Cataract Surgery

Cataract surgery is one of the most common surgical procedures performed. Cataracts occur when the lens in the eye, which helps to focus images, becomes cloudy. Cataracts affect a very high proportion of people and occur with older age - they affect 90% of people aged 75 years or older. Surgical removal of the cataract and replacement of the cloudy lens with a clear, synthetic, substitute lens is a treatment that results in highly satisfactory results. Surgery is currently the only cure for cataracts as once the lens starts to become cloudy there are no medical treatments available to stop this process.

By removing the clouded lens from the eye and replacing it with a permanent intraocular lens (IOL) the vision problems caused by the cataract are eliminated. The surgery can have major effects on the daily life of the patients and allows people to return to driving, reading, and working.

The Procedure

The basic operation to remove a cataract is a process called phacoemulsification / extracapsular cataract extraction. The lens sits inside the eye behind the cornea (the clear layer at the front of the eye) and is contained within a sac-like capsule. A small incision is made where the cornea and the sclera (the white of the eye) meet, and an incision is made in the capsule. Through this incision, two of the three structures of the lens -- the hard nucleus and the soft cortex -- are removed.

An ultrasonic probe is inserted into the lens capsule and is used to break up the cloudy nucleus and cortex tissue of the lens, which is then suctioned out by the probe and the lens capsule is left in the eye to support the intraocular lens implant. After the clouded lens tissue has been removed, the surgeon places a new, clear, intraocular lens (IOL) into the capsule to replace the clouded lens that was removed. When implanted, the new IOL is folded so that it can fit through the small incision that was made, and once placed inside the lens capsule it is unfolded. The new, clear, lens (IOL) that has been inserted now performs the same function as the old clouded lens that was removed.

The average cataract surgery is about an hour long, but can be as short as twenty minutes, and the procedure is usually performed in an outpatient facility of a hospital. After the procedure is over, there is a short stay to check for complications, but all patients are able to go home the same day.

Local anesthesia, often administered as eye drops at the beginning of the procedure, takes care of the any pain. There may be minor pain during the healing process, but this is usually relieved by simple painkillers like paracetamol.

After Your Procedure

You will need someone to drive you home after the procedure. Post-operative care often includes the use of eye drops or the wearing of glasses or shields. Recovery is generally short, with full healing occurring within 2 to 6 weeks of the surgery. Some people have noticeable improvement in their vision from the day of surgery onward, while others need about a week for their vision to clear.

Long-term Outcome

Cataract surgery is a highly successful treatment. In about 50% of all treated patients, several months to a year after the procedure the capsule of the lens will become clouded also know as "secondary cataracts". If the "secondary cataract" develops can be treated using a procedure called a YAG capsulotomy which is when a laser is used to clear a hole through the damaged capsule tissue for light to enter the eye.

Risks and Limitations

All surgery carries some risks. Cataract surgery can result in high pressure in the eye (glaucoma); blood collection inside the eye; infection inside the eye; artificial lens damage or dislocation; drooping eyelid and swelling or clouding of the cornea. There are other risks that are specific to this procedure, and it is important that you talk to your surgeon about the possible complications prior to surgery.

Pre-existing medical conditions can alter the level of risk associated with any procedure, and it is important that you notify your surgeon

Cost

The components that determine the cost of the procedure are the surgical theatre costs, hospital costs, anaesthetic fee and the surgeon's fee. Prices vary and depend on; the extent/complexity of the procedure, the physical attributes of individual patients, and the surgeon performing the operation. Cataract surgery typically costs around $3200 per eye.