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Cataract Surgery
Cataracts occur when the lens of the eye, which is responsible for focusing, becomes cloudy and opaque. Cataract surgery includes conventional surgery that involves a larger incision, causing more trauma to the eye and requiring stitches; and minimally invasive phacoemulsification surgery, which is quicker, and does not require stitches.
In conventional cataract surgery, an incision is made at the edge of the cornea to remove the cataract (cloudy lens), and an artificial lens is inserted before suturing the wound. This method is generally used for older patients, those with very mature cataracts, or cases where minimally invasive surgery is not feasible.
Minimally invasive phacoemulsification surgery is currently the most common and preferred option. A small stainless steel ultrasonic tool is used to break up the cataract into tiny fragments, which are then suctioned out, followed by implantation of a foldable lens. The incision is typically around 2mm and does not require stitches.
Q2. How is the surgery performed? Can elderly patients with dementia undergo the procedure?
Cataract surgery is usually performed under local anaesthesia, where the patient stays awake with the eye numbed with eye drops before the procedure. If the patient feels anxious, panicked, or prefers not to stay awake during surgery, it can be performed under monitored or general anaesthesia. As patients with dementia may fail to cooperate, either monitored or general anaesthesia may be required.
Q3. Can cataract surgery also correct presbyopia, astigmatism, and nearsightedness?
Cataract surgery is also a refractive surgery. It can address presbyopia, nearsightedness, farsightedness, and astigmatism, depending on the lens chosen. There are three types of artificial lenses: single-focus, multifocal, and an intermediate called extended depth of focus (EDOF). The choice of lens varies with the patient’s expectations, preoperative condition, and if one prefers to continue wearing glasses after surgery.
Q4. Can patients with macular oedema undergo cataract surgery?
Macular oedema has various causes. If one has macular oedema before surgery, it should be treated first. If the cause is identified, the condition can be treated properly. During cataract surgery, specific medications can also be injected to improve macular oedema.
Q5. What precautions should be taken after cataract surgery?
Good hygiene is crucial after cataract surgery, especially during the early period. While you can shower and wash hair, try to prevent dirty or raw water from entering the eye. Use prescribed eye drops as per doctor’s instructions and attend follow-up appointments. In case of any serious problem or abnormality, contact your doctor as soon as possible.
Q6. What are the potential complications of cataract surgery?
All surgeries carry risks. The main concerns of cataract surgery include infection, retinal detachment, or refractive errors. Since the surgery replaces the natural lens with an artificial one, the visual experience may differ. Some patients may become sensitive to light, see halos around light sources in the dark, e.g. streetlights or car headlights, or experience a foreign body sensation or discomfort. These symptoms are common and usually improve over time.
Q7. How long does it take to recover vision after cataract surgery?
Vision recovery is usually very quick after cataract surgery. Most patients show significant improvement the day after surgery. However, some cases may take longer to recover, as certain pre-existing eye conditions such as macular oedema or glaucoma may affect recovery speed. Vision improvement is generally measured in days. If vision does not improve after one to two weeks, consult a doctor to identify the underlying cause.
Q8. If the outcome of my first cataract surgery is not ideal, can I have a second surgery?
Cataract surgery is usually performed once in a lifetime. If there are no major issues, a second surgery is not necessary. However, if the postoperative vision is unsatisfactory, further investigation is necessary. For instance, it could be due to refractive errors or unmet visual expectations. Further treatment can be arranged based on the patient’s condition.
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