Cataract surgery is one of the most commonly performed procedures in Australia and throughout the developed world. As hundreds of cataract operations are conducted every day in our country, efforts are continually being made to advance the efficacy and safety of this procedure. So, how do cataracts affect you, what is cataract surgery and how does it work? Keep reading to find out.
What Are Cataracts?
In simple terms, a cataract is defined as any loss of transparency to the natural lens inside the eye. This lens starts out transparent at birth (barring any congenital cataract), which allows light to be transmitted through it to reach the retina at the back of the eyeball. This step is the beginning of the process we know as sight.
As we age, the natural lens of our eyes begins to lose its clarity. Although there are a few proposed underlying reasons for this, one cause is thought to be oxidative damage to the lens fibres, which results in them becoming cloudy. Ultraviolet exposure is also thought to contribute to the development of age-related cataracts. While increasing age is the most common cause of cataracts, which is why cataract surgery is so prevalent in our ageing population, it is not the only cause. Cataracts may also be:
- Present at birth (congenital cataracts)
- Caused by trauma, such as a high impact blunt blow or penetrating injury
- Associated with systemic diseases, including diabetes or galactosaemia
- As a result of another medical intervention, such as a retinal detachment repair or steroid use, known as an iatrogenic cataract
The result of a cataract is impaired sight. This is typically noticeable in the form of blurry, hazy, or foggy vision, but may also manifest as alterations to your colour vision, increasing glare sensitivity, or increased difficulty in low contrast lighting conditions.
In most cases, cataract surgery is able to safely and effectively restore your vision. So, what is cataract surgery?
What is Cataract Surgery?
At this time, cataract surgery is the only way to effectively treat a cataract. If you are in the early stages of cataract development, you may opt to safely defer cataract surgery. Managing the changes to your vision with updates to your glasses or contact lenses is a valid way of improving your functional sight while you wait for your cataracts to be ready for surgical removal.
During a modern cataract surgery procedure, your entire cloudy crystalline lens is removed from the eye and replaced with an artificial lens, known as an intraocular lens implant. This artificial implant is typically calculated to correct your eye’s prescription, resulting in the potential for clear, spectacle-free vision after your surgery!
There are two popular techniques of cataract surgery in Australia at the moment. The traditional, conventional method is known as phacoemulsification. This technique, although older, is still widely used by eye specialists and is considered safe and effective. With the advent of femtosecond laser technology, a highly precise laser tool, femtosecond laser-assisted cataract surgery is gaining popularity among some surgeons. Some ophthalmology clinics may even offer both surgery techniques, depending on your specific situation.
Both phacoemulsification and femtosecond laser-assisted cataract surgery techniques involve the same basic steps. The difference is typically whether the step is performed manually or with the femtosecond laser. In general, studies have concluded that both techniques are safe, effective, and result in very similar visual outcomes.
What is Cataract Surgery? The Steps
Before the operation, the eye must be prepared with an anaesthetic. This is administered either by topical eye drops or a local injection around the eye area. Once the eye is appropriately numbed, an incision must be made at the edge of the cornea, which is the clear dome of tissue at the front surface of the eyeball. This can be performed with a bladed instrument, as in conventional phacoemulsification, or with a femtosecond tool. Once this incision has been created, tools may be inserted into the eyeball to access the cataract.
The cataract sits inside a membrane, known as the capsular bag. To extract it, the capsule is cut open, either with a manual tool or with the laser. From here, an ultrasound probe is needed to break the cataract into smaller fragments. During phacoemulsification, ultrasound is utilised solely for this process. Alternatively, femtosecond technology may be used to first soften the cataract before the ultrasound probe is applied, which may reduce the amount of ultrasound energy required to fragment the cataract.
Once the cataract is broken into smaller pieces, it is then suctioned from the capsular bag. An intraocular lens is then inserted through the corneal incision and manipulated into position within the capsule. Some intraocular lenses may be placed in a different location within the eye, such as in front of the coloured iris rather than behind it inside the capsule. However, unless there is a reason the capsule is unsuitable to hold the implant, the majority of cataract surgery procedures will position the intraocular lens here.
You will be sent home with a protective eye shield and post-surgery instructions. Regardless of which surgery technique you had, the eye will take some weeks to settle and heal fully. The end result? Clear, crisp sight.
Call us on (03) 9070 5753 today for a consultation.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.