Cataract surgery: What should I expect?

In his latest online article, renowned consultant ophthalmologist Mr Balasubramanian Ramasamy explains cataract surgery in detail. He offers his expert insight into the different techniques used for this procedure, and the new technologies and advancements in the field of cataract surgery.

What is cataract surgery, and how does it help improve vision in individuals with cataracts?

Cataract surgery is one of the most common surgical procedures not only in ophthalmology but across the entire medical field. Human eyes contain a crystalline clear lens, akin to a camera's focusing lens, directing light rays onto the retina, functioning as the eye's film. With ageing and other factors, this lens gradually becomes cloudy, referred to as a cataract. The surgery, a brief medical procedure primarily under local anaesthesia, lasting 20 to 30 minutes, swiftly addresses this issue.

During the day case procedure, the cloudy lens is removed through a small incision that requires no stitches. It is then replaced with a clear artificial intraocular lens. The benefits are substantial: enhanced vision clarity, vibrant colours, and reduced dependence on glasses, with some advanced intraocular lenses even eliminating the need for glasses.

What are the different types of cataract surgery techniques, and how do they differ in terms of procedure and recovery?

Over the last 30 to 40 years, cataract surgery has evolved exponentially, particularly in the past 10 to 20 years. Phacoemulsification, the standard for cataract surgery today, is a quick 15 to 20-minute procedure under local anaesthesia. High-frequency ultrasound breaks the cloudy lens into smaller pieces, which are then aspirated through the same incision. This technique ensures a swift recovery, with most patients resuming normal activities the next day.

In contrast, extra-capsular cataract extraction, used before phacoemulsification, involves a larger wound and may require stitches. Another recent technique, femtosecond laser-assisted cataract surgery, introduces precision in calculating visual outcomes. These advancements aim to streamline the process and hasten recovery for cataract patients.

What are the potential risks and complications associated with cataract surgery, and how are they managed?

Cataract surgery boasts a high success rate, making it one of the safest procedures. However, as with any medical intervention, there is a minimal risk of complications. The capsular shell supporting the plastic lens may be fragile, leading to rare instances of cataract material dropping to the back of the eye. Common side effects include grittiness, bruising, and dry eye symptoms, promptly managed with postoperative drops. Complications are rare, occurring in less than one in 1000 cases.

How should patients prepare for the surgery?

Preparation for cataract surgery is minimal. After initial measurements, patients need only stay calm on the day of the procedure. Local anaesthesia allows them to eat normally before the surgery, and within half an hour, they are back home. Avoiding splashing water into the eye for a day or two and following prescribed drops are the only postoperative precautions.

Are there any advancements or new technologies in cataract surgery that have improved outcomes or patients' experiences in recent years?

Advancements in cataract surgery have been numerous and transformative. The femtosecond laser, offering high precision, and customizable intraocular lenses have significantly improved surgical techniques and outcomes. These technologies provide patients with options for distance, intermediate, and near vision without glasses, showcasing the rapid and tailored development in cataract surgery.

If you would like to book a consultation with Mr Ramasamy, you can do so today via his Top Doctors profile.