example of cataract eye

Cataract is the most common cause of loss of vision worldwide.  It results from thickening, hardening and loss of transparency of the natural lens of the eye.  In early stages, it may cause minimal symptoms and escape notice.  Since it usually worsens slowly, many people do not even realize the change in their vision despite the blurring, loss of colour and contrast that they experience.  Often, it is brushed off as simply “getting old”, which in reality, does not have to be.

Early stages of the disease is also called dysfunctional lens syndrome, when symptoms such as declining night vision, fluctuation in eyesight and increasing discomfort in bright environment from glare begin.  Most sufferers try to cope by curtailing some of their affected daily, such as driving at night or playing golf.

Eye drops do not play any significant role in the prevention or treatment of cataract.  Current treatment of cataract is by surgical removal and replacement of the extracted lens with an artificial lens implant.  This is a highly successful surgery with short downtime in experienced hands, and vision improvement can be achieved the next day.  The surgery usually uses  ultrasound energy; the harder the lens, the higher the ultrasound energy required.  In the past 5 years, femto-second laser has also been incorporated as an add-on technique to make the surgery safer and more precise.

Every surgery requires a surgical incision to access the required part.  As with other parts of the body, generally the smaller the incision, the quicker and more comfortable is the recovery.  The smallest incision size currently is 1.8mm, and this can be performed both by the traditional blade and the 100% bladeless method.  However, eyes have to be assessed for suitability for this nifty micro-incision surgery.  Late stages and severely hardened lenses may not be ideal for such small incisions.  Therefore please don’t leave the surgery till too late if you want quick recovery!

A good discussion with your cataract surgeon is highly recommended so that your visual needs can be fulfilled by choosing a suitable lens implant. Choose the right lens the first time!  Although lens exchange surgery after implantation is not impossible, it is generally more risky and incurs cost.

The types of lens implants can be divided into 2 classes: monofocal versus multifocal / extended range lenses.  Both classes can be combined with correction for astigmatism, called toric lenses.   Monofocal lenses can provide high quality vision, but most patients still require spectacles afterwards.  The second class, the multifocal or extended range lenses, can significantly reduce dependence on spectacles both for distance and for reading, although they usually have a small amount of temporary side effects such as seeing glare and halos.

The available lens implants in our clinic are from reputable companies with good track-record.  We employ reliable surgical techniques, updated calculation formulae and customize treatment for our patients.  We constantly audit our already excellent results (100% success rate*) to improve our surgical outcome for our patients.

*100% achievement of unaided vision of better/equal to 6/12

by Dr Daphne Han – Senior Consultant Ophthalmology