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Cataract surgery is one of the most commonly-performed surgeries in Australia. A cataract is a clouding of the natural crystalline lens in the eye. This most commonly occurs gradually after 50 years of age due to natural age-related changes. Sometimes, however, cataracts can form at birth (congenital cataract); or grow secondary to trauma or medication use (steroids).
Cataracts can cause blurred vision, increased glare sensitivity, reduced brightness and colour perception, and difficulties with driving at night. As a cataract progresses, vision can no longer be corrected with spectacles. When your ability to perform daily activities like reading and driving becomes significantly impacted by cataract, your ophthalmologist may recommend cataract surgery to improve your vision. Currently, cataract surgery is the only proven way to treat a cataract.
During cataract surgery, patients are placed under sedation and the eye is numbed with local anaesthesia. A small, micro-incision is made on the surface of the eye and the cloudy crystalline lens is broken up using a small ultrasound device. This process is known as phacoemulsification. The fragmented crystalline lens is then removed under microscopic guidance and a new artificial intraocular lens, known as an IOL, is inserted into the eye. IOLs are biocompatible (that is, your body will not reject an IOL) and do not need to be replaced or changed in your lifetime.
Cataract surgery takes less than 30 minutes and most patients can go home the same day with a clear eye shield over the eye. Postoperative eye drops (antibiotics, anti-inflammatory drops and lubricating drops) are used for a few weeks after surgery. Most people are aware that their vision is brighter and “more white” after surgery, and vision is generally noticeably clearer after a few days. The eye itself is usually comfortable, and most patients report only mild discomfort or grittiness.
Patients cannot drive for 24 hours (to allow the sedation to clear their system), however most other normal activities can be resumed immediately after surgery. We recommend avoiding strenuous activities (such as heavy lifting), gardening and swimming for two weeks.
Take our cataract surgery quiz to find out which cataract surgery is most likely to deliver the vision you want.
Refractive cataract surgery treats your cataracts and aims to eliminate the need for glasses altogether. This is achieved by using special intraocular lenses that offer a range of focuses from distance, intermediate and near. Refinement procedures such as LASIK laser vision correction may be required to “fine tune” the focus of the eye after cataract surgery and to improve vision quality.
There is no single “best” intraocular lens that would meet the needs of everyone. Intraocular lenses vary as much as we differ as individuals with our own vision and lifestyle needs.
OKKO offers a complete range of the latest lens types and laser vision correction techniques available. These will help you achieve the vision that will best suit your lifestyle and vision needs . At your initial assessment, your ophthalmologist will explore your lifestyle needs and discuss which lens options are suitable for you based on a comprehensive eye examination. Scans of your eye are taken and these are used to calculate the best possible IOL and target focus for you.
Reduces your dependence on glasses (including reading glasses and bifocals) for most day-to-day tasks.
Reduces your dependence on glasses, however prescription glasses are likely to still be required for reading and other near tasks
Corrects any astigmatism you may currently have in your glasses or contact lenses
In lifestyle cataract surgery, special intraocular lenses are used to try and reduce your dependence on glasses. For example, extended-depth-of-focus IOLs (or EDoF lenses, for short) can correct your distance vision and “intermediate” vision so that you can see clearly from 50cm to far away without the need for glasses. This is very useful for general lifestyle activities such as driving (and seeing through the windscreen and your dashboard), swimming and going to the theatre. Spectacles are still expected to be required for reading and near work (particularly reading small print, for a long period of time or in dim light).
A small proportion of patients may need limited use of glasses for specific activities such as driving at night. Some patients choose to wear progressive glasses for convenience.
In standard cataract surgery, a single focus intraocular lens is inserted into the eye. This improves vision clarity, particularly for distance, however spectacles are expected to be required for activities at closer distances like reading, using a mobile phone and working on the computer.
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No, however if you do not treat your cataracts then over time, your vision will continue to decline. Eventually, you may find that your glasses no longer enable you to see clearly. The cataract will eventually blur your vision to a point where daily activities can become difficult to perform.
In some people, a cataract can also cause narrowing of the drainage pathway of the eye (the trabecular meshwork). This can put you at risk of a condition known as angle-closure glaucoma which can result in irreversible vision loss.
We know that eye surgery can be a daunting thought. We’re happy to talk through the procedure with you and help put you at ease.
The specific type of lens that will best suit you depends on your lifestyle and vision needs, and the results from your preoperative testing. At your assessment, we conduct an extensive analysis to determine which intraocular lens will meet your lifestyle requirements.
Once we have removed your cataract at the time of surgery, we replace it with an artificial lens called an intraocular lens (IOL). It is possible in most cases to choose an IOL that can correct the prescription you wear in your glasses or contact lenses.
To do this, we perform a series of scans at your initial visit which gives precise measurements of your eye. These include measurements of the length of the eye and the curvature of the front of the eye. These measurements are then used in a mathematical formula to calculate the required IOL power.
It is important to understand that no intraocular lens can completely replicate the vision that you may have experienced in early adult life. Additionally, despite extensive measurements and calculations, we cannot guarantee that the lens will achieve the exact focus that you and your ophthalmologist aim for.
Your ophthalmologist will discuss the range of intraocular lens options with you as well the target focus for your eye after surgery. By working through this process, the best IOL implant and focus target that most suits your needs is likely to be achieved. Some possibilities include, but are not limited to:
We perform cataract surgery using intravenous sedation and local anaesthetic eye drops to ensure the procedure is pain-free. You will have little or no awareness of your surroundings during the procedure. For the majority of patients, the sedative effect will wear off within 15 to 20 minutes following surgery.
You will not be able to drive for 24 hours after your procedure due to the residual effects of sedation such as drowsiness and decreased reaction times. We recommend you have a carer to escort you home and avoid public transport for the same reason.
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. These symptoms are usually manageable with lubricating eye drops.
If you are noted to have dry eyes at your preoperative assessment, your surgeon may recommend you commence the use of artificial tears before surgery.
Your vision may be blurred to some degree on the day following surgery but will gradually improve over the next few days. Updates in spectacles can be made approximately one month to 6 weeks after surgery, once your ophthalmologist has given you clearance to do soo.
Postoperatively, there are no significant restrictions on lifestyle. In the first week, we advise you to defer any activities which could introduce foreign matter into the eye (this includes avoiding getting water in your eye when showering). We will give you a clear shield (for use when sleeping) and dark safety glasses to protect the eye.
There can be a degree of variability in achieving the desired prescription following cataract surgery, between both individuals and eyes. This is because we calculate the IOL implant using a regression equation, and it is possible that your eye may not conform exactly to this mathematical model.
In the majority of cases, even if the focus is not exactly as predicted, it is likely to be very close to the expected result, and the quality of your vision should still be very good.
Wearing glasses for certain activities may be necessary. In cases where the desired postoperative prescription is significantly different from the expected result, your ophthalmologist may discuss with you the possibility of fine-tuning your vision with an additional procedure such as LASIK laser vision correction. This is included in patients who have elected to undergo refractive cataract surgery (insert link here) but may incur out-of-pocket costs for those who have undergone standard or lifestyle cataract surgery.
Medicare and health insurance usually contribute towards cataract surgery. We can provide item numbers for you to give to your health fund to check what your health fund covers. Find out more about our fees and insurances.