Standard cataract surgery suitability criteria
Standard cataract surgery is one of the most common surgeries in the world. It is safe and very effective when treating cataract.
To be sure that you are suitable for standard cataract surgery in Brisbane, we will need to examine your eyes in your initial consultation.
How standard cataract surgery works
The only way to treat a cataract is to surgically remove it and implant an artificial lens in its place. Cataract surgery is the most commonly performed surgery in Australia; the procedure typically takes less than an hour and does not require an overnight stay.
Cataract surgery is performed in a Day Surgery using local anaesthetic eyedrops and twilight sedation. A tiny incision is made in the cornea (the clear membrane on the surface of the eye) and a fine ultrasound instrument is then inserted. The ultrasound energy is used to gently emulsify the lens, and this is then carefully removed under microscopic guidance.
Once the surgeon has completely removed the cataract, they will 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 crystalline lens. Sutures are not usually required.
The surgery takes less than an hour. Generally, the total time at the hospital is approximately three hours. Once the operation is complete, we will place a clear shield over the eye which stays on for four hours post-surgery. After this, you will need to commence postoperative eye drops (antibiotic and anti-inflammatory drops). Each eye is treated separately on different days. Driving is not permitted for 24 hours following surgery due to the twilight sedation.
With standard cataract surgery, we implant monofocal lenses which have a single point of focus. This means the lens will be fixed for either near or distance vision, but not both. You will need to resume wearing your normal prescription glasses after the surgery.
You can usually proceed with updating prescription glasses 4 to 6 weeks after surgery, once your surgeon has given you clearance to do so. The lens implants are permanent and ordinarily do not need to be replaced – they are good for the life of the patient.
Advantages and disadvantages
- Cataract surgery is the most commonly performed surgery in Australia; the procedure typically takes less than an hour and does not require an overnight stay.
- Vision is usually improving the day after cataract surgery; most patients can report an improvement in the brightness of their vision and enhanced colour perception
- 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.
- Medicare and health insurance usually cover basic cataract surgery.
- You will almost certainly continue to need spectacle correction of some kind.
- 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.
- It is also quite normal to be sensitive to light 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 eyelids
- Allowing water/shampoo to come into direct contact with the eye
Standard cataract surgery risks
- There is a 98-99% chance that your surgery will be performed without complications. Cataract surgery is the most commonly performed surgery in Australia. It is considered highly successful with favourable outcomes for the majority of patients.
- After cataract surgery, it is common to experience mild irritation, dryness and light sensitivity.
- Serious complications related to cataract surgery may include infection, retinal detachment, inflammation and oedema, glaucoma, haemorrhage and bleeding, residual lens material, and the possible worsening of pre-existing conditions.
- Should you notice any severe pain, sudden changes to your vision, worsening of your vision or anything that seems out of the ordinary following your surgery, we recommend you call OKKO Eye Specialists immediately to discuss your concerns.
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
Restore your vision AND eliminate your need for glasses
If you would like to experience freedom from glasses after your cataract surgery, you have the option to choose your desired prescription by opting for:
- Lifestyle cataract surgery – Restore clarity of vision AND correct your glasses prescription to suit your active lifestyle
- 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 at night)
Does a non-surgical treatment exist?
The alternative to having cataract surgery is quite simply not undergoing cataract surgery. Cataracts are unable to be treated with anything other than a surgical procedure. If you do not treat your cataracts 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 cataract 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.
Standard cataract surgery steps
The most common type of cataract surgery is known as micro-incision phacoemulsification cataract extraction. We perform this procedure with local anaesthetic (eye drops) and copious sedation.
We make a small (2-2.5mm) self-sealing incision on the side of the cornea, the clear membrane on the surface of the eye. We then insert a fine ultrasound (phaco) probe. Vibrations from the tip of the probe fragment and emulsify the cataract into a pulp. We then carefully remove these fragments of cataract under microscopic guidance.
Following this, we replace your natural lens with a biocompatible monofocal lens, specifically preselected for your eye. The implant is rolled up in a special lens injector and gently guided into place by your surgeon. In the majority of cases, the IOL will sit within the natural bag that originally held the crystalline lens (the capsule), and sutures are not usually required to position the IOL.
Standard cataract surgery results
After standard cataract surgery in Brisbane, we will have removed your cataracts and your potential for good vision will be back to its former level.