What Is A Cataract?

A cataract forms when the lens inside the eye becomes cloudy and as a result the quality of vision is reduced. For most people this is a natural (or ‘aging’) change but less commonly can happen due to some medical conditions (such as diabetes) or after an injury to the eye. The lens is positioned directly behind the iris (the coloured part of the eye). In order to remove the cataract, the lens of the eye must be removed by a surgical operation. It is not the case therefore that a cataract is something which is scraped off the surface of the eye.

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How Do I Know If I Have A Cataract?

Cataracts usually develop slowly over a period of months or even years. The more cloudy the lens becomes, the blurrier the vision. This usually leads to difficulties with driving, watching television and reading. Colours also become muted and less brilliant. Sometimes the cataract develops in segments within the lens. In this case, while the vision may remain good, there may be significant disability from glare due to sunlight or on-coming car headlights. For most people, a cataract is first noticed by an optician during a routine eye test.

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When Should I Have The Cataract Removed?

An early cataract may not give you any symptoms at all. As the cataract develops, vision becomes less distinct. It is sensible to have a cataract removed when it is starting to have an impact on daily life. However, this will came at different times for different people depending on how much they depend on their vision. The more you demand from your eyes, the sooner you will notice a cataract.

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Do I Need To Be Seen Before The Operation?

Before the operation takes place your eyes need to be examined to see how much cataract is present and whether there are any other eye problems which may also be affecting the vision and hence the success of future cataract surgery. You can then decide whether surgery is right for you now or later. If you decide to go ahead with surgery, then the next step is to measure both eyes to calculate the strength of the new replacement (or implant) lens.

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What Is Biometry?

Both eyes need to be measured to calculate the strength of the new replacement acrylic lens implant that is required. This process is called biometry. These painless measurements take about 15 minutes to perform and are usually performed on a separate occasion from the initial visit and this allows you to have thought about the operation and to ask more questions if you want.

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How Is A Cataract Removed?

Cataracts are removed by a technique called phacoemulsification. Firstly, the eye needs to be anaesthetised. The most frequently used technique is local anaesthetic whereby the eye is numbed either by an injection of anaesthetic around the eye or by the use of anaesthetic drops alone. Some patients require general anaesthetic so that they are fully asleep during surgery. The anaesthetic is administered in a room beside the main operating theatre and takes about ten minutes to have its effect.

Next, the patient is taken into the operating theatre. The eye is cleaned with an anti-septic solution and covered with a light plastic drape. Next, a very small cut is made in the cornea (the clear part at the front of the eye). The human lens is surrounded by a clear membrane or bag. A circular port hole or disc is removed from the front part of the lens bag. This allows access to the lens proper. The phacoemulsification handpiece is then introduced into the eye. Looking like a large pen, the tip vibrates very quickly and is able to break the lens up into pieces. These pieces are then sucked out of the eye until all the lens fragments are removed leaving the outer lens capsule intact. The lens bag is now ready to accept the new lens implant. The lens is made from acrylic and can be folded in half enabling it to be introduced into the eye through a very small incision. Once inside the eye it unfolds and positions itself within the lens bag. A protective eye pad is used to cover the eye. The operation is over at this stage and takes 20-30 minutes depending on the maturity (hardness) of the cataract.

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Do I Need To Stay In Hospital Overnight?

Most patients prefer to have their operation as a daycase, going home on the day of surgery. This is possible even for those who live alone, although it is reassuring to have family, friends or neighbours nearby if possible. However, some patients prefer the reassurance of staying in hospital overnight.

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What Happens After The Operation?

The day after the operation the eye pad is removed at home. Antibiotic drops are used to help prevent the likelihood of a postoperative infection and are used four times a day initially. A follow up appointment is arranged for two weeks. Most patients find that they get the best vision post operatively after having their spectacles updated by their local optician 5-6 weeks after surgery.

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How Safe Is Cataract Surgery?

Cataract surgery is very successful and safe procedure. However, no operation can be risk free and complications are possible during or after surgery. The likelihood of having a problem for any one person is low but does need to be considered before deciding to go ahead with surgery.

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