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What you need to know about cataract surgery

Cataract surgery can seem scary – but it's more common than you think.

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Cataract surgery is one of the most commonly performed surgeries in the world. It’s also one of the safest, and you won’t feel a thing.

Of course, it’s very natural that you might feel apprehensive when considering cataract surgery. Here are a few things you should know about the procedure, your different options, and the results you can expect.

What are cataracts?

Although some people may be born with a cataract (known as a congenital cataract), cataracts are mainly diagnosed in older people, particularly those over 65 years of age.

A cataract is when the lens of the eye, which is naturally clear, becomes cloudy.

This may lead to symptoms such as:

• Blurred or dim vision
• Difficulty seeing at night or in lowlight situations
• Light/glare sensitivity
• Seeing halos (bright circles around light sources)
• Faded colours
• Double vision in the affected eye(s)
• Frequently changing glasses/contact lens prescription

Age-related cataracts may appear normal and won’t always cause vision impairment in the early stages. Cataracts can be picked up either by your ophthalmologist or your optometrist during a routine check. If you have a cataract, your ophthalmologist will guide you in regards to further management options.

“The procedure itself is usually around 20 minutes and can be performed in a day surgery or hospital.”

What happens during cataract surgery?

The procedure itself is usually around 20 minutes and can be performed in a day surgery or hospital. Under local anaesthesia, the cloudy lens is removed and replaced with a clear artificial lens (known as an intraocular lens or IOL).

There are two types of cataract surgery available – manual cataract surgery and femtosecond laser cataract surgery (FLACS).

In FLACS, a laser is used to perform some of the steps that an ophthalmic surgeon would normally perform manually. While studies do support the use of FLACS, both manual and laser-assisted cataract surgery can produce great results.

“Trifocal IOLs are typically the best option for achieving clear vision without glasses.”

Will I still need glasses after cataract surgery?

Intraocular lenses, or IOLs, can also be used to correct pre-existing refractive errors, such as short-sightedness, longsightedness or astigmatism (imperfection in the curvature of the cornea or the shape of the eye lens), with the power calculated individually for each eye.

There are different types of IOLs, and this will impact if you still require glasses for certain activities post-surgery:

  • Monofocal IOLs, the first commercially available option, allow clear vision at a single distance (i.e. near/reading or far). Following surgery, glasses will still be required.
  • Multifocal IOLs allow clear focus at multiple distances (i.e. both near/reading and far). These do not address focus at intermediate distances, which is important for tasks such as computer work. Following surgery, glasses will most likely be required for certain tasks.
  • Trifocal IOLs represent the latest in lens technology. These premium lenses are also multifocal but offer clear vision at three distances – near/reading, intermediate and far. Following surgery, glasses are not usually required for standard day-today activities.

Your ophthalmologist should discuss the pros and cons of each IOL option against your post-surgery expectations, as well as the possibility of surgery on the second eye to achieve even clearer vision.

There are no guarantees when it comes to cataract surgery, but trifocal IOLs are typically the best option for achieving clear vision without glasses. This is most likely to be a good solution for people who, prior to surgery, are over 55 years of age, rely heavily on glasses/contact lenses and are long-sighted.

For people who don’t mind wearing glasses after their cataract surgery or who are highly sensitive to visual imperfections, monofocal IOLs could still remain a preferred option.

For more expert advice on cataracts and eye health, visit Vision Eye Institute

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