A Guide to Cataract Surgery
Unsure about what exactly a cataract is?
A Cataract is the natural crystalline lens inside your eye becoming cloudy. Contrary to common beliefs cataract is not a skin growing across the eye.
The commonest form occurs from ageing however cataracts can occur from birth (congenital). They also can at an earlier age from trauma, or from a variety of medical conditions such as diabetes or prolonged steroid use.
Cataract Surgery: How is it treated?
The treatment of cataracts is cataract surgery which removes the cloudy lens inside your eye and replaces it with a clear plastic one. There are no drops that will make your cataract better.
Do I need to have the surgery?
The decision to have cataract surgery is made with your Ophthalmologist in a consultation. He or She will assess how much your cataract is affecting your ability to do your day to day activities. Together you both will decide if it is time to proceed to surgery. The diagnosis of a cataract does not in itself necessitate surgery and if you are not symptomatic then surgery may wait. However, the cataract will not get better or disappear without treatment.
Am I awake for the surgery?
The vast majority of cataracts are done with local anaesthetic (either just drops or an injection around the eye). For particularly anxious patients sedation may be required. It is rare to have a general anaesthetic for cataract surgery. The procedure is a daycase meaning you will come and go home the same day. Typically you will take drops for 4-6 weeks after the operation.
What are the lens options I can have?
Everyone having cataract surgery will get a new replacement lens. In the NHS we implant monofocal lenses. These lenses are chosen to give distance vision, and you then need reading glasses for near work. Privately there is the option to have multifocal or trifocal lenses which then also allows the patient near and intermediate vision. These options will be discussed with you during the consultation and a decision made together with the patient about which lenses would most suit your needs.
What are the risks of the procedure?
Though cataract surgery is safe and very effective it carries a 1/10 000 risk of sight loss from infection or bleeding.
Infection typically occurs within the first 10 days after the operation and is from pathogens (bugs) on the surface of the eye going into the eye during surgery. The advent of antibiotics left in the eye at the time of surgery has significantly reduced how often this occurs. Bleeding occurs typically in elderly women with high blood pressure whose blood vessel behind the retina start to bleed during surgery.
The capsule that holds the lens is damaged in the course of the operation in about 1/100 cases nationally. If this damage occurs after the cataract is out the new lens can be placed in front as opposed to inside the capsule. If the capsule is damaged whilst the lens is inside the eye, it may fall to the back of the eye. This then requires a second operation on a different day often in a different hospital to remove it. This is typically done within a week and the eye takes a month to recover.
There are many other risks of the procedure but these are minor and your surgeon can discuss them all with you if you wish.
Is it safe to have both eyes on the same day?
In a word – yes. Both eyes on the same day for cataracts have taken place for years privately across the world and in the UK. The National Institute of Clinical Excellence (NICE) has approved bilateral cataract surgery on low-risk patients in the NHS.
Despite occurring on the same day, the procedures are treated as two separate operations. The second eye operation does not happen unless the first eye has gone well without complication. The risk of loss of sight in both eyes is 1/12 million.
To find out more about how the surgery works click here.
Book a consultation so that we can help decide which options suit you best.
We look forward to helping restore your vision.
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