Cataract Information

A cataract is a cloudiness in the natural lens of the eye. This lens is about the size of a smartie and is situated in the middle of the eye behind the iris, that is the coloured part of your eye. Only the very young have completely clear lenses and with time everybody develops some degree of a cataract. Even in 40 year olds this can become apparent and virtually everybody aged 60 and above has some degree of cataract. However, it is not always necessary to treat cataracts unless they start to interfere with vision. Often the first sign of trouble is when vision goes below driving standard and if this is a slow process one may not be aware of the change.

The natural lens in the eye can be compared to a fruit in that it has a clear skin called a capsule. Inside this is a pulp called the cortex and in the middle of the natural lens is a hard nucleus. To remove the cataract a circular opening is created in the capsule and then the nucleus is broken up by an ultrasonic device and the pulpy cortex is then aspirated leaving a clear capsular bag. In order to restore vision after cataract surgery this natural lens must be replaced by an implant and this is folded and injected into the skin of the old lens. This type of surgery has now been carried out for 50 years although the type of implant and the way of removing the cataract has altered.

There are a number of implants available with different characteristics and one can compare these with the different types of spectacles. The NHS only provides straight forward single vision implants but I also carry out implants which are like bifocal glasses or varifocal glasses and can therefore restore reading vision and middle distant vision as well as distant vision, at least to some degree. These implants are a newer technology then the single vision lenses. One type such as the Humanoptics ICU lens or the Crystal lens has a small hinge mechanism that allows the lens to focus for near and middle distances as well as far distance. Another type called the Restor has properties similar to bifocal glasses. Although these lenses have a shorter history of use they do appear to work well in the majority of patients and I can discuss the sort of implant that would be most suitable for you. Some of the implants have FDA approval meaning they are well tried and tested.

I have done implant surgery now for 20 years and carry out between 500 and 600 of these implants per year. There are some risks to this surgery as with any other type such as infections or haemorrhages or technical problems of one sort or the other. The latter often being where the lens capsular is not strong enough to support an implant. However, in my practice approximately 98% of patients get excellent results after the surgery and I have had no patients with post-operative infections over the last three years.

I will discuss these points with you and any others you wish to bring up at the consultation.