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Cataract
Many people think poor vision is an unavoidable frustration of growing older. However cataract surgery is a successful procedure to restore vision.
It’s certainly true that cataracts often develop with age: as we get older, the lens of our eye become more susceptible to degeneration of proteins of the lens that cause frosting or cloudiness. But that doesn’t mean you have to endure them forever. Cataract surgery is a very common and highly effective procedure. It works by replacing the natural lens of the eye with a new, artificial lens. It’s swift (typically around 15-20 minutes per eye) and painless. And it can correct prescription issues at the same time, leaving you free to enjoy clear vision again – perhaps for the first time in years.
Frequently asked questions
When should you have cataract surgery?
There is no specific level of vision at which surgery is indicated, but as soon as your impaired vision interferes with your daily life, the procedure is worth considering. You may notice your impaired vision when reading, working, watching TV, driving, playing sport or caring for others.
If you are a driver, you must be able to achieve the visual standard required by the DVLA and it may be necessary to have cataract surgery to keep your licence. Leaving a cataract untreated does not damage the eye, but as the lens opacity worsens, your vision will deteriorate until little sight remains. Surgery at this stage may be more difficult.
Which implant lens should you have?
As with spectacle lenses, there are different implant lenses available. You may be given a choice of using a regular monofocal lens (single-vision power), or a multifocal lens which is designed to give you a degree of spectacle independence for most everyday tasks.
We will discuss with you the type of implant lens that will best suit your needs, and the visual outcome you can expect.
What do you need to consider prior to surgery?
Since most cataract surgery is only carried out with drops to numb the eye (known as ‘topical anaesthesia’), there are usually no restrictions on what you can eat and drink prior to admission. If you require a general anaesthetic, we can supply you with additional written advice about this.
The procedure is usually carried out as a day case, with a hospital stay of a few hours. Please remember that you won’t be able to drive yourself to hospital. You may wish to ask a relative or friend to accompany you, or to drop you off and collect you when you’re ready to go home. If getting to and from the hospital is difficult, we may be able to offer assistance. Please alert our secretarial team, as the hospital bookings office won’t be able to help with transport.
What will my surgery journey look like? Find out more on our preparing for surgery page.
What happens during surgery?
Most cataract surgery today is carried out using topical anaesthesia. This is done with eye drops to numb the eye and surrounding area. You will be awake during the operation and aware of some movement, touch and water, but the procedure will be painless. We routinely offer intravenous sedation, which many people find reassuring and relaxing.
For potentially challenging cases, we may recommend a local anaesthetic block for your treatment. This involves gently injecting anaesthetic around the eye, and it will help you to relax while the procedure is carried out.
We will make sure you feel comfortable on the operating couch. We then thoroughly cleanse the skin around your eye and place a sterile cover (or ‘drape’) over your eye and face. The cover will be lifted off your mouth so you can breathe and talk easily. A tiny clip is gently used to hold your eyelids open. The surgeon will then ask you to look at a central light, which allows us to position your eye correctly for surgery.
Since you will only see a little of what’s happening during surgery, we will explain what we are doing as the operation goes along. The theatre staff will be on hand to help you feel relaxed and comfortable. We can even make sure that someone is there to hold your hand if you wish. The operation usually takes about 15 to 20 minutes, though in some cases it may take longer.
Many people believe that cataracts are removed with lasers, but that’s not usually the case. The modern technique for extracting cataracts is called phacoemulsification. It’s carried out under an operating microscope and involves making a very small incision in the cornea (the clear part at the front of the eye, which covers the iris and pupil). We then insert a tiny probe through the incision to remove the cloudy lens. The incision is self-sealing, so stitches are not required.
The natural lens of the eye is contained within a ‘capsular bag’. The aim of surgery is to remove the lens contents while leaving the capsular bag intact, apart from a small circular hole on the front surface which allows us to perform the operation.
An ultrasonic probe breaks up and then vacuums away the cataract material, leaving a cavity for the new lens.