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Cataract Surgery

The only effective treatment for a cataractA cataract forms when the natural lens in the eye is, or is starting to become, opaque. If not treated, it can lead to blindness, which in most cases can be treated. See Cataract Centre – Understanding Cataracts. is to remove the diseased lensThe lens fulfils the same role as the lens in a camera. It handles about one-third of the focusing power of the eye and is critical for good vision.See Info on Eyes – Anatomy. from the eye by means of a method called a cataract extraction. No patient should feel intimidated by the fact that they are developing cataracts - the vast majority of patients see much better after a cataract extraction compared to what they have for many years before. Patients should have a cataract extraction when their vision is impaired to such an extent that they cannot proceed normally with their work or daily activities.

Since the common old age cataract occurs in both eyes, it does not necessarily mean that each eye will be affected to the same extent. Many patients may have quite an advanced cataract in one eye, with only a hint of cataract in the other eye. Since the old age or degenerative type of cataract is the most common, the following remarks are particularly directed towards this type of cataract.

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Cataract Surgery

The most advanced technique today, which we use at Optimed, is removal of the diseased lens with a process called phaco-emulsification. A tiny self-sealing incision of less than 3 mm is made on the side of the corneaThe cornea is the clear, transparent 'front window' of the eye through which light enters the eye. It handles about two-thirds of the focusing power of the eye and is critical for good vision. See Info on Eyes – Anatomy.. The cataract is then removed from the capsular bag that surrounds it by means of a thin ultrasonic probe that emulsifies (liquidises) the cataract and aspirates the material. The capsule membrane is left in place and serves as a receptor for the placement of an intra-ocular lensAn intra-ocular lens is an artificial lens that is implanted into the eye to either correct severe refractive errors, or to replace an opacified natural lens (cataract) during a cataract procedure. See Cataract Centre - Intra-ocular Lens Options..  The small incision aids in rapid healing and quick recovery of vision.

The cataract can be removed under general, local or topical anaesthetic. A cataract operation lasts approximately 15 to 30 minutes, depending on the complexity of the case. Since patients are discharged on the day of the operation, they should ensure that they have transport and adequate nursing services at their place of residence.

Cataract surgery is probably one of the most successful operations in the whole of medicine. Patients who have had an intra-ocular lens implant, generally see much clearer and better than before. However, after the intra-ocular lens has been placed in the eye, patients may find that they still need glasses for reading. The reason is that standard spherical intra-ocular lenses are focused for distance only and they do not have the ability to focus close-up like the natural human lens. However, new multifocal lenses, which provide vision at more than one distance, are now available to help overcome this problem.

A number of options are available for refractive correction after cataract surgery, which are discussed elsewhere on this website.

The good news for the patient who had a cataract removed is that it is impossible to develop one again. However, with some patients the lens capsule, into which the intra-ocular lens was placed during the surgery, thickens and may again lead to decreased vision. In such cases a quick and painless YAG laser treatment can remove the part of the capsule that causes disruption of the vision.

Older patients should keep in mind that, in addition to the common degenerative cataract, other degenerative eye diseases may also be present. Commonly, one in three patients over the age of 70 has some degree of age-related macular degeneration of the retinaThe retina is the receptor of light at the back of the eye. It fulfils the same function as the film in a film camera or the image sensor in a digital camera. The retina translates the images into electrical signals that are sent via the optic nerve to the visual cortex in the brain, where it is interpreted as the images we see. See Info on Eyes – Anatomy., which prevents them from being able to read, sew or see objects clearly in the center of their visual field. These patients are often disappointed after a cataract operation, as they do not experience the same optimal benefit from their new vision as some of their friends who have had this type of surgery. These patients are inclined to blame the cataract operation as a failure, when they clearly have two different diseases. At the current state of technology, however, even though the cataract has been treated, there is limited scope to treat the retinal condition. These patients are still better off after the operation than before because, if a cataract is allowed to progress, it will steadily deteriorate and increasingly block their eyesight to a point where they can eventually become blind.