Marc Guerin performs on-axis micro incisional cataract surgery at the Mater Private Hospital
What is a cataract?
A cataract is when the natural lens inside your eye, which lies behind your pupil, becomes cloudy. We look out through this lens everyday to see clear images. When you are young, this natural lens is crystal clear and perfectly transparent. However as we get older, the lens undergoes aging changes just like the rest of your body. As the years progress the lens gradually becomes cloudy and opaque. This clouding of the lens is known as a cataract.
Cataracts usually occur in both eyes, although one eye may be worse than the other. Patients with cataract experience a number of symptoms including reduced vision, cloudiness of the vision, sensation of a film covering the eye, reduction in the brightness of colours and reduced contrast sensitivity. They may also experience glare or haloes in bright light conditions such as on a sunny day or when driving at night when headlights can be very dazzling.
About cataract surgery
Cataract surgery has transformed the lives of millions of people. The operation is usually performed under local anaesthesia, which means that you are awake for the operation but your eye is completely numb so you don’t feel anything. If you are nervous, the consultant anaesthetist may offer you some sedation to make you more relaxed. The cataract is then removed through a 2.2mm incision and replaced with an artificial intraocular lens (IOL) implant. The power of the IOL can be chosen to correct your glasses prescription and after surgery patients often find that their quality of vision is improved and that they are much less dependent on glasses, especially for distance. Many of the surgical techniques have been developed and fine tuned over the last 30 years. Surgery is now minimally invasive, safe, predictable, and has a low complication rate.
Surgery in the mater private hospital
Having your cataract surgery privately gives you the peace of mind that your surgery will be carried out by a fully qualified Consultant Eye Surgeon and Consultant Anaesthetist at one of the leading hospitals in the country, giving you the best chance of having an excellent result. Mr Guerin will see you at all stages of your treatment and will guide you through the best treatment options available to you.
Types of lenses to put in your eye during cataract surgery
Technology surrounding intraocular (IOL) lens design is rapidly advancing. Cataract surgery is now a keyhole surgery performed through tiny incisions that heal rapidly and in most cases without stitches. The intraocular lens is folded and injected into the eye through an incision that is less than 2.2 mm in size.
There are several types of lenses available that address different visual and lifestyle needs:
The monofocal lens is a fixed focus lens that gives clear vision at a set visual distance. This is the standard type of lens and does not address astigmatism or reading vision. Most patients choose this sort of lens and prefer to have clear distance vision and don't mind using glasses for reading.
An alternative strategy with these lenses is called mono-vision. Mono-vision is aimed at increasing your range of focus so that it gives you some ability to see near objects. Typically one eye is left very slightly short sighted (this acts as your near vision eye) whilst the other eye is fully corrected for distance. This works well in most but not all patients. You may have already tried this with your glasses or contact lenses.
Toric lenses correct astigmatism and are bespokely manufactured to the specifications of your eyes. These need to be aligned correctly along the axis of astigmatism at the time of surgery and give excellent quality of vision. Toric lenses in themselves have a fixed focus and do not address reading vision unless a monovision strategy as described above is used.
Things to know about cataract surgery
Because everyone develops cataracts as they get older or due to conditions such as diabetes or steroid use, cataract surgery is the most commonly performed surgery in the world. Like any type of surgery, complications can occur during cataract surgery but are relatively infrequent. It is also useful to know what sort of vision you can expect.
In the UK the The National Cataract Dataset audit of over 55,000 surgeries provides us with useful information about outcomes and risks of surgery
1. What vision can you expect?
95% of patients having cataract surgery who had otherwise normal and healthy eyes had driving standard or better vision without glasses after surgery. In eyes with other eye diseases 79.9% reached the driving standard or better vision. The outcomes of surgery are thus excellent.
2. What are the risks of surgery?
Again based on the UK National Audit Dataset of more than 55,000 cases the risks are as follows;
• 1 in 10,000 risk of blindness.
• 1 in 1100 risk of a severe complication such as infection or internal bleeding that could permanently reduce vision.
• 1 in 100 risk of needing a second operation on the same eye to reposition or replace the lens.
• 1 in 10 chance of a membrane growing over the lens needing a simple laser procedure performed sometime after surgery (up to several years later).
3. What to expect after your surgery
Here's what's normal over the first couple of days after surgery;
• Your vision will seem hazy as your pupil will remain dilated for 24-48 hours after surgery.
• Sunlight and artificial light will seem a lot brighter than normal as the dilated pupil lets in lots of light
• You may notice haloes or a circle around light, particularly after multifocal lens implants. This will settle
• Your pupil will return to normal function within a couple of days and your vision should become much clearer once this happens.
• You should not feel severe pain after cataract surgery but your eye will feel gritty or scratchy. Like a grain of sand irritating the eye.
• Your eye may look pinkish after surgery and there may even be some bright red localised bruising. This is more likely if you are taking asprin or warfarin. This is normal.
• Your eye may feel a little bit achy for a few days.
Here's what's not normal and if you have any of these symptoms you should consult Mr. Guerin as soon as possible;
• Loss of vision
• Decreasing vision
• Increasing pain
• Increasing redness,
• Sticky discharge from the eye
• Cloudiness of the cornea (the clear window of the eye)
• A shadow in the vision that increases in size
Cataract surgery is usually a successful surgery and most patients get excellent results. Having your surgery performed by a consultant eye surgeon ensures that you're receiving the best possible standard of care.