A comprehensive overview of cataract surgery

Experienced ophthalmologist Mr Venki Sundaram explains everything you need to know about cataract surgery.

What is cataract surgery and what does the procedure consist of?

A cataract is essentially a clouding of the natural lens in the eye, and in most cases it occurs with increasing age, causing vision and images to be blurred. The way to treat this is through cataract surgery, which involves removing the cloudy natural lens from the eye and replacing it with a clear artificial lens.

It is normally performed using micro incisions with very small instruments placed in the eye. A special ultrasound probe is used to break up the lens and remove it from the eye, and then a clear plastic lens is inserted into the eye.

It doesn’t usually involve stitches and is performed as a day-case procedure, with patients having the ability to go home within an hour after surgery.

When is cataract surgery necessary, and how do I know if I need it?

Cataracts are very common and most people of a certain age will develop cataracts. However, that doesn’t necessarily mean that all people with cataracts will require surgery. I would recommend having surgery if your quality of vision or quality of life is starting to become negatively affected.

Surgery may be necessary if vision is being affected in the following circumstances:

• If you're having more difficulty watching television.
• If you’re having difficulty seeing a golf ball.
• If you’re struggling while reading.
• If you’re having difficulty while driving
• If you’re struggling to see the road signs while driving or finding that there some glare with car headlights or bright lights.

If you have a cataract and your vision is affecting your quality of life or you're not able to meet the driving requirements for seeing a car license plate at a certain distance, it is advisable to think about having a cataract.

However, if you’ve been told that you have a cataract, but you're perfectly happy with your vision and your life and managing well, it is very reasonable to leave things alone for the time being; you will not come to any harm just by leaving it alone for a bit longer.

What are the different techniques available for cataract surgery and what are their advantages and disadvantages?

The vast majority of cases of cataract surgery are performed using the Phacoemulsification approach. This approach uses an ultrasound probe, which helps to break up the lens. In some cases, laser eye surgery may be used instead of the Phacoemulsification approach, but having said that, current research hasn’t proven that laser eye surgery has any extra benefit.

The main variation is in terms of the intraocular lenses which are inserted during the surgery. The standard lens is a monofocal lens, which mainly corrects distance vision, meaning that patients will require glasses if they're looking at a computer screen or reading.

However, some people wish to be able to see more clearly close up. Premium monofocal lenses or multifocal lenses can help to achieve that. It is essential to have a careful discussion with an experienced ophthalmologist about the risks and benefits of both lenses and what criteria is applicable to your situation.  

How long does it typically take to recover from cataract surgery and what can I expect during the recovery period?

The surgery is usually performed under local anaesthetic and takes around 10 minutes. In terms of recovery, we advise that patients keep things light and gentle for the first week, without engaging in strenuous activity.

The majority of healing and improvement in vision will come within the first three or four days. Patients can ease themselves in by starting with light exercise, such as walking or light jogging after one week, but I would recommend waiting at least two weeks before doing more training activities such as going to the gym, playing tennis or playing golf.

With regards to swimming, I would recommend waiting at least four weeks and patients should refrain from wearing eye make-up for at least two weeks.

They will normally have a follow-up appointment three or four weeks after surgery.

Are there any potential risks or complications associated with cataract surgery that I shouldn't be aware of?

Cataract surgery is one of the most effective and efficient operations in the field of medicine. It's sort of a stored site to millions of people around the world.

As with all operations, there are some complications. There is approximately about a one in a thousand risk of a serious infection or bleed in the eye which can make the vision a lot worse than it was prior to surgery.

Some patients may experience a watery or gritty eye for a few months afterwards, but that can usually be helped by using artificial tear drops. Over 95% of patients will be satisfied with the outcome of the operation and as previously mentioned, I would say, it’s an operation to consider when your symptoms are affecting your quality of life.

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