Cataract phacoemulsification surgery + lens implant

Cataracts is cloudiness of the lens (the normally clear structure in your eye which focuses the light). They can develop in one or both eyes. The cloudiness can become worse over time, causing vision to become increasingly blurry, hazy or cloudy. Most cataracts develop with age, although rarely babies are born with cataracts or children develop them while they are still young. It is the most common operation performed in the UK, with more than 300,000 procedures carried out each year.

Cataract surgery
Cataract surgery

Eye with cataract

Cataract surgery 1

Diseased lens is removed

Cataract surgery 2

Implant inserted

Cataract surgery 3

Lens implanted into position

Pre-operative tests for cataract surgery

Before surgery, the length of your eye will be measured in what is called an A-scan and the curve of your cornea will be measured in a technique called keratometry (biometry). These measurements help your doctor select the proper intraocular lens (IOL) implant for your eye.

We will also discuss the various lens options available to you. In standard practice a single vision IOL is implanted however multifocal and toric IOL are available. In case you are interested, please discuss with Mr. Lim.

If you plan to have cataract surgery and you have had LASIK or other laser vision correction, provide your doctor with the vision correction prescription you had before LASIK, if possible. This information will help your doctor calculate the correct IOL prescription for you.

If you are having cataract surgery, be sure to tell your ophthalmologist about all medications and nutritional supplements you are taking. If you currently use or have ever used alpha-blocker drugs for prostate problems, such as Flomax®, Hytrin®, Cadura® or Uroxatral®, tell your doctor. These medications may prevent your pupil from dilating properly during surgery, leading to possible complications. If your surgeon is aware that you have had these drugs, he or she can adjust their surgical technique to adapt as needed, allowing for a successful cataract removal procedure.

You should also tell your doctor about any other sedative medications you are taking.

The latest procedure used for removing cataracts is called phacoemulsification. A small incision is made in the side of the cornea (the front part of your eye), where your doctor inserts a tiny instrument that uses high-frequency ultrasound to break up the centre of the cloudy lens and carefully suction it out.

After the cloudy lens has been removed, the surgeon will replace it with an intraocular lens (IOL) implant made of plastic, silicone or acrylic. This new, clear lens allows light to pass through and focus properly on the retina. The IOL becomes a permanent part of your eye. In most cases, the IOL is inserted behind the iris, the coloured part of your eye, and is called a posterior chamber lens. Sometimes, the IOL must be placed in front of the iris. This is called an anterior chamber lens. When the IOL is in place, the surgeon closes the incision. Stitches may or may not be used. After the surgery, your doctor usually places a protective shield over your eye.

Life through a lens

Intra-ocular lens was first developed by Sir Harold Ridley and implanted at St Thomas’ Hospital over 60 years ago. In this documentary, you will see the background to this revolutionary invention and watch Mr Lim operate on one of his patients at St Thomas’ Hospital as part of this documentary.

Cataract surgery recovery

You will spend a short period of time resting in the outpatient recovery area before you are ready to go home. You will need to have someone drive you home.

Following your surgery, it is very important to put in the eye drops exactly as prescribed by your ophthalmologist to promote healing. You will also need to take care to protect your eye by wearing the eye shield whenever you sleep. Be sure not to rub your eye.

The first day of your recovery, you must avoid strenuous activity such as exercise or bending and heavy lifting (including anything over 25 pounds). You will also need to avoid getting any water, dirt or dust in your eye, which can lead to infection. After 3-4 days, you can get back to your normal activity.

You may have some blurry vision a few days to weeks after surgery procedure. If you experience any pain or loss of vision, be sure to call your ophthalmologist.

Cataract surgery risks and complications

As with any surgical procedure, there are risks associated with cataract surgery.

Risks and complications can include:

  • Infection
  • Bleeding inside the eye
  • Increased pressure inside the eye (glaucoma)
  • Swelling of the retina
  • Swelling of the cornea
  • Retinal detachment
  • Loss of vision (partially or completely)

If you experience any of these symptoms telephone the Kersley Clinic for advice immediately. Or, if out of hours, visit your nearest accident and emergency (A&E) department.

In some cases, the part of the lens covering that supports the IOL (called the capsule) can become cloudy several months or years after the first cataract was removed. This is called an “after cataract” or “secondary cataract.” If this occurs and blurs your vision, your doctor will make an opening in the centre of the cloudy capsule with a laser to allow light to pass through the lens properly again. This procedure, called a posterior capsulotomy, takes about five minutes in the doctor’s office and requires no recovery period.

Most people wearing bifocals or reading glasses for near vision may still need to wear glasses after cataract surgery for reading and, in some cases, even for distance. If you choose to have a multifocal or accommodative IOL, your dependence on glasses may be minimized or, in some cases, eliminated completely. However, not everyone is suitable for these types of lenses.Ageing is the most common cause of cataract development, because as we get older, protein in the lens can clump together and becomes cloudy. Over time, this clouding grows gradually which lead to cataract formation. Most people over 60 years has mild cataract but surgery is not required if vision remains unaffected. Although in some rare instance, children and young people can develop cataract.

There are a number of factors which may contribute to the development of the condition:

  • Family history
  • Previous eye operation
  • Other eye conditions; injury, inflammation
  • Use of corticosteroid medications
  • Prolonged exposure to ultraviolet radiation e.g sunlight
  • Obesity and a lack of vitamins;
  • Certain medical conditions like diabetes, hypertension and high myopia
Cataract Surgery