Specialising in Cataract and Strabismus Surgery & general Adult and Paediatric Ophthalmology

Cataract Surgery & Treatment

A cataract is an opacity in the normally clear crystalline lens of the eye. As cataracts become more dense, they cause progressive deterioration in vision, and may require removal and replacement with an intraocular lens (IOL).

Cataract surgery is the most common eye operation, and one of the most common operations performed in Australia. Improvements in instruments, techniques and IOL technology have progressively improved the outcomes and reduced the risks of cataract surgery.

Causes of Cataract

Cataracts most frequently develop as a normal consequence of aging, so that by age 70 almost everyone has some degree of cataract. Cataracts usually develop slowly, but occasionally progress rapidly, and may develop at a different rate in each eye.

Cataract may also be caused by some eye diseases, diabetes, some medications, and UV light exposure.

Common symptoms of cataract include blurred vision, reduced colour and contrast sensitivity, and haloes around lights when driving at night. Some cataracts can cause intense glare and increased sensitivity to bright light, before they cause blurred vision.

Assessment Before Surgery

Pre-operative assessment involves assessment of your general medical history, including current medications and previous drug allergies, as well as full assessment of your eyes. If you are found to have significant cataract impairing vision your eyes will need to be measured to enable an IOL to be chosen

Northside Eye Specialists is appointed with the most advanced clinical biometric equipment. For example, Dr Forrest uses the Zeiss IOL Master (optical coherence interferometry biometer) to measure the length of your eye and corneal curvature, and the Oculus Pentacam to assess corneal astigmatism. These tests are normally performed by one of our orthoptists (university-trained allied health professionals trained in eye movement assessment and the use of ophthalmic diagnostic equipment).

Intra-ocular Lenses

An IOL is an artificial lens that is implanted into the eye to replace the natural lens that is removed during cataract surgery. Most modern IOLs are made of acrylic plastic or silicone, are foldable and implantable through a small incision in the cornea. IOLs are designed to last a patientʼs whole life.

With modern instruments and formulae most patients are able to avoid or minimize the need for distance glasses. Whilst most IOLs are single focus lenses, a number of multifocal IOLs are now available that are designed to allow near vision without glasses as well. These IOLs are not suitable for all patients.

Surgical Technique

Most cataract surgery is performed using a technique called phacoemulsification, in which high frequency sound waves are used to break up the lens and remove it through a small wound, which usually doesnʼt require stitches.

Recovery from Surgery

Immediately after surgery, patients are taken to a “Recovery” area and relax for a time before being ready to leave. You are not able to drive home and will need someone else to pick you up.

Regular Paracetamol can be helpful for the first 12 hours or so, but if you feel you need stronger pain relief you should alert Dr Forrest.

Recovery from cataract surgery is usually rapid, but you will need to take some extra precautions for the first few weeks. It is customary to wear a plastic eye shield at night for a few days to protect your eye from inadvertent bumps during sleep. For many people recovering from cataract surgery lights can feel intense and sunglasses can help, as well as providing some physical protection. You should also avoid heavy lifting and strenuous activity for a couple of weeks.

Possible Complications of Cataract Surgery

Cataract surgery is successful in greater than 95% of cases, but complications can occur, and can have permanent effects. The visual outcome of cataract surgery will also depend on the condition and health of your eye. Before your surgery Dr Forrest will discuss the risks, potential benefits and expected outcome in detail with you.

Serious complications are rare, but may include:

  • infection inside the eye (endophthalmitis) which may lead to blindness and, very rarely, loss of the operated eye; the risk of endophthalmitis is less than 1 in 1000 at Queensland Eye Hospital; Dr Forrest routinely injects antibiotics though the existing wounds at the end of the operation, which has been shown to dramatically lower the risk of infection
  • swelling and clouding of the cornea
  • retinal detachment
  • inflammation and loss of vision in the unoperated eye (sympathetic ophthalmia); the risk of this complication is less than 1 in 14000
  • retained lens fragments requiring a second operation for removal

Pre-existing eye conditions such as glaucoma, macular degeneration or corneal scarring can continue to interfere with vision after otherwise successful cataract surgery.

 

Congenital and Childhood Cataract

Cataracts in infants and children are rare. Medicare statistics usually report around 50 eyes operated on for juvenile cataract per year in Australia. Infantile and childhood cataracts generally represent a more complex problem than cataracts in adults. The surgery itself can be more complicated, usually requiring vitrectomy surgery as well as lens aspiration in younger children, and IOL insertion can be more difficult, and is controversial in infants. The child’s eye is growing and continues to grow after surgery, and this has serious implications. Most importantly a child’s eye is connected to a developing brain, so that visual rehabilitation and follow-up must continue, often for many years, after surgery.

Dr Forrest performs juvenile cataract surgery privately at Queensland Eye Hospital and publicly at the Mater Children’s Hospital.


Subscribe to the Forrest Eye Blog

Dr Forrest practices at Northside Eye Specialists, based at Chermside, North Brisbane. He also consults at Blackwood Street, Mitchelton.

Northside Eye Specialists
Chermside Medical Complex
3/956 Gympie Road
Chermside QLD 4032
Phone: 07 3359 8886
Fax: 07 3359 5557

17-19 Blackwood Street
Mitchelton  QLD 4053
Phone: 07 3354 3580
Fax: 07 3354 4133