The process of cataract surgery
Cataract surgery is Dr Andrew’s core line of work and our clinic, Sight Specialists, is purpose-built to help his cataract patients achieve their best possible results. Please read below to learn all about the process of cataract surgery.
Here, he explains the seven key steps of the process of cataract surgery, in order to achieve world-class results.
The seven steps for premium cataract surgery
At your first visit, Dr Andrew and his team will conduct a thorough examination of your eyes, to assess your cataracts and determine the appropriate course of action.
With the aid of advanced diagnostic imaging, we will show you the problems that are limiting your vision. Our goal is to explain all of the information clearly, so that you can make the decision that’s best for you.
We understand that eyecare can be daunting, but we want you to feel at ease. As such, we strive to deliver care that is warm, welcoming, and personal.
During cataract surgery, an artificial lens is implanted to re-focus your vision. Modern lenses are made from flexible, acrylic plastic. They come in many different brands, designs, and powers. No artificial lens is perfect, and each design has its advantages and limitations. Once your lens is implanted it is challenging (but not impossible) to change it. Therefore, it is important that your surgeon selects the lens that is best for you. Although Dr Andrew has implanted nearly every lens design available, he now uses only a relatively small selection of the highest quality products.
Modern intraocular lenses can reduce or eliminarte your need for glasses for both distance tasks and near tasks. These lenses are called multifocal lenses, extended depth of focus lenses and presbyopia-correcting lenses. They work by different mechanisms and each lens design has specific considerations.
Each eye has a unique shape, and therefore, each eye is suitable for certain lens implants only. If your lens implant does not match the optics of your eye, then your vision will be blurry. In addition, your lifestyle and visual needs must be considered. This is why selecting the most appropriate lens implant is a complex process that must be tailored to you. If a suboptimal lens is implanted then your vision won’t be as good as it could have been.
Dr Andrew’s focus is on both quantity of vision (how many letters you can read in the distance and up close without glasses), and quality of vision (how clear the image is).
Some intraocular lenses give a much higher quality of vision than other lenses. Quality of vision can be understood by comparing a low-resolution TV with a high-resolution TV. Although the picture is visible on both screens, the image quality on the high-resolution TV is significantly clearer and richer. Likewise, some intraocular lenses will give you clearer vision than others.
Low quality of vision is the main problem with diffractive multifocal lenses. For this reason, Dr Andrew typically uses extended depth of focus (EDOF) lenses for his patients, which is a newer technology.
More accurate intraocular lens (IOL) selection
The surface of your eye needs to be as smooth and healthy as possible. This improves the accuracy of the laser scanners used to measure your eye, and this is scientifically proven to increase the precision of cataract surgery outcomes.
Reduced risk of infection
When the cornea is dry, its ability to heal after surgery is compromised.
Faster postoperative recovery
Any eye surgery makes dry eye symptoms transiently worse for six weeks, due to the antiseptic solution that must be used. If a patient has untreated dry eye, they may experience more significant discomfort,foreign body sensation, and fluctuating vision after the procedure.
Enhanced visual acuity and IOL selection
Dry eye causes blurry vision, and vision that fluctuates from day to day. This can interfere with accurate assessment of your vision before and after surgery.
You’ll be happier with the outcome
Cataract surgery is performed to improve vision and quality of life. If you have untreated dry eye, it could undermine the benefits of the cataract surgery.
Your intraocular lens (IOL) must “fit” your eyeball and be the correct power to focus your vision correctly. IOLs come in thousands of different models and powers, just like contact lenses. Accurate eye measurements are therefore essential for selecting the lens that is best for you.
The dimensions and curvature of your eye are precisely measured using a laser scanner (optical biometry) and a high definition camera (corneal topographer). To achieve the most accurate result, Dr Andrew will use seven different instruments to measure your eyes.
Sight Specialists is also the only clinic in Australia and New Zealand to scan our cataract patients with both of the world’s leading optical biometers– the “EyeStar900” and the “IOL Master 700”.
Your eye measurements are entered into mathematical formulas that try to predict the lens power that will be best for your eyes. There are simple, basic formulas, and new, sophisticated formulas. In contrast to most eye surgeons, Dr Andrew uses his own, custom-built computer program to combine the most advanced “4th generation” mathematical formulas in the world. This significantly increases the likelihood of his patients achieving their best possible outcome.
Obtaining perfect measurements and selecting the best possible lens for each eye is fundamental to premium cataract surgery. This is one of Dr Andrew’s key areas of interest and he has published research papers on this process.
Cataract surgery is performed in a day surgery as a walk-in, walk-out procedure. You are positioned on a bed and the entire procedure takes approximately 15 minutes only. Below are the key steps:
Anaesthetic
Dr Andrew gives all of his patients intravenous sedation. The vast majority have absolutely no recollection of their surgery at all!
Incision creation
A tiny incision is made on the edge of the cornea to allow specialised instruments to be used. This incision is self-sealing, meaning that no stitches are required.
Phacoemulsification (Cataract Removal)
An ultrasonic device is used to break up the cataract and wash the particles out of the eye.
Intraocular Lens (IOL) Insertion
The new artificial lens implant is rolled up and injected through the incision. It opens up inside your eye to rest inside your natural lens capsule.
Optimal surgical technique is highly ritualised to minimise the risk of complications, and to produce consistent results.
Medicated eye drops are used for four weeks to help the eye to heal. Several brief check-ups are performed in clinic during this time. Most of Dr Andrew’s patients achieve “20/20” vision within 1-2 days of their surgery, but vision takes 8 weeks to settle completely.
The different types of lens implant
Standard cataract surgery with a single-vision lens. Excellent distance vision but reading glasses are required for objects within arm’s length.
Refractive cataract surgery with a customized depth-of-focus or multifocal lens. Both distance and near objects are in focus.