cataract blurred vision

Cataract Assessment  and Surgery with your Ophthalmologist

The Care You Deserve in Central London

Having done over 1500 cataract operations, treatment for patients as an Ophthalmologist has been my focus on providing this valuable service. I offer this & other specialised options to anyone in need of a cataract surgeon they can trust. London is a great city with world class healthcare.  I’m Ahmad Aziz, and I’m dedicated to building long-lasting relationships based on trust and medical integrity with every single patient. My London clinic is well located for you to have your eye assessment.

 
 

CATARACT SURGERY

DAY CASE PROCEDURE

Treatment allowing you to go home the same day

LOCAL ANAESTHETIC

Giving faster recovery. You can be asleep or given a sedative if you are very nervous.

SHORT SURGICAL TIME

Most cases take less than half an hour to do although a small proportion do take longer.

Cataract surgery

Cataract - All you need to know about Cataract Surgery

 

Cataract is the clouding of the clear lens inside the eye. The clouded lens that causes blurred vision which cannot be corrected with glasses, contact lenses or laser refractive procedures such as LASIK.

 

Cataract can sound scary but it a common condition associated with ageing. Cataract treatment is with surgery & is one of the most common performed operations and can help restore the vision lost to cataract and reduce your dependance on wearing glasses as well.

Cataract surgery is one of the most effective and safest operations performed today by Ophthalmologists thanks to modern technology and appropriate training of surgeons.

Cataract surgery essentials

During cataract surgery, the cloudy cataract lens inside your eye that has become is removed. Following its removal an artificial lens (called an intraocular lens, or abbreviated to IOL) in placed to restore clear vision.

The procedure typically is performed by Ophthalmologists as a day case which does not require an overnight stay in a hospital.

 

Modern cataract surgery involves the use of a high-frequency ultrasound probe to break up the cloudy cataract lens into very small pieces, which are then gently removed from the eye. It is for this reason why you cannot keep your cataract following surgery as the small particles are flushed out of the eye with fluid.

This procedure using high-frequency ultrasound, called phacoemulsification or "phaco," can be performed with smaller incisions than previous surgical techniques for cataract removal, which results in faster healing and reducing the risk of cataract surgery complications, such as a retinal detachment.

After all the pieces of the cataract have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied. (In special cases, an intra-ocular lens might be placed in front of the iris and pupil, but this is less common)

The surgeon then completes the cataract removal and implantation of the new intraocular lens procedure by closing the incision in your eye (here a stitch may be needed but most commonly it can be closed without any stitches), and a protective shield is placed over the eye to keep it safe in the early stages of your cataract surgery recovery. As the cataract can be yellow and brown in tone, patients often report seeing more vivid colours and blues after cataract surgery.
 

Laser cataract surgery

Femtosecond lasers — similar to the lasers used to create the corneal flap in all-laser LASIK — have been approved for use in cataract surgery.

These lasers are used in a number of steps in cataract surgery, reducing the need for surgical blades and other hand-held tools but an incision still needs to be made to access the cataract just as in traditional cataract surgery:

  1. Creating corneal incisions to allow the surgeon access to the lens

  2. Removing the anterior capsule of the lens which is the front layer coating the cataract

  3. Fragmenting the cataract to break it into small pieces to be flushed out

  4. Creating side corneal incisions to reduce astigmatism (when needed)

Laser cataract surgery is more accurately termed laser-assisted cataract surgery and due to the cost of the equipment significantly increases cataract surgery cost. 

While studies have shown that lasers can improve accuracy during certain steps of cataract surgery, they may not necessarily improve cataract surgery safety, recovery time and visual outcomes in every case.  Laser-assisted cataract surgery still creates an incision for the surgeon to access the cataract and cataract surgery cannot be performed with laser alone.

Preparing for cataract surgery

Prior to cataract surgery, your ophthalmologist will perform a comprehensive examination for the eyes to check the overall health, evaluate whether there are reasons why you should not have surgery and identify any risk factors you might have.

 

A refraction or basic eye test also will be performed to accurately determine the amount of shortsightedness, longsightedness, and astigmatism you have prior to surgery. Additional measurements of your eyes will be taken to determine the curvature of your cornea (the front layer of the eye) and the length of your eye.  These measurements are important to help your cataract surgeon select the correct intraocular lens and give you the best vision possible after surgery.  The measurements are taken and equated to give a recommended lens power that gives the best estimate of the what the post operative refraction of the eye will be.

Today there are numerous many types of intraocular lenses to choose from for your cataract but not all lenses are suitable for all people. The selection of the correct intraocular lens depends on your specific needs and the outcome of the eye examination. In addition to intraocular lenses that correct short sightedness and long sightedness, there are lenses that correct astigmatism as well which are known as toric intraocular lenses.

A mono-focal lens implant is most commonly used in cataract surgery which still requires glasses to have the full range of vision. Often, only part-time use of reading glasses is needed after cataract surgery with monofocal intraocular lenses. But if prescription eyeglasses are needed (which often is the case if you only need cataract surgery in one eye), your eye doctor typically will prescribe new glasses for you approximately two months after surgery.

If you like the idea of being less dependent on glasses after cataract surgery for distance vision and reading vision, one way to correct presbyopia (the inability to focus on distance and near which happens in middle age) and reduce your need for reading glasses is to have your cataract surgeon adjust the power of one of your mono-focal IOLs (assuming you have cataract surgery performed in both eyes) to give you a mono-vision correction, similar to mono-vision with contact lenses.  This is usually only recommended if you have had monovision before where one eye is adjusted for reading vision and one eye for distance vision. If you have not had mono-vision before then this is approached with caution and your doctor may  recommend you trial mono-vision with contact lens first to see if you like it.  Some people are unable to tolerate having one eye adjusted for near vision and the other for distance vision.

 

Another option is to choose multi-focal intra-ocular lens to improve your reading vision and have glasses free distance vision.They are designed to provide a greater range of vision after cataract surgery than conventional mono-focal intra-ocular lenses.

Be aware that not everyone is a good candidate for lenses, part of their marketing is that they are termed premium intra-ocular lenses but this shouldn't make you feel that they are better; they just serve a different purpose depending on what your required outcome is. These lenses tend to be more expensive and will increase the out-of-pocket cost of your cataract surgery.

Before having cataract surgery, you will be advised about what to expect before, during and after your surgery to help you make an informed decision about whether to proceed with surgery.

If you have any questions or concerns about cataract surgery, be sure to discuss them with your cataract surgeon before the operation.

Recovery after cataract surgery

Routine cataract surgery takes about 20 minutes although your time in hospital will be considerable longer and typically half a day. This is because additional time is needed to prepare you for the operation, dilate the pupil and give any medication preoperatively that may be required. After the surgery you will be given instructions on how to care for your eye and when to re-attend or seek help before you leave to go home. 

You must have someone drive you home after cataract surgery; do not attempt to drive until your eye doctor confirms that you are safe to drive.

You will be prescribed medicated eye drops to use several times each day for a few weeks after cataract surgery. You also must wear your protective eye shield while sleeping or napping for about a week after surgery. 

Also, many hospitals require someone to be with you  overnight after cataract surgery if you received sedation or general anaesthesia. Be sure to ask about this requirement prior to your cataract procedure so you are prepared on the day of the surgery.

While your eye heals, you might experience some eye redness and blurred vision during the first few days following the operation.

During at least the first week of your recovery, it is essential that you avoid:

  • Strenuous activity and heavy lifting.

  • Bending, exercising and similar activities that might stress your eye while it is healing.

  • Any activity that would expose your healing eye to dust, grime or other infection-causing contaminants.

  • Keep your eye closed while showering or bathing. Also, avoid swimming or hot tubs for at least two weeks.

 

Your cataract surgeon may give you other instructions and recommendations for your recovery following cataract surgery, depending on your specific needs. If you have any questions at any time after cataract surgery, speak to your cataract surgeon for advice.

If you need cataract surgery in both eyes, your surgeon may prefer that you wait one to three weeks between both eye procedures. This is so that your first eye has time to heal and you have good vision in that eye before the second surgery is performed.

Your optician after cataract surgery

Having cataract surgery will not mean that you no longer you need to see your optician. You will still need to see your optician routinely to ensure the health of the eye is maintained and that any other problems are picked up early. Unless you choose multifocal intra-ocular lenses, it's likely you will need reading glasses after cataract surgery to see near objects and read clearly. Even people who choose these multifocal intra-ocular lenses often have better vision with reading glasses for certain near tasks and seeing very small print.

You may have some mild refractive errors or astigmatism present after surgery which is common and this can be corrected with glasses.

For some people they feel their eyeglasses are part of their identity and want to protect their eyes. They can still prefer wearing glasses after cataract surgery even if they have good vision.

If you choose to wear glasses after cataract surgery, lenses with anti-reflective coating and photochromic lenses are highly recommended for the best vision, comfort and appearance. Ask your eye care professional for details and to demonstrate these lenses.

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