Cataract Surgery

What Is It?

"A cataract is a clouding of the lens within the eye. The lens is just behind the coloured Iris and pupil. It helps bring any light coming into the eye into focus. This gives a clear image or picture to the layer at the back of the eye called the retina. The lens is normally transparent and clear. Some loss of clarity may be normal or unimportant. When clouding is more marked, it interferes with vision. Patients notice blurring of objects and a loss of brightness in colors. Often reading vision is more affected than distance vision."

What Does Treatment Involve?

"The only effective treatment of a cataract is surgical removal of the lens. The operation may be done under local or general anaesthetic. Local anaesthesia involves an injection of anaesthetic into the eyelid area and this is generally well tolerated and often completely pain free. Day case patients go home the same day but are asked to return the following day to be examined. The procedure itseld involves the removing the lens and usually replacing it with a plastic lens implant, There are various techniques. Basically the eye is opened where the coloured iris changes to the white of the eye. This incision allows the envelope of the the lens to be cut. Then the lens is removed, leaving the back surface of the envelope of the lens to be cut. Onto this surface the new plastic lens is implanted. Finally the cut opening into the eye is stitched with a very fine material that does not dissolve.

A newer technique called phaco-emulsification uses and ultrasound tip to remove the cataract through a small incision. A smaller or folding lens implant is used and stitching may not be required. A microscope is used for this operation as it is so delicate and precise."

What Would Happen If It Was Not Treated?

"Left untreated, a cataract worsens and may make the eye completely blind. In a few patients it may over-ripen (become over-mature). Then it can cause inflammation in the eye or swell up with fluid. Problems of this sought can make pressure in the eye to high, and cause discomfort. Permanent damage can also be done to the optic nerve coming into the eye causing irreversible blindness."

(as provided by) Mr. N. A. Jacobs FRCOpth consultant surgeon
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