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What is a Cataract?

A cataract is the lens of the eye, which has become opaque, thereby reducing or blurring the vision. Car headlights or bright sunshine can cause problems because the cataract scatters light and causes glare.Cataract usually affects individuals of 60 years or more. Most people over the age of 70 have some signs of cataract. Eventually the cataract if left untreated will remove almost all of the vision but usually the patient will opt for surgery before this to restore vision.Thankfully surgery has become technically advanced and the success rates are very high. Cataract extraction and prosthetic lens implantation is the commonest surgical procedure on the eye.  

phacoemulsificationModern Cataract Microsurgery

During surgery the cataract and therefore the lens of the eye is removed. To allow the eye to focus a prosthetic lens implant is inserted. Measurements (biometry) are taken before surgery to make sure that the correct lens implant is used.  This usually allows the surgeon to aim for a particular focus for the eye postoperatively.

 Cataract surgery involves these manoeuvres:

  • Incision of the eye. A special small incision is made to allow access to the front of the eye. This is so small that suturing of the wound is not performed routinely at the end of the surgery.
  • Removal of the front part of the capsule (this is a clear membranous sac around the lens).
  • Cataract extraction using phaco-emulsification. Ultrasound energy vibrating 40,000 times per second is used to liquefy the cataract to allow aspiration of the tissue through the small wound. Ultrasound is currently the most effective method for removing cataracts.
  • Insertion of an intra-ocular lens implant (IOL). This is made of a material that can be folded, allowing insertion this through the small wound, and then unfolded during placement into the remaining capsule.

[hacoemulsification2The operation is performed with local anaesthetic as a day case and takes approximately 15-20 minutes to complete.

The vision is rapidly improved after surgery.

If you wish to have an assessment for a cataract extraction please contact my secretary on 0207 323 4432.

Complications of cataract surgery and the management of these by the vitreoretinal surgeon.

Cataract is extremely safe and effective. However occasionally complications occur and it is the skills of the vitreoretinal surgeon which are called upon to remedy the situation.  It is important to realise that these complications are rare. The vitreoretinal surgeon encounters them from time to time because of the high numbers of cataract operations being performed.

Rarely the cataract surgeon will drop fragments of the cataract into the posterior portion of the eye. These must then be removed by the vitrectomy procedure to restore the vision in the eye.

Bacteria can enter the eye during the operation and cause infection inside the eye (endophthalmitis) this must be treated by injection of antibiotics into the eye and sometimes vitrectomy.

The risk of retinal detachment is slightly increased after cataract extraction. If you experience an increase in floaters or flashes of light after cataract surgery (or laser to the capsule of the lens implant) you must have your retina inspected as soon as possible for a possible retinal detachment.

 

Disclaimer. The information provided in the Retina Surgery web site is not a substitute for professional medical care by a qualified doctor or other health care professional. Always check with your doctor if you have concerns about your condition or treatment. The authors of this web site and St Thomas’ hospital are not responsible or liable, directly or indirectly, for any form of damages whatsoever resulting from the information contained in or implied by the information on the site.
(Information for Patients only provides a guide. It is important that you consult your ophthalmologist if you are experiencing problems with your eyes.)

The text and images are the copyright of Tom H Williamson.