Your Guide to Cataract Surgery at Centre for Sight

The purpose of the consultation performed by a consultant ophthalmologist is to carry out a thorough evaluation of your eye(s) to ensure that cataract is the sole cause of reduced vision and that there are no other underlying problems like for instance Diabetic retinopathy, Glaucoma or Age Related Macular Degeneration AMD. At the same time, measurements and investigations are performed to determine whether a high performance lens is an option and if there is any astigmatism that needs to be corrected.

If you wear contact lenses, you will be asked to remove and not wear them for a period time leading up to your consultation. This is to enable us to accurately determine lens power.

Find out why Centre for Sight performs so many tests prior to laser lens / cataract surgery by reading our article “Pearls For Premium Lens Success“.

Click here to watch the video.

Usually, one eye is treated at a time although increasingly cataract surgery is being performed in both eyes on the same day. Modern cataract surgery is performed as a Day Case operation and while the procedure only takes 15 minutes, prepare to spend 2 to 3 hours at the Centre. You will be instructed when to arrive at the centre.

On arrival

A series of checks will be conducted and further investigations may be required to ensure absolute accuracy of the treatment plan. Your consent form will be checked.

Preparing for surgery

• You will then receive dilating drops to expand your pupil so that the surgeon can have access to your cataract.
• The Surgeon may need to mark your eye before the actual procedure to ensure accurate placement of laser astigmatic limbal relaxing incision or a toric IOL (astigmatic lens).
• You will receive strong anaesthetic and antibiotic drops.
• You may have a small IV cannula placed so that the anaesthetist can give you intravenous sedation or you may receive an oral sedative.
• Be wheeled into the theatre and then have to lie on the bed of the laser. More drops will be instilled and the surgeon will perform a series of pre-operative “flight checks” with the operating team.

You will feel a little pressure of the suction ring that connects to the laser.

You must hold still during this process where an online scan checks a series of measurements in your eye and determines where the laser treatment takes place. A beeping sound indicates the laser in action. The laser will create a perfectly circular opening in your lens, break the lens up into small fragments and if necessary create incisions to correct your astigmatism.

Once the laser treatment is complete, the consultant eye doctor /surgeon will continue to remove the fragmented cataract with fine instruments in a process known as phacoemulsification and implant an intraocular lens. You will probably see a series of colours and flashing lights – enjoy the show!

After the surgery

Once IOL implantation is complete and the procedure comes to an end, the Surgeon will inject antibiotic medication into the eye and ensure the eye is well sealed. The eye will be patched with an eye shield placed on your eye. This will be removed the next day. Cataract surgery recovery is very rapid and most patients notice a remarkable improvement in vision as soon as the patch is removed.

After the procedure, you will have time to recover and enjoy some refreshments. You will receive a toiletry bag with medications and instructions for usage. Afterward, you may go home and are advised to rest for the remainder of the day.

The next day, remove your shield and patch, keeping the shield for possible night time use. Start your eye drops as instructed. You may have a follow-up appointment scheduled that day, or if not someone from Centre for Sight will contact you to check your progress.

If you have surgery to both eyes on the same day, you will not have eye patches (as this will really be debilitating). Instead, you will have elasticated eye goggles and will need to start your drop regimen the same day.  To ensure rapid recovery and reduce the risk of infection you must keep both eyes closed as much as possible on the day of the procedure.

Visual recovery is often very rapid with patients obtaining excellent vision the day following cataract surgery. Sometimes vision is blurred for one or two days and this might be the case if the cataract was particularly hard. If you have had a high performance lens like a trifocal lens implant, then you will find that you will also be able to read. If you have had a monofocal lens, then you might need to get a temporary pair of off the shelf reading glasses to help during the period of recovery (usually 4 weeks) before you see your optometrist.

Some patients may develop a secondary cataract or cloudiness of the membrane holding the intraocular lens implant, either in the following months or years after surgery. This condition is easily treated with a YAG laser capsulotomy during an outpatient visit..

Most cataracts develop slowly over time and affect people over age 50. About half of the U.K. population has a cataract by age 65, and nearly everyone over age 75 has at least a mild cataract in one or both eyes.

In rare cases, infants can have congenital cataracts. These usually are related to the mother having German measles, chickenpox, or another infectious disease during pregnancy; but sometimes they are inherited.

Today rarely does anyone have to wear thick, heavy eyeglasses after cataract surgery these days. Most modern cataract procedures replace your eye’s natural lens with an intraocular lens (IOL) that often can correct your distance vision to 20/20 without glasses or contact lenses. At Centre for Sight, we aim to correct vision without glasses at the time of cataract surgery – so called “Refractive Cataract Surgery “which involves the use of high performance Trifocal lenses.

As with any surgery, pain, infection, swelling and bleeding are possible, but very few people experience serious cataract surgery complications. In most cases, complications or side effects from the procedure can be successfully managed with medication or a follow-up procedure.

To reduce your risk for problems after cataract surgery, be sure to follow the instructions your surgeon gives you and report any unusual symptoms immediately.

Because a cataract is a clouding or “opacification” of the natural lens, and cataract surgery entails removal of the natural lens, a cataract cannot come back after surgery. What can happen in about 5% of patients is clouding of the membrane holding the lens implant. If this were to occur then a simple YAG laser capsulotomy could be used to make an opening in the lens capsule.

In patients who have glaucoma and are on eye drops, there is an option available that reduces or in many cases eliminates the need for glaucoma eye drops and tablets. Microscopic Incisional Glaucoma Surgery ( MIGS ) involves a microscopic stent which can be inserted at a specific location inside the eye at the time of cataract surgery. While this is more costly (the stent is a very sophisticated microscopic device), it is a great option for those who wish to reduce the number of eye drops or stop them altogether. Combining Cataract and MIGS surgery also enables safe use of Trifocal lenses where there is less concern about progression of glaucoma.