CATARACT SURGERY

A cataract is a clouding of the eye’s natural lens. Metabolic and/or structural changes within tightly packed crystallin proteins which make up the lens alter their transparent status. When this happens, the light is blocked and scattered, and therefore the image we see is blurred. It can be compared to a window that is frosted, or “fogged” with steam.
Cataract surgery involves removing the cloudy lens through tiny incisions using a process called phacoemulsification. Once removed the lens is replaced within the eye with an injectable lens that can not cloud over. This lens does not need to be changed and offers a permanent solution. Corneal astigmatism, whereby the shape of the clear window at the front of the eye is asymmetrical (think rugby ball compared with a soccer ball) can also be corrected at the same time. This may involve making tiny relaxing incisions in the cornea or may involve correcting the curvature difference through special corrective implanted lenses (Toric lenses). Ultrasound technology is used for lens extraction and 99% of procedures are carried out using topical anaesthetic. These are administered as drops and do not involve injections. Very rarely, general anaesthesia can be used.Incisions are so small that stitches are not necessary. Eye pads are also unnecessary and visual recovery is extremely quick–usually within a few hours. This type of topical, no stitch surgery with a monofocal implant to correct for distance vision is Mr Jones’ standard procedure. Other, premium lens choices are available. See LENS IMPLANTS
1. CATARACT SURGERY ESSENTIAL INFORMATION

These are sophisticated and very small corrective lenses implanted at the time of cataract surgery. Most are either silicone or acrylic and can be monofocal correcting for one distance, or multifocal correcting for more than one focal point. They are aspherical designed to minimize or abolish any distortion and aberrations.

Mr Jones accepts referrals directly from optometrists and or GP’s. If you would like to be seen, simply obtain a report from your optometerist regarding the latest examination.

All surgery is day-case based. The hospital can accommodate overnight stays but that it usually unnecessary from the medical side of things. Surgery takes 15 to 20 minutes in the operating theatre. But patients should allow 2-3 hours in the hospital for preparation etc.

Common sense prevails. Light exercise after a day or two, but no heavy lifting for a couple of weeks. Light exercise can be commenced after that time and vigorous exercise after two weeks. Swimming should be avoided for three to four weeks and make-up can be applied after two weeks

There are small risks associated with cataract surgery as with any operation. Theses are outlined Here.

Mr Dylan Jones will personally perform your treatment.

This is a much misunderstood topic. Many new surgical techniques are touted as laser cataract surgery. They are more expensive, take longer as they involve two procedures; one involving a laser to make the cuts into cornea and the lens and a second, usually in a different room, to physically remove the lens and implant a new IOL using ultrasound. As yet there has been no proven significant benefit over the standard phacoemulsificiation technique. Surgeons remain divided over the cost vs any real benefit. Much of the research is funded by laser manufacturers. An interesting article explains more HERE
Some people–up to 40%–require a small laser procedure to treat capsular opacification which occurs some years after cataract surgery. This is explained Here.

2. LENS IMPLANTS

Cataract Surgery has changed dramatically over the years. Now, both patient and surgeon expect not only good vision after surgery but good vision without glasses in many instances. Cataract surgery has now become a refractive procedure in Mr Jones’ hands. Some people are happy to wear glasses as they have done for years and in cases where a cataract is only in one eye and glasses will be needed for the other eye, a balance in correction needs to be struck. Most people are happy to get good distance vision and wear glasses for reading. Some people may want to be as spectacle free as possible. There is no complete solution for this, but there are excellent compromises. Mr Jones uses a variety of lenses from big companies like Bausch and Lomb, AMO, Rayner and Oculentis. Obviously, these premium lens options are usually more expensive due to the technology involved in design and manufacture.

MONOFOCAL LENS IMPLANTS
Monofocal lens implants generally correct a single vision whether it is distance focus, intermediate or near. The may be implanted symmetrically in both eyes or asymmetrically (monovision), the latter giving a range of vision with one eye used for distance and the other eye used for near. This can be undertaken successfully in patients who have had this previously either with their natural vision or with contact lenses.

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Toric lenses correct astigmatism which can be incorporated either into a single vision or multi focal contact lens. Your surgeon will advise as to suitability but often these lenses help to reduce further dependence on spectacles after the operation.

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These work through a variety of ways using bifocal or diffractive technology. Some extend the range of vision from distance alone to distance and near to allow reading a phone or working at a computer.
The Symfony lens is an example of this kind of technology.

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Most people still need reading glasses for small print.
Some bifocal lenses mix and match the near addition segment in each eye to attain blended vision. The Oculentis M Plus is an example of this type of lens.

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More recently, TRIFOCAL  diffractive lenses which give far distance, computer distance and reading distance correction have gained popularity. An example of this is the Fine vision trifocal.

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People’s needs differ and these sophisticated lenses provide different solutions. It is important to discuss each case individually. Then and only then can a joint decision be made about the bespoke IOL choice. More information about Multifocal implant is available HERE

This is explained HERE 


More information on the types of conditions encountered and amenable to treatment may be found in the Conditions section of the website. But lid problems that can cause excess watering, droopy skin, in turning eyelids or out turning eyelids, as well as various lumps and bumps van all be dealt with under local anaesthetic as a day case or even in out patients with minimum fuss. Read more HERE