Cataract is an eye condition which is a consequence of ageing and develops gradually over time. A cataract is a loss of transparency or a cloudy lens. The crystalline lens is a part of the eye that helps focus light rays on the retina. It is located inside the eye behind the iris. With age the lens becomes harder and leading to difficulties reading or Presbyopia. As time progresses the lens becomes cloudy and affects vision.
Cataracts can be treated easily using small incision along with Lasers. Centre for Sight introduced the first VICTUS femtosecond laser to the UK in 2012. This laser (featured on SkyNews and the Daily Mail) has enhanced the precision and safety of Cataract surgery with implantation of an intraocular lens (IOL). An intraocular lens implant is an artificial lens that enables the eye to focus.
Cataract surgery in combination with high performance Premium or added value intraocular lenses such as Trifocal multifocal IOL implants can provide a patient with complete independence from optical aids – Visual Rejuvenation.
What is a Cataract?
A cataract is a loss of transparency or clouding of the normally clear lens of the eye. This lens is a part of the eye that helps focus light on the retina. It is located behind the iris.
What causes Cataracts?
The lens of the eye is located immediately behind the iris and is responsible for 33% of the focussing power of the eye. The cornea is a clear structure at the front of the eye and provides the remaining 67%.
The function of the lens is to provide fine focus, especially up close. The lens changes shape to alter the power of the eye (accommodate) and adjusts focus for near and intermediate objects. At birth it is like jelly but with age layers are added on to the lens making it gradually harden. Lens hardening results in loss of ability to change shape and in turn provide focus at near. Evidence of this hardening normally starts to affect us in our mid-forties when many require reading glasses for close work. This is called Presbyopia.
With further increase in age, the lens continues to harden and starts to become more compact and cloudy, reducing initially quality of vision and later obstructing vision and interfering with day to day activities. A cloudy opaque lens is called a cataract and unfortunately is inevitable and will affect us all should we live long enough.
Underlying conditions such as Diabetes increases the risk of developing cataract. Some medications like oral steroids can also cause cataract. There are no eye drops that are available at this moment in time that can either cure or prevent cataract.
Some patients are born with cataracts. Known as congenital cataract this is a condition that requires close monitoring and care and early removal if vision is affected by the cloudy lens.
What are symptoms of Cataract?
The typical symptom of cataract formation is a slow, progressive and painless decrease in vision of variable degrees. The loss of transparency of the lens may be so mild that vision is hardly affected, or so severe that no shapes or movements are seen, only light and dark.
Other symptoms are:
- Blurring of vision
- Poor night vision
- Glare, particularly at night
- Frequent eyeglass prescription change
- A decrease in colour intensity
- A yellowing of images
- Double vision (in rare cases)
Who can have Cataract removal ?
- Those with visually significant lens cloudiness
- People of any age
Prior to cataract surgery, it is important to have a comprehensive eye examination including visual acuity test, tonometry (measurement of the pressure inside the eye), pupil dilation, cornea measurements and tests to measure the size of the eye as well as a check to eliminate retinal detachment and other retinal conditions (e.g. macular degeneration & diabetic retinopathy) which may account for visual loss.
How is Cataract eye surgery performed?
At Centre for Sight, femtosecond laser cataract surgery is the method of choice and is performed on all refractive cataract surgery patients. The basics of the operation involves selecting a replacement lens with your cataract surgeon or ophthalmologist who will consider your lifestyle and visual needs. The most common multifocal lens implant used at Centre for Sight is a trifocal IOL and have been used regularly since 2010. Trifocal IOL implants in those who are suitable provide a full range of focus and better than Extended Depth of Focus (EDOF) lenses often advertised. Femtosecond laser cataract surgery takes about 15 minutes (each eye) with a small incision into the eye, lens capsule incision and lens fragmentation. The fragments of the old lens is removed through a small incision of only 1.8mm by minimal ultrasound phacoemulsification and IOL implantation performed through the same incision.
What is Femtosecond Laser Cataract Surgery ?
Femtosecond Laser Cataract Surgery is the most precise technology available. As the procedure provides a whole new level of precision and in turn safety. The laser combines 3 dimensional imaging of the eye in real time and the femtosecond laser is directed to perform surgery very much like robotic surgery. A capsular opening is perfectly circular at 5.0mm or whatever selected by the ophthalmologist and fragmentation choices depend on how hard the lens is determined to be at consultation. The reproducibility of femtosecond laser cataract surgery reduces the bandwidth of error and in turn complications of surgery thereby increasing safety n the operated eye. Complication rates are measured at Centre for Sight and considerably lower than the national average with a posterior capsule rupture rate of less than 1:800 (vs 2% nationally)
How quick is cataract surgery recovery ?
Cataract surgery recovery is also very quick with patients often seeing extremely well from the operated eye the next day.
Can I become completely free of glasses following cataract surgery?
Yes this is possible if your surgeon uses a multifocal IOL such as a trifocal IOL rather than a monofocal lens and where there is considerable astigmatism a toric lens. However not all patients are suitable for the option of a multifocal IOL implant. Your cataract surgeon at Centre for Sight will at the time of consultation indicate to you whether this type of lens is suitable in your case.
Those requiring glasses or a contact lens most of their life (i.e. before their 40’s) for shortsight, longsight and/or astigmatismvusually have what is called a Refractive Disorder. This is where the length of the eye in relation to the shape of the cornea causes the point of focus at the back of the eye to fall short of or beyond the retina. Prior to development of cataract, many with a refractive error find laser eye surgery a good option for correction. However with the presence of cataract , careful calculation of the intraocular lens implant and higher performance lenses like toric IOL and multifocal IOL implants, patients are in a position to avoid glasses altogether for all activities. Learn more about Multifocal and trifocal intraocular lenses.
Those who have had previous laser refractive surgery are also able to have a multifocal lens and if you have had this performed be sure to mention this so that your care will be directed to a cataract surgeon with experience in this area.
Author Information
Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth, Consultant Ophthalmic Surgeon & Medical Director, June 2019.
Revised August 2020
Next review due August 2024.