Cataract surgery is an operation to remove the cloudy lens inside the eye and replacing it with an artificial lens implant.
Over the last 2 decades, the technology of phacoemulsification machine and the technique for cataract surgery have improved dramatically. Cataract surgery now is a very safe procedure and it is commonly performed under local anaesthetic as a day case. Patients can expect 99% success rate with very low risk of complication under the hands of experienced eye surgeons.
Cataract is commonly formed as part of an ageing process. The crystalline lens inside the eye is normally clear, over the years, the protein inside the lens undergoes ageing process that cause gradual cloudiness and impair vision. it is estimated 1/3 of patients age 65 or above have cataract in one or both eyes in UK.
Some people can develop cataract earlier due to other systemic or eye conditions, e.g. diabetes, use of systemic or topical steroid medicines, chronic eye inflammation (uveitis), ocular trauma, previous eye surgery, etc.
Children or newborn babies can also develop cataract as an isolated or part of an systemic genetic condition, however, this is very rare.
Patients commonly complain of blurry vision for distance or near vision like looking through a frosted glass. This is more obvious when the cataracts develop in different speed between the two eyes.
Patients can also complain of glare under bright sunlight or when driving at night that the headlights from opposite side causing extreme glaring making driving dangerous.
Cataracts can affect people differently depends on the job and hobbies. People require to perform miniscule tasks, e.g. watch maker, may complain of visual difficulties early than other people.
Therefore, the need for a cataract operation is very much depends on the day-to-day demands of vision for that person.
When the cataracts has caused significant visual difficulties for patients, then a cataract operation is warranted.
In patient with angle closure glaucoma, the crystalline lens is too big inside the eye. This can cause gradual narrowing of the anterior chamber drainage angle as the lens grows bigger with age. This can cause acute raised eye pressure and hence acute angle closure glaucoma attack. An early cataract operation would be necessary if the angle is still narrow after laser iridotomy treatment. Sometimes, a cataract operation is necessary even when there is no significant cataract formation in patients with very narrow anterior chamber angle and at high risk of angle closure attack.
Patients will require a Biometry test before cataract surgery. Biometry is a test to measure the dimension including the curvature of the cornea and the length of the eyeball in order to determine the lens implant power.
Patients need to make sure that there is no active infection (e.g. leg ulcers) in the body before undergoing cataract operation. Patients with blepharitis (chronic infection of the eyelids) should perform vigourous lid hygiene before the cataract surgery in order to reduce the local bacteria load hence reducing the risk of postoperative infection. In severe blepharitis, a course of oral antibiotics may be necessary before the operation.
Patients do not need to stop aspirin or warfarin before surgery. However, for patient on warfarin, the INR level must not be higher than 4 before surgery. Otherwise, this will increase the risk of serious bleeding at the time of surgery.
Patients with high blood pressure should make sure that theie blood pressure is under good control. Excessively high blood pressure can increase the risk of bleeding during operation.
Birmingham and Midland Eye Centre
Sandwell and West Birmingham Hospitals NHS Trust
City Hospital, Dudley Road
Birmingham B18 7QH
BMI Priory Hospital
Priory Road, Edgbaston, Birmingham B5 7UG
Phone: 0121 4461636
Consultation time: Saturday 8:30 am - 12:00
West Midlands Hospital
Colman Hill, Halesowen, West Midlands B63 2AH
Phone: 01384 560123
Consultation time: 5:30 pm to 8:00 pm
BMI Droitwich Spa Hospital
St Andrews Road, Droitwich Spa WR9 8DN
Phone: 01905 793316
Consultation time: Monday 5:00 pm to 8:00 pm
The Westbourne Centre
53 Church Road, Edgbaston, Birmingham B15 3SJ
Phone: 0121 456 0880
Consultation time: Tuesday 9:00 am to 12:00 pm.