Cataract Surgery
Cataracts:
Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers due to age or trauma lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore clear vision.
If a cataract is suspected or diagnosed, a complete medical eye exam will determine if the cataract needs to be removed.
Specifically the clinician will perform Ultrasound size measurements (IOL master) of the eye to determine the most appropriate power for the replacement lens. This intraocular lens (IOL) will reduce the need for glasses and if glasses are required, they will be much thinner and lighter than if an IOL was not implanted.
The primary choices of IOLs are monofocal, multifocal, and accommodating. Each has its own advantages and disadvantages. Only after careful discussion with the doctor can the appropriate type of IOL can be selected.
Following surgical removal of the natural lens, an artificial intraocular lens implant is inserted. Cataract surgery is performed by an ophthalmologist in an a day surgery or hospital, using local Anaesthesia (either topical, peribulbar, or retrobulbar), usually causing little or no discomfort to the patient.
The Surgery:
After arrival at the hospital the anesthetist will ensure you are fit and well wenough to to have surgery then anesthetise the eye (either topical, peribulbar, or retrobulbar), mild sedatives can also be given to ensure you are relaxed and comfortable during the procedure.
Phacoemulsification (Phaco) is the preferred method of removal in almost all cataract operation preformed today.
It involves a very small incision made in eye and the use of a machine with an ultrasonic handpiece equipped with a titanium or steel tip. The tip vibrates at ultrasonic frequency (40,000 Hz) and the lens material is emulsified. A second fine instrument (sometimes called a cracker or chopper) may be used from a side port to facilitate cracking or chopping of the nucleus into smaller pieces. Fragmentation into smaller pieces makes emulsification easier, as well as the aspiration of cortical material (soft part of the lens around the nucleus). After phacoemulsification of the lens nucleus and cortical material is completed, a dual irrigation-aspiration (I-A) probe or a bimanual I-A system is used to aspirate out the remaining peripheral cortical material.
The surgery site is then cleaned and prepared for the insertion of the artificial lens. The lens is folded and inserted using a injector and positioned into place.
The small incisions do not need stitching and the wound will self seal within minutes of the operation. The absence of stitches means the visual recovery is fast and there is little discomfort after the surgery. A protective patch will be positioned over the patient's eye. The complete surgery process will take between 20-40 minutes.
The patient can go home on the same day as the surgery or stay overnight in the hospital. Transportation home from the surgery and back the following day for a vision and pressure check, needs to be arranged. The patient will be required to use both an antibiotic and steroid drop for approximately 4 to 6 weeks following surgery.
Recovery is often short within 2 to 6 weeks and complete healing at three months. Some people have noticeable improvement in their vision from the day after surgery onward, while others need more time for their vision to clear.
There is no major restrictions following surgery, however it is advisable not to lift heavy objects after surgery and no swimming for 4 weeks.
The surgery can be performed at the Norwest Private Hospital by the Ophthalmologist of your choosing.
If you have health insurance the hospital fees are usually fully covered.
The surgeons fees and anesthetist fees will be fully discussed with you prior to surgery and a written quote will be given to you.
We offer very competitive fees with pensioner discounts available. We will work with you to ensure that you are comfortable with your choice of surgeon and the fees associated with surgery.
YAG laser capsulotomy
A small number of patients may experience capsule thickening months after cataract surgery but more commonly it occurs two or three years after. When the capsule thickens it becomes opaque. This stops the light reaching the back of the eye, as a result vision can be effected and sight becomes cloudy or misty, this will be most obvious at night, or in sunlight.
Laser treatment makes a small hole in the centre of the capsule, and can restore vision to how it was after the cataract operation. This procedure is painless as the eye is anaesthised with eye drops. The procedure usually only takes a few minutes.
Following a YAG laser capsulotomy, normal activities can be continued. The experience of some floaters afterward is normal and these will likely resolve within a few weeks. Most people can expect their vision to improve within a day.
