ABOUT CATARACT SURGERY
WHAT IS A CATARACT?
The natural lens inside the eye is clear and flexible. It can change shape according to the desired focus required. A young, healthy lens can easily and quickly change shape to allow clear focus when looking at a near object or far in the distance. Numerous factors including ageing, diabetes, inflammation, trauma and UV radiation lead to clouding of the lens. The lens also loses the ability to change shape around the age of 40. A cloudy and dysfunctional lens is then called a cataract.
Cataracts cause blurring of focus, glare around light (especially when driving at night), glare and a loss of contrast sensitivity. Cataracts are progressive and only have one cure, surgery.
Surgery is advocated if the visual acuity and or quality drops to below desired levels. This is usually when the vision cannot be corrected to 100% with spectacles or if symptoms of glare and haziness become unbearable.
WHY CATARACT SURGERY?
Cataract surgery is one of the marvels of modern medicine. It is safe, accurate and fast. The recovery time is very rapid, with most patients able to read the 6/6 or 100% line on the first day following surgery. The natural lens is removed and a clear, acrylic lens or IOL, is inserted in the eye. This lens remains inside the eye permanently.
Cataract surgery has an excellent safety profile, with millions of procedures successfully performed each year around the globe.
Replacing the opacified lens is currently the only treatment option available internationally to remove cataracts.
IS LASER FOR YOU?
Laser vision correction can only be performed if you have a clear lens. That means you cannot have a refractive laser if you have a cataract.
Laser vision correction is used in cases where spectacle independence is desired in patients with clear lenses.
Laser can however be used as a top up procedure following cataract surgery, if the desired refraction was not obtained.
The choice of intraocular lens will be discussed with you in detail during the consultation. We offer standard monofocal, toric, EDOF and multifocal IOL's according the the needs and anatomy of the patient.
It is important to note that no IOL is perfect. No IOL can give you the vision that a healthy 20 year old eye can see. There are certain trade offs that you need to be aware of and accept.
Cataract surgery overview
Monofocal lenses can only give you clear vision at one focal distance.
You can choose to be far sighted, meaning that you have excellent distance vision, but you will need near vision spectacles following surgery.
Alternatively, you can choose to be near sighted, meaning that you will have excellent near vision, but you will need distance spectacles following surgery. This is usually reserved for patients who are near sighted before the surgery is performed and who wish to read without spectacles and do not mind wearing spectacles when driving or watching TV.
Extended depth of focus or EDOF lenses provide clear distance and intermediate vision, but a reader will still be needed following surgery. These lenses are very popular and is implanted in most of my patients.
They have minimal glare or halo effect, similar to standard monofocal lenses. They provide intermediate distance vision in addition to distance.
Multifocal lenses provide distance, intermediate and near vision. They are reserved for patients who have a great desire to be spectacle independent following surgery. Both eyes need to be operated and implanted with these lenses to gain the optimum effect. It may however still be necessary to wear reading glasses when reading very small print or when reading in poor lighting.
The lens design allows more than one focal point to be presented to your retina, this causes a small reduction in the amount of light entering the eye, leading to a small loss of contrast sensitivity. You will also be aware of glare and halo around lights when driving at night. These do fade over a period of 6-12 months as the brain adapts to the new lenses.
Multifocal lenses are not fully covered by your medical aid and there will be a co-payment to fund these lenses. An advanced eye assessment is mandatory for patients desiring multifocal lens implants, as numerous parameters need to be assessed and excellent eye health is needed to qualify for these lenses.