MR ALEX BANEKE - OPHTHALMIC SURGEON - GLAUCOMA & CATARACT
Cataract surgery is one of the most common and safest procedures performed in the UK, with millions of successful surgeries worldwide each year. It’s a quick, effective way to restore clear vision and significantly improve your quality of life.
Most patients still rely on glasses for near vision following cataract surgery. Premium lenses, including multifocal and extendend depth of focus (EDOF) lenses, can be used to remove or significantly reduce glasses dependence. Unfortunately most of these lenses are not available on the NHS.
Mr Baneke offers a comprehensive array of treatments for patients with cataracts. These are described in more detail below.
Clear Vision Ahead: Understanding Cataract Surgery
If your vision has become cloudy or blurry, you might be dealing with a cataract. The good news? Cataract surgery is a highly effective procedure that can restore your sight, helping you see the world clearly again.
How is Cataract Surgery Performed?
Cataract surgery is usually a straightforward procedure that involves removing a cloudy lens and replacing it with a clear artificial lens. The most common technique used today is called “phacoemulsification".
First your eye is made numb using drops or an anaesthetic injection.
During the surgery, tiny incisions are made in the eye, and a small probe is used to break up the cloudy lens into smaller pieces. These pieces are then gently removed, and the eye is irrigated with water to keep it clean and comfortable. For most patients the operation takes 15 to 30 minutes.
Once the cloudy lens is removed, it is replaced with a clear plastic lens that is carefully chosen to focus light correctly onto your retina, restoring clear vision.
For most people, the new lens is selected to give good distance vision, which means you might still need glasses for close-up tasks like reading or using a computer. However, there are more advanced lenses available, such as toric lenses for correcting astigmatism, multifocal lenses, and extended depth of focus (EDOF) lenses, which can reduce or eliminate the need for glasses altogether. Unfortunately, most of these premium lenses are not available on the NHS.
Cataract surgery results in excellent outcomes for the vast majority of patients. However, as with any operation, there are risks involved. A small minority of patients end up with worse vision after surgery, or need a second operation to improve the vision. Posterior capsular opacification can cause blurring following surgery: this can be fixed with a simple laser procedure (see below for further details). Some patients need a stronger glasses correction than expected. The risk of vision loss from a complication such as a severe infection or bleed is around 1 in 1000 cases.
What to Expect After Cataract Surgery
Cataract surgery is one of the most common and successful surgical procedures performed in the UK today, with the vast majority of patients experiencing significantly improved vision afterwards.
Approximately 1 in 10 patients develop posterior capsule opacification (PCO) following cataract surgery, which can be treated with a simple laser procedure in clinic. Rare complications include a deterioration in your vision or a need for further surgery.
Recovery is usually quick, and most people are able to return to their normal activities within a few days. In more complex cataract surgery it can take a few weeks for the vision to improve. Patients should avoid excessive bending and heavy lifting for the first month.
Potsterior Capsule Opacification
During cataract surgery, your eye's natural lens is replaced with a clear artificial lens. The lens is held in place by a natural bag, which is left intact during the procedure.
Sometimes the back of this bag can become cloudy over time. This common complication of cataract surgery is called posterior capsule opacification (PCO). Around 1 in 10 people experience it after cataract surgery and symptoms include blurred vision, streaks, and halos around lights. These symptoms can gradually worsen if left untreated. The good news is laser treatment is simple, straightforward and very effective.
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Choosing the Right Lens for Your Vision: A Guide to Premium Lens Options
If you're considering cataract surgery and want to reduce or even eliminate your need for glasses, premium lenses like Multifocal, Extended Depth of Focus (EDOF), and Toric lenses could be the perfect choice. These lenses offer fantastic results, but they may not be suitable for everyone. Let's explore what each option has to offer, so you can make the best decision for your vision.
The Standard Option: Monofocal Lenses
In standard cataract surgery, a monofocal lens is used. This type of lens focuses light at a single distance, most commonly for distance vision. With this choice, you'll likely need glasses for near tasks like reading or intermediate tasks like using a computer.
Monofocal lenses are reliable and work well for many patients, but if you're looking to be less dependent on glasses, you might want to consider a premium lens.
Multifocal Lenses
Multifocal lenses are designed to focus light from a range of distances, potentially freeing you from the need for glasses altogether. These lenses are a great option if you prefer not to wear glasses, have a strong glasses prescription, and don’t have other eye conditions like glaucoma.
However, there are some trade-offs: multifocal lenses can cause increased glare, halos, reduced night vision, and lower contrast sensitivity. They might not be the best choice if you do a lot of night driving or have high visual demands. Additionally, these lenses aren't always suitable for patients with astigmatism. It's also common to need a Yag laser capsulotomy after surgery with multifocal lenses, which is a simple procedure but might not be included in the initial surgery cost.
Extended Depth of Focus (EDOF) Lenses
EDOF lenses provide an extended depth of focus, offering clearer vision at multiple distances and reducing your reliance on glasses. These lenses are an excellent choice if you want to be independent of glasses for most tasks but don't mind using reading glasses occasionally for small print.
EDOF lenses tend to cause fewer issues with glare, halos, and reduced night vision compared to multifocal lenses, though these effects can still occur to a lesser degree. Like multifocal lenses, EDOF lenses are not recommended for patients with advanced glaucoma, and you may need a Yag laser capsulotomy after surgery.
Toric Lenses
If you have astigmatism, Toric lenses could be a great option. They correct the uneven curvature of your cornea, which is shaped more like a rugby ball than a football. Toric lenses can significantly reduce your dependence on distance glasses if you have two or more dioptres of corneal astigmatism (your ophthalmologist can determine this for you).
While these lenses increase your chances of achieving glasses independence for distance vision, it's important to note that in a small number of cases, the lens can rotate after surgery, requiring a follow-up procedure to reposition it correctly.
Monovision
Monovision is another strategy to reduce your dependence on glasses using standard monofocal lenses. This approach involves setting one eye for distance vision and the other for near or intermediate vision. While this can reduce your need for glasses, it does come with some downsides, such as a reduction in depth perception. Some people may find it difficult to adjust to the difference in prescription between their eyes.
If you’re considering monovision, it's a good idea to test it out with contact lenses first, with one eye corrected for distance and the other for near vision. Even with monovision, you’ll likely still need glasses for tasks like reading small print.
LENSES
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Restoring Your Vision After Cataract Surgery: Yag Laser Posterior Capsulotomy
If you've had cataract surgery and your vision has started to blur again, you might be experiencing a common issue that can develop after the procedure. The good news is that a quick and painless laser treatment called Yag laser posterior capsulotomy can restore your clear vision in just a few minutes.
Yag Laser: Why Do I Need This Treatment?
During cataract surgery, your eye's natural lens is replaced with a clear artificial lens. The lens is held in place by a natural bag, which is left intact during the procedure.
However, sometimes the back of this bag can become cloudy over time, leading to blurred vision, streaks, or halos around lights. These symptoms can gradually worsen if left untreated.
What Does the Yag Laser Do?
In the past, treating this cloudy bag required another trip to the operating theatre. Thankfully, modern technology allows us to quickly and safely remove the cloudy part with a Yag laser right in the clinic. The procedure is straightforward and usually painless.
Here’s what to expect:
Anaesthetic Drops: Before the treatment begins, numbing drops are applied to your eye to keep you comfortable.
Laser Treatment: A special lens may be placed against your eye, and the Yag laser is used to create a small opening in the cloudy bag. This allows light to pass through clearly again, restoring your vision.
Quick and Easy: The entire process takes just a few minutes, and most patients find it completely painless.
After the treatment, you might be given a short course of steroid drops to help your eye heal. Your vision should improve rapidly, and you can return to your normal activities right away.
Are There Any Risks?
Yag laser posterior capsulotomy is a very safe procedure, but as with any surgery, there are some risks to be aware of.
You might notice new floaters or spots in your vision afterwards. In rare cases, the lens could be damaged, leading to "pitting," or you might experience a more serious complication like retinal detachment or fluid buildup in the retina (cystoid macular oedema), which could affect your vision.
There’s also a chance your eye pressure could rise temporarily.
While these risks are rare, it’s important to discuss any concerns with your eye specialist, who will ensure you’re fully informed and prepared for the procedure.