Lifestyle cataract surgery suitability criteria
To be sure that you are suitable for lifestyle cataract surgery, we will need to examine your eyes at your initial consultation.
How lifestyle cataract surgery works
The surgeon makes the corneal incision and softens the cataract. An ultrasound probe emulsifies the clouded lens into pieces and suctions them out.
The surgeon then puts the new lens implant in the eye. The incision heals on its own without stitches.
This is where lifestyle cataract surgery most differs from standard cataract surgery. We can use a lens implant to provide an enhanced range of vision. The lens power is calculated using scans taken at your initial consult for surgery.
At this consultation, your ophthalmologist will discuss lens options with you as well the target focus for your eyes after surgery. This enables us to select the best implant and focus target to suit your needs.
With a special EDOF or multifocal lens, you will have good intermediate and distance vision or functional near vision. You may still need glasses to read and drive at night or read very small print, but you may be able to be free from glasses for either most tasks requiring either near focus or distance focus.
If you would like to reduce your dependence on glasses for both tasks that require near and distance vision, you should consider laser cataract surgery.
Advantages and disadvantages
- Vision that suits your lifestyle: With lifestyle cataract surgery, you have the option to choose your desired prescription after your surgery.
- Cataract surgery is the most commonly performed surgery in Australia and New Zealand; the procedure is considered an outpatient procedure, which typically takes less than an hour and does not require an overnight stay
- Vision is usually improving the day after surgery. Optimal improvement in vision is usually achieved with toric or multifocal lenses. We can even top-up/enhance the procedure with laser refinement at a later date to give you spectacularly accurate results
- Cataract surgery is one of the safest surgeries performed on the human body. Generally, your recovery will be short and uneventful, and you will be kept informed at every stage
- The lens implants are permanent and ordinarily do not need to be replaced – they are good for the life of the patient
- Mild discomfort: After surgery, it is normal to feel mild discomfort, irritation or a stingy sensation. If you experience these symptoms you can take paracetamol (such as Panadol, Panamax, Dymadon or Panadeine). Mild mucous, a small amount of bloody discharge and watering of the eye is also considered normal
- Driving is not permitted for 24 hours following surgery, due to the sedation used
- Lifestyle cataract surgery will incur additional fees to cover premium lenses and possible laser enhancements
- It is also quite normal to be sensitive to bright lights after surgery. You will be given a pair of dark glasses to aid with this if necessary. It is important after cataract surgery to not rub the eye. For two weeks following surgery, it is also advised to avoid:
- Engaging in strenuous activity/exercise, gardening or heavy lifting (greater than 10kg)
- Wearing makeup directly on the eyelid to prevent infection
- Allowing water/shampoo to come into direct contact with the eye
Cataract surgery risks
- There is a 98 – 99% likelihood of undergoing cataract surgery without complications that may permanently affect your best possible vision. You may experience mild grittiness and dry eye symptoms following surgery, and this can last for a few weeks and in some cases several months. Some people may experience fleeting sharp pain related to dryness of the eye. These symptoms are usually manageable with lubricating eye drops. If you are noted to have dry eye at your preoperative assessment, your surgeon may recommend you commence use of artificial tears prior to surgery.
The risk of not having cataract surgery
In certain people, the growth of a cataract can make them prone to primary angle-closure glaucoma. This is where the drainage channel in the front of the eye (trabecular meshwork) is gradually narrowed by the increasing size of the crystalline lens.
Eventually, the drainage channel can become completely blocked, resulting in a rapid increase in the pressure within the eyeball and a painful red eye. Long-sighted patients are more likely to be at risk of angle-closure glaucoma. Your eye specialist will be able to assess if you are at risk of primary angle-closure glaucoma and whether you would benefit from cataract extraction or another treatment to prevent this serious condition.
Options and alternatives
The only way to treat a cataract is to surgically remove it and implant an artificial lens in its place.
An alternative to lifestyle cataract surgery is:
- Laser cataract surgery – Restore clarity of vision AND correct your glasses prescription so you no longer need glasses to read – (even in dimly lit conditions or at night)
- Standard cataract surgery – An ideal treatment for someone who has no astigmatism or other refractive error (only approximately 30% of the population).
Does a non-surgical treatment exist?
The alternative to having cataract surgery is quite simply not undergoing surgery. Cataracts are unable to be treated with anything other than a surgical procedure. If they remain untreated, then over time they will continue to cause your visual acuity and contrast sensitivity to gradually decline. Your optometrist may ultimately be unable to prescribe glasses to provide any form of visual clarity.
The cataract will eventually blur your vision to a point where daily activities can become difficult to perform.
In some cases, if you do not opt for surgery, the natural lens will thicken in addition to going cloudy, and can potentially cause the drainage pathway of the eye (the trabecular meshwork) to narrow. This can put you at risk of a condition known as angle-closure glaucoma, which can result in irreversible vision loss.
Lifestyle cataract surgery steps
Step one: We use local anaesthesia in the form of eye drops and light (twilight) sedation. We make a tiny incision in the cornea – the transparent membrane on the surface of the eye – using a laser.
Step two: We insert a fine instrument through the incision, which uses ultrasound vibrations to break up the lens into a fine pulp. We then carefully remove this pulp under microscopic guidance.
Step three: Once we’ve had the cataract removed, we implant the artificial lens (intraocular lens or IOL) using a special lens injector. In the majority of cases, the IOL will sit within the natural ‘bag’ that held the original lens, and the incision heals on its own.
Step four: Once the surgery is complete, we place a clear shield over the eye, which stays on for four hours post-surgery. We will ask you to commence the use of postoperative drops which consist of an antibiotic drop and two anti-inflammatory drops. The surgery takes less than an hour, and generally, the total time at the hospital is approximately three hours.
Lifestyle cataract surgery results
After surgery, you’ll have clear vision and will no longer be dependent on glasses for many of your chosen tasks and activities.