Mr Nicholas Glover - Cataract Surgery
Mr Nicholas Glover  - Consultant Cataract & Vitreoretinal Surgeon




Cataract Surgery            


  The only effective treatment for cataracts is surgery to remove your cloudy lens and replace it with an artificial lens implant.    

 Lasers aren't used to remove cataracts and there is no evidence to suggest that changing your diet, taking vitamins or using eye drops can cure cataracts.     

Most people choose to have their cataracts removed when the change in their vision starts to cause them difficulties in everyday life. There is no longer a reason to wait until your cataract is "ripe" before removing it. The timing of this varies from person to person.   

 Many people with cataracts are still legally able to drive. If you have any concerns about whether you should be driving, your optometrist should be able to tell you whether your sight is within the legal limits for driving. Sometimes people may be legally able to drive but might find driving difficult in bright sunlight or at night. If this is the case, then you may think it is a good time to consider having your cataracts removed.     

Pre Assessment    

Before cataract surgery, your eye health and general health will be checked and your eye will be measured by a machine that measures the length and the shape of your eyeball. These tests help the ophthalmologist decide which lens is the best to implant when they perform your operation.   

 If you have a cataract in both eyes your ophthalmologist will decide which cataract to remove in the first operation. In most cases, this is the eye with the worst cataract.     

Surgery    

Cataract surgery usually takes about 30 to 40 minutes and most people go home from hospital a few hours later. It is usually performed with a local anaesthetic, which means you will be awake during the operation but you won't feel any pain. If a patient is very anxious then a general anaesthetic may be possible if there are no other health issues.     

The local anaesthetic may involve drops and an injection or just drops. For your surgery, you will be given drops to dilate your pupil. Your face will be covered by a sheet, which helps to keep the area around your eye clean during the operation. To remove the cataract, the ophthalmologist needs to remove the natural lens in your eye and replace it with a synthetic lens implant.   

 Cataracts are removed by a technique called phacoemulsification. This technique uses high frequency sound energy to break up your cataract. Micro-incisional cuts are used, so you don't need any stitches, and this helps to speed up your recovery from the surgery. The ophthalmologist uses a microscope to get the best view of your eye as possible.     

The lens in your eye is made up of different layers and the outside layer is called the lens capsule. During the operation, the ophthalmologist cuts through the front of the lens capsule so they can reach the lens inside. Using the same instrument, the ophthalmologist can break up the cataract inside your eye, and remove it using suction. Your lens capsule is kept in place so that the artificial lens implant can be placed inside it. The tiny implant is folded so that it can be put into the eye through the same instrument that is used to remove the cataract. Once it reaches the right position, the ophthalmologist unfolds the artificial lens so that it sits in the right place inside the lens capsule.     

As you are awake during the operation, you will be able to hear what is happening in the operating room. You can also communicate with the ophthalmologist and the nurses who are on hand to reassure you.     

Your eye will be covered with a dressing, which stays in place when you go home, normally a few hours later. Your eye may begin to feel sore once the local anaesthetic starts to wear off. The pain isn't usually too bad and you can take a painkiller tablet, such as paracetamol, to help.   

 The dressing, which is put on in the hospital, usually needs to stay on your eye overnight, but you should be able to take it off the following morning. Your eye may look bloodshot, but this will improve over the next few days.     

Immediately after the operation some people can tell that their sight has improved straight away however if your cataract was quite mild you might not notice a big change in your vision. Either way, your sight may not be as good as you expect for the first week after the operation, as the eye is still recovering from the surgery and will probably be a little swollen.     

Immediately after the surgery you will be given eye drops. You will probably have two types of drops - an antibiotic drop to prevent infection and a steroid drop to help reduce any swelling. It is important to take these drops as the ophthalmologist recommends and to complete the course. If you have problems using the drops you should let your GP know, as they may be able to arrange some help for you. Most people have no problems after the surgery and they are up and about as normal the next day. If your eye is very painful or your vision suddenly gets a lot worse, then you should let the hospital know as soon as possible as this may mean they need to see you again.     

Cataract surgery is generally very successful. Only about three per cent of people who have cataracts experience complications.     

The most common complications can be dealt with and usually don't affect sight in the long term   More serious complications are much rarer and include:    

•   retinal detachment  
•   problems with the lens implant, the wrong lens implant or problems with its position  
•   a break in the lens capsule  
•   infection.     

These complications are much rarer and treatments are available which will minimize their effects on your vision.   

 Before being offered a cataract operation the ophthalmologist will talk you through the potential risks specific to your situation.