Cataract Surgery

As we get older, a number of different changes occurred within our body. One such change that is noticeable is the development of cataracts.

Cataracts can an result in blurring of vision and if left untreated can result in significant loss of vision. In such situations, cataract surgery may be offered to the patient. In this article, we shall take a look at cataract surgery, how it is performed and they benefits and complications associated with it.

What are cataracts?

It cataract refers to a change in the lens in the eye that is characterised by the formation of cloudy patches. In the initial stages, they do not have any significant effect on the patient but as they progress, they tend to join together resulting in a large part of the lens becoming cloudy. Eventually this causes blurring of vision and can cause a degree of blindness.

This video explains cataracts in a bit more detail.

What is cataract surgery?

Cataract surgery is the most common type of eye surgery performed. It involves the removal of the diseased lens and replacement with an artificial lens. It is a fairly straightforward surgical procedure.

How is cataract surgery performed?

Cataract surgery is usually performed under local anaesthesia. Prior to the procedure, patients may undergo a health assessment to make sure they are well enough to undergo the surgery. The local anaesthetic blocks the nerves that supply the eyeball and prevents any pain during surgery. Sometimes, general anaesthesia may be used.

The most common type of cataract surgery performed is called phaco-emulsification. Initially, the pupils are dilated using eye drops and this will give the surgeon a clear view of the lens in the eye. Local anaesthetic is applied as well in the form of eye drops. The face and head is covered in sterile drapes with the room to allow the patient to breathe freely. Once the anaesthetic has kicked in, a tiny incision is made on the cornea following which a small ultrasound probe is inserted into the eye.

This ultrasound probe uses high-frequency ultrasound waves to shatter the cataract. This can be heard as a soft buzzing sound in the background. The lens pieces are then removed using a suction catheter.
Once the cataract has been removed, a replacement plastic lens is inserted through the same incision. This sits in the same position that the lens was previously i.e. in the lens capsule. The choice of lens depends upon what the individual’s vision was previous to the operation. They can help correct vision and can be either fixed strength lenses or multifocal lenses.

The video below demonstrates how cataract surgery is performed.

The entire procedure takes anywhere between 30 to 45 min to perform. Following the procedure, and eye patches applied on the patient’s eye to protect it from any injury and dust exposure. The sensation in the eyeball can take a few hours to return.

Patients will be provided with painkillers if required. The patient’s vision returns to normal in 2 to 3 days though complete healing may take a bit longer. Patients are recommended to have a friend or family member to drive them home after the procedure.

For the first week to 10 days following cataract procedure, patients are advised to avoid rubbing the eye or touching the eye. Wearing an eye patch can help prevent this from occurring when asleep. Avoid performing strenuous exercise and heavy lifting of any sort. Attempts must be made to prevent soap and shampoo from entering the eye. Participating in sporting activities such as swimming is not recommended during this time (it can be commenced once the surgeon has given the patient the all clear).

Risks of the procedure

Patients may experience stickiness of the eyelids and blurred vision immediately after the procedure. A mild amount of pain may occur which can be easily treated with painkillers. As the pupils are dilated, patients may find that they are excessively sensitive to bright light but this usually passes after a short period of time.

There are certain complications that the patient needs to be aware of before undergoing cataract surgery. In general, cataract surgery is such a commonly performed procedure because the risks are extremely low. In fact, studies have demonstrated that less than 2 out of 100 patients have any complications whatsoever.

The most common complication that can occur following cataract surgery is cloudy vision. This occurs due to thickening of the lens capsule in the area where it is seated in the eyeball. In the medical world, this condition is called posterior capsule opacification. It is a fairly common condition that can be seen in up to 50% of patients who have undergone cataract surgery. It can occur anywhere between six months to 5 years following the procedure.

Posterior capsule opacification usually warrants repeat eye surgery. This is performed as a laser eye surgery and involves the removal of the part of the lens that has become cloudy. The procedure only takes 10 to 15 min to perform and patients will notice an improvement in their vision within a few days.

There are a number of other complications that may occur but are relatively rare. Some of these include bleeding within the eye, inflammation of the structures within the eye, infection, damage to the cornea and incomplete removal of the cataract. In the rare cases, the retina may get detached and this can cause sudden loss of vision. If this occurs, then it is essential to see an ophthalmologist immediately.

Another complication that may occur following cataract surgery is called cystoid macular oedema. This is characterised by the accumulation of fluid within the different layers of the retina causing a degree of loss of vision.

The video below discusses some of the complications that can occur.

Long term outcomes

Cataract surgeries are very successful and over 95% of patients notice a significant improvement in their vision.

Cataract surgery is a commonly performed procedure that is associated with a low rate of risks and complications.

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