Cataract Surgery

Cataracts Video

What are Cataracts?

A cataract is the clouding of the eye's natural lens, which normally focuses light onto the retina to produce clear vision. Like the lens of a camera, the eye's lens helps you see clearly at different distances. As cataracts develop, the lens becomes cloudy, causing vision to become blurred or hazy.

Cataracts most commonly develop as part of the natural ageing process, although they can also occur due to injury, certain medical conditions, medications, or previous eye surgery.

Symptoms of Cataracts?

Common signs and symptoms include:

• Blurred, cloudy, or hazy vision
• Colours appearing dull or faded
• Increased sensitivity to bright lights or glare
• Halos around lights, especially at night
• Difficulty seeing in dim lighting
• Poor night vision
• Double vision or multiple images in one eye
• Frequent changes in spectacle prescription

If cataracts begin to interfere with your daily activities such as reading, driving, or recognising faces, cataract surgery may be recommended.

Cataract Surgery Options

Modern cataract surgery is a safe and highly effective procedure that removes the cloudy lens and replaces it with a clear artificial intraocular lens (IOL).

There are two main surgical techniques.

1. Phacoemulsification (Small-Incision Cataract Surgery)

   

   Phacoemulsification is the most commonly performed cataract procedure and is suitable for the vast majority of patients.

   Key features

   • Small incision (approximately 2.2–2.7 mm)
   • Foldable intraocular lens (IOL) implant
   • Usually requires no stitches
   • Faster healing and visual recovery

   How the procedure is performed

   

   During surgery, ultrasonic energy is used to break up and remove the cloudy lens through a tiny incision. Once the cataract has been removed, a foldable artificial lens is implanted into the eye.

   In selected cases, Dr Nah may recommend laser-assisted cataract surgery, where a femtosecond laser performs specific steps of the procedure with enhanced precision. The overall surgical principles remain the same.

   Most patients experience rapid visual recovery and can return to normal activities within a short period.

2. Extracapsular Cataract Surgery

   Extracapsular cataract extraction (ECCE) is a traditional surgical technique that may be recommended for very dense or advanced cataracts where phacoemulsification is less suitable.

   Key features

   • Larger incision (approximately 10–12 mm)
   • Rigid intraocular lens
   • Multiple stitches required
   • Longer healing period

   How the procedure is performed

   

   Although less commonly performed today, ECCE remains an effective option in selected cases.

Types of intraocular lens (IOL) implants

An intraocular lens (IOL) is an artificial lens that is implanted into the eye after a cataract has been removed. The lens is placed inside the natural lens capsule and is usually made of a flexible acrylic or silicone material.

There are three main types of intraocular lenses (IOLs):

1. Monofocal Aspheric IOL

   Monofocal aspheric lenses provide excellent quality vision, particularly for distance, in both daytime and night-time conditions.

   Benefits

   • Excellent quality distance vision
   • Good night vision with improved contrast
   • Reduced visual distortions compared with standard monofocal lenses

   Limitations

   • Reading glasses are usually still required for near tasks
   • Does not correct pre-existing astigmatism

2. Monofocal Aspheric Toric IOL

   Monofocal aspheric toric lenses are designed to correct astigmatism while providing the same high-quality distance vision as a standard monofocal lens.

   Benefits

   • Corrects or significantly reduces astigmatism
   • Excellent distance and night vision
   • Particularly suitable for patients with moderate to high astigmatism (approximately 1.0 dioptre or more)

   Limitations

   • Reading glasses are usually still required for near tasks

3. Multifocal and Extended Depth of Focus (EDOF) IOLs

   Multifocal and EDOF lenses are designed to reduce dependence on glasses by providing a broader range of vision for distance, intermediate, and near activities.

   Benefits

   • Greater freedom from reading and distance glasses
   • Ideal for patients who wish to minimise their dependence on spectacles
   • Available in toric versions to correct astigmatism

   Considerations

   • Some patients may experience halos, glare, or reduced contrast sensitivity, especially in dim lighting or at night
   • Although newer lens designs have reduced these visual side effects, some reduction in contrast sensitivity may still occur

Monovision: An Alternative to Multifocal Lenses

In addition to multifocal and EDOF lenses, monovision is another option for reducing dependence on glasses. With monovision, one eye is corrected primarily for distance vision and the other for near vision. Many patients adapt well to this approach, although it may not be suitable for everyone. Dr Nah can advise whether monovision is appropriate based on your lifestyle and visual needs.

How are cataracts diagnosed?

Cataracts are diagnosed through a comprehensive eye examination. Dr Nah will assess the clarity of your natural lens and evaluate the overall health of your eyes using several tests, which may include:

• Visual Acuity Test

  This eye chart test measures how clearly you can see at different distances and helps determine how much your vision has been affected by the cataract.

• Dilated Eye Examination

  Eye drops are used to enlarge (dilate) your pupils, allowing Dr Nah to examine the retina and optic nerve in greater detail. An Optos retinal scan may be performed to check for signs of retinal disease, glaucoma, or other eye conditions.

  After the examination, your near vision may remain blurred, and your eyes may be more sensitive to bright light for a few hours.

• Tonometry

  Tonometry measures the pressure inside your eye (intraocular pressure) to screen for glaucoma. Numbing eye drops are applied before the test to ensure your comfort.

• Anterior Segment Imaging (Scheimpflug and Retroillumination Photography)

  Advanced imaging technology is used to capture detailed images of the front part of your eye, including the lens. This allows Dr Nah to objectively measure the density and severity of the cataract and monitor its progression over time.

• Optical Coherence Tomography (OCT)

  A macular OCT scan may be recommended to assess the health of the retina, particularly the macula, which is responsible for sharp central vision. This helps identify any underlying retinal conditions that may affect your vision or influence the outcome of cataract surgery.

Together, these tests provide a comprehensive assessment of your eye health and help Dr Nah determine the most appropriate treatment for your cataracts.

How are cataracts treated?

The treatment for cataracts depends on how much it affects your vision and day-to-day responsibilities.

• When surgery is not yet needed

  If your vision is still good and your cataracts are not interfering with your daily routine, you may be able to improve your vision temporarily by:

  • Updating your glasses prescription
  • Using a magnifying glass or increasing the font size when reading
  • Ensuring you have good lighting for reading and other close-up tasks

  These measures can help you continue your normal activities while your cataracts are being monitored.

• When cataract surgery is recommended

  When cataracts begin to impair your vision and interfere with your daily tasks - such as reading, driving, working, or enjoying your hobbies, cataract surgery is the only effective treatment.

  During cataract surgery, the cloudy natural lens is removed and replaced with a clear artificial intraocular lens (IOL). The procedure is safe, highly successful, and is one of the most commonly performed operations worldwide.

  Dr Nah will recommend surgery based on your visual needs, lifestyle, and the extent to which your cataracts are affecting your quality of life.

What to expect

Before your cataract surgery

Before your cataract surgery, we will perform a series of essential eye measurements to determine the most suitable intraocular lens (IOL) for your eye. These tests help us select the correct lens power and IOL type to achieve the best possible visual outcome.

The pre-operative assessment includes:

• Corneal Topography – Measures the shape and curvature of your cornea.
• Biometry – Measures the length of your eye to calculate the appropriate IOL power. This test may be performed using contact ultrasound, immersion ultrasound, or laser interferometry.

Depending on your lifestyle and visual needs, Dr Nah may also discuss monovision as a vision correction option. Monovision uses one eye primarily for distance vision and the other for near vision, reducing the need for reading glasses for some patients.

Before the operation

• Begin using your prescribed eye drops one day before surgery, following your doctor's instructions.
• Do not eat or drink for at least 6 hours before your scheduled surgery.

Important Note

The measurements taken during your pre-operative assessment are only valid for 3 months. If your surgery is postponed beyond this period, the tests will need to be repeated to ensure the most accurate IOL calculations.

During your cataract surgery

Your cataract surgery will be performed at Novaptus Surgery Centre or another equivalent accredited surgical facility.

Upon admission to the day surgery ward, dilating eye drops will be administered to enlarge your pupil in preparation for the procedure.

The surgery typically takes 20–30 minutes. An anaesthesiologist will provide sedation to help you remain comfortable and relaxed throughout the procedure. You should not experience pain during the surgery.

Before the operation begins, the area around your eye will be thoroughly cleaned and disinfected. Topical eye drops and/or a local anaesthetic will be administered to numb your eye.

After the procedure, an eye pad or protective shield will be placed over your eye. You will rest in the recovery area for approximately 1–3 hours, during which our medical team will monitor you for any immediate post-operative concerns, such as raised eye pressure or bleeding.

Most patients are able to return home on the same day. As your vision may be temporarily blurred and you will have received sedation, you should arrange for a family member or friend to accompany you home.

After Cataract Surgery

1 Day After Surgery

Most patients notice an improvement in their vision within one to two days after surgery.

Once your eye pad has been removed, you may resume normal activities such as reading and light work.

It is normal to experience:

• Mild itching
• Mild discomfort
• A small amount of watery discharge
• Temporary sensitivity to light and touch

If you experience any discomfort, please inform Dr Nah. Mild discomfort usually settles within one to two days.

1 Week After Surgery

This follow-up visit is important to:

• Assess your healing progress
• Check for any residual refractive power
• Ensure there are no signs of infection

It is still normal to experience mild itching, slight discomfort and a small amount of watery discharge during this stage of recovery.

4–5 Weeks After Surgery

This routine post-operative review allows your doctor to:

• Assess your final healing
• Check for any remaining refractive power
• Monitor your visual recovery

Caring for Your Eye

To promote healing and reduce the risk of infection:

• Use your prescribed eye drops exactly as instructed. Our team will explain how and when to use them.
• Wear your protective eye shield while sleeping, and wear spectacles or sunglasses outdoors to help protect your eye.
• Avoid rubbing or pressing on your eye.
• Avoid bending with your head below your waist when picking up objects.
• Do not lift heavy objects weighing more than 5 kg.
• Walking, climbing stairs and light household activities are generally safe unless otherwise advised by your doctor.

Within 6 Weeks

• Vision continues to improve as your eye heals.
• Most patients achieve their best vision during this period.
• Healing is complete in the majority of cases.

The above recovery timeline is a general guide for patients who have undergone phacoemulsification (small-incision cataract surgery). Recovery may vary depending on individual eye conditions and healing response.