptoms may include increased difficulty seeing or driving at night and a change in your glasses “degree” (typically an increase in short-sightedness). Later symptoms could include blurring of vision, glare and haloes. Advanced cataracts in elderly individuals may even lead to falls, and the sensory deprivation from poor vision has been shown to increase the risk of dementia.

Age

Age-related cataracts is the most common factor, with cataracts often starting after age 60, and sometimes much earlier at the late forties in highly short-sighted individuals.

Medical Conditions

Conditions like diabetes can accelerate the development of cataracts.

Medications

Long-term use of corticosteroids can promote cataract formation.

Trauma

Injury to the eye, or even constant rubbing of the eyes can induce cataracts.

Pre-Surgical Assessment

A comprehensive eye examination is performed to rule out other causes of visual impairment and identify factors that may affect the outcomes of surgery. Eye measurements are taken to determine the appropriate intraocular lens (IOL) power.

Choice of intraocular lens

There is no “one size fits all” to which intraocular lens is the best. Your doctor will discuss with you the options, which includes mono focal, multifocal and extended depth of focus (EDOF) intraocular lenses. Depending on your lifestyle, work, hobbies, and pre-existing eye conditions, you and your doctor can then make an informed decision on the intraocular lens that will give you the best vision while reducing your dependence on glasses if desired.

The Procedure

Cataract surgery is performed as a day surgery procedure. Intravenous sedation is performed and most patients will sleep through the procedure. Topical numbing drops are instilled in the eye. The vast majority of patients will feel no pain or discomfort during the surgery. A small incision is made in the cornea, the cataract is broken up (phacoemulsification) using an ultrasound probe and removed. An artificial lens is then placed into the eye. The incision is self-sealing and stitches are typically not required.

Recovery

Most patients will have good vision the day after cataract surgery. There is usually no pain, but patients may experience dryness. Eyedrops will be given and are to be used for up to a month. Avoid getting water in the eye, eye rubbing and vigorous activities for 1-2 weeks after surgery. There is no restriction to diet or air travel. A typical follow up schedule would be at day 1, week 1 and month 1 after surgery.

Risks and Complications

While extremely rare, complications can include infection, posterior capsule rupture, corneal injury, raised eye pressure, retinal tears or detachment.