Cataract surgery and treatment

Treatment for cataract

The most common cataracts treatment is a refractive lens exchange operation to remove the cloudy lens and replace it with a clear artificial replacement. This treatment is quick, taking between 30-60 minutes, and can greatly improve vision.

Laser cataract surgery

If you decide with your consultant surgeon to have laser cataract surgery (also know as femto-phako) your consultant will use femtosecond laser to partially breakdown the cataract. Removal of the cataract then proceeds as for conventional (non-laser) cataract surgery, with a clear artificial lens (intraocular lens implant or IOL), made of a plastic-like material, placed inside the eye. Current available evidence shows that both conventional and laser cataract surgery are as good as each other in terms of vision and safety.

Lens options

Mono focal lenses

Monofocal lenses have a fixed focal point. This means they provide clear vision at near, intermediate, or distance vision. As a result, many patients require glasses after cataract surgery.

Combining a clearer distance focus in one eye with a clearer focus at arms’ length is a good option if you have no strong preferences and had good vision in both eyes, with or without glasses before the cataracts developed. Spreading the focus between the eyes in this way does not normally stop them working together or make you feel unbalanced, and it helps you to do more activities comfortably without glasses. You will probably still prefer to wear glasses for at least some activities after surgery and it may take you a few weeks to get used to your new vision. This option requires careful consideration and may not be suitable for all patients.

Multi-focal lenses

Multifocal lenses are lenses that work to correct vision for both near and distance vision. This means that patients can reduce or remove the need for glasses after their cataract surgery.

There are many types of multifocal lenses that each have advantages and disadvantages. it is important to discuss your options with your consultant in the context of your eye health, prescription and lifestyle so you can choose the right lens for you.

Toric lenses (astigmatism correcting lenses)

Toric lenses are available for patients who have moderate to high astigmatism. A toric lens is made of the same material as a standard lens, but also incorporates astigmatism correction as well. The aim is to improve your vision so that the need for distance glasses is minimised but, as with standard lenses, you will still need to wear glasses for close up work.

Anaesthetic options

Your anaesthetic options will be discussed with you at your initial appointment and pre-operative assessment.

There are four main anaesthetic options:

  • Anaesthetic drops: used in all cataract surgeries, these drops numb the eye
  • Sub-tenon block: a form of local anaesthesia that boths numbs the eye and optic nerve
  • Sedation: relaxes you and puts you in a 'semi-awake' state
  • General anaesthesia: only used for patients who are unable to lay still on their back on a theatre bed

After cataract surgery

You will be given instructions for your cataract surgery aftercare following your operation, including information regarding follow-up appointments.

Cataract surgery recovery times are different for every person. Usually, there is a fairly quick recovery time for cataract surgery, approximately 3-4 days.

During your cataract surgery recovery, it is normal for your vision to take a few days to improve. Your eyes may additionally be sore, scratchy and light sensitive during this period. You will have both antibiotic and anti-inflammatory drops to help with your cataract operation recovery, typically starting the day after surgery. Cataract surgery is performed on a day-care basis. This means you are admitted to hospital, have your operation and are discharged home all in the same day. Therefore, you should be able to return to work a few days after your operation, depending on your occupation. If you perform a job that is physically demanding, you may require a longer period of recovery. Your consultant will advise you appropriately.

When it comes to cataracts and driving, you can drive after your operation once you vision meets the DVLA requirements. This normally takes 3-4 days. The DVLA standard is reading a number plate with both eyes open at 20.5 meters (approximately 25 strides). Your consultant can advise you at your follow-up appointment if your vision meets this standard.

Can cataracts come back?

Once the cloudy (cataractous) lens has been removed as part of cataract surgery, it doesn’t come back. However, the thin membrane behind the new lens implant (posterior capsule) may become opaque during the first few months or years after cataract surgery. This creates a filter-effect and can cause your vision to deteriorate. A simple laser treatment (YAG laser capsulotomy) can be performed in the outpatient clinic to clear this membrane and restore clear vision. Approximately 1 in 5 (20%) patients may benefit from YAG laser capsulotomy after cataract surgery. Your consultant will discuss whether this treatment is suitable for you.

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