Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk
This is not essential for a private consultation but it is helpful if you have one and especially if you have health insurance as it will be needed for policy claims. Both the GP and your Optometrist can directly refer you.
Cataract symptoms include: glare, dazzle, halos, blurred dim vision and occasionally double vision. Once the cataract (the cloudy lens of your eye) is removed, an artificial lens is implanted. Using a standard artificial lens which has a fixed distance of focus, almost all people will need glasses especially for intermediate and near vision. With the use of special artificial lenses (Accommodating or Multifocal) the need is much less. Scientific studies have shown that over 90% of patients with a Multifocal lens such as the Lentis Comfort in either eye are free of glasses for their general daily activity.
If you are over 40 and are considering Laser surgery (LASIK or LASEK) then you should consider Multifocal intraocular lenses. This is because Laser will only give you a fixed distance of focus whereas a multifocal lens will give you both distance intermediate and near vision. Laser is not used to remove your lens / cataract. Your options will be carefully discussed with you at your appointment.
No. Modern Cataract Surgery in skilled hands is very successful. This means that the threshold for recommending surgery has changed over the years. Because my audited complications are low (over 99% surgically uncomplicated), I am happy to offer clear lens surgery for people who are short or long-sighted or have astigmatism. The chance of making your vision permanently worse following uncomplicated surgery is under 0.5% approximately. If you are in poor health it may be advisable to have your cataract operation at an early date while you are able to lie flat for 20 minutes.
No. There is no age limit for Cataract Surgery. Not too long ago I performed surgery on a lady who was 102 years old. She was delighted with the outcome and wished that she had had the operation years ago.
Yes. Usually Cataract surgery performed under local anaesthetic involves the injection of anaesthetic around the eye. This has a small rate of complications but some can be serious such as a bleed behind the eye or accidentally entering the eye. My preferred method of Cataract Surgery is using eye drops only. This allows for faster visual recovery as well as avoiding the fear of needles around the eye. This eye drop technique also means that the eye will not look bruised after. Infact by looking at the eye you will hardly be able to tell that the operation has taken place.
The natural history is for the cataract to get worse with time. This will make your vision more and more misty over the months and years ahead.
No. Many patients with macular degeneration will get benefit from removing the cloudy cataract lens. Vision, especially peripheral vision, will be much brighter. A magnifying glass appointment should occur following the surgery as this can improve some of the central vision as well. The IOL-VIP is a lens specially designed for people with macular degeneration and can further improve vision a little due to the effect of magnification and deflection of the light onto a healthy part of the retina but unfortunately the results are quite variable. Because of this a standard cataract operation with good modern magnification aids is probably a better option.
In the NHS the cataract waiting list is shared. You may be operated on by a different team who initially saw you and the surgeon could be a consultant or supervised training eye doctor. Although listed under a particular named consultant team, this does not mean that the consultant is the person doing your operation. With a Private operation I specifically will do the operation and you can have the second eye done a week later.
We use artificial lenses (intraocular lens implants) in children now as well, so these lenses are designed to last for life.
This essentially depends who performs the surgery. Under a Consultant Ophthalmologist it will take approximately 15 minutes. Under a training eye doctor it is more likely to last 30 – 45 minutes.
All treatments are unique to every patient I treat. It is best to get in touch for you to discuss the treatment that would work best for you as costs can vary.
No. The majority of Lens surgery is undertaken as a day case procedure. You will be in the hospital for approximately 2 hours.
No. The operation takes place through a small wound of under 3mm in size. This is self sealing so no stitches are needed. Rarely one may be used for refractive purposes.
No. The operation is performed using eye drops only so all needles are avoided. This means that no shield is required after the operation.
For the NHS, the current recommendation in Leeds is for the first eye surgery to be done within 3 months with a similar additional wait for the second eye. Only one eye is done at a time. By going Privately not only do you chose your surgeon but also the time and date of your surgery as well as the comfort of free easy parking. Privately the second eye can be done 1 week following the first eye.
It is sensible to have a few days off from driving. Legally, if you can see the number plate at 67 feet and your visual field is fine, you can drive a normal vehicle. Only drive if you feel safe./p>
Be sensible and don’t exhaust yourself. Vision can be quite strange for the first few days. The exact answer to this question really depends on the type of work you do but I usually suggest a few days off is all that is really needed.
It is perfectly safe to use your eyes immediately following lens surgery. After a week most normal activities can be undertaken including hair washing. What I do suggest is the avoidance of swimming and heavy physical exertion for at least a month and importantly do not rub your eye. Please report any bad pain or sudden vision deterioration.
The eye takes a few weeks to settle properly so it is advisable to wait at least a month. In the meantime you can wear your old glasses as they can not damage the operated eye but the prescription will be wrong for you and so the vision may blur. Cheap reading glasses (approximately +2.5) are available from shops such as Boots and can tie you over this period before you get your proper glasses. For the first few days following the operation dark glasses can make the eye more comfortable as it will be sensitive to bright light.
Yes. The calculations for a precise result are less predictable following Laser surgery to the cornea but thankfully new formula used for the lens power choice are good these days.
Yes. This is because accurate measurements before the operation allows us to precisely calculate the power of the artificial lens needed to focus the image on the retina. By choosing a multifocal lens such as the Comfort lens in either eye, this allows freedom from glasses of the majority of daily activities..
Yes. Astigmatism is an irregularity of the window of the eye (cornea) that blurs the image on the retina by producing two points of focus. By using a Toric artificial lens, this special lens will correct the astigmatism and so produce a clear image.
You can go the next day but it would be advisable to wait a few days so that you are confident the eye is settling down well.
No. However the bag the artificial lens sits in can become cloudy months or years later – people often refer to this as an ‘after cataract’. You will realise this as the vision will not be as sharp as it was before. It appears as if the cataract has come back. A Laser Capsulotomy can easily restore the good vision. It is done on an outpatient basis and takes only a few minutes to do in the clinic on a machine similar to the small slit-lamp you are examined on.
A continuous audit of my NHS and Private cataract work shows over 99% to be surgically uncomplicated. Please contact my secretary on 0845 456 1729 should you wish to make an appointment.
This lens is specially designed for people with macular problems. The macula is the part of the retina that sees things in fine detail. IOL-VIP stands for intraocular lens for visually impaired people. The IOL-VIP works on the principle of magnification as well as deflecting the image by 10 degrees onto healthy retina.
No. When you are being assessed for suitability for the IOL-VIP any signs of active changes in the macular means the lens should not be used. People with stable macular change (dry are old wet changes) are suitable for the lens trial. Those with small macular scars have the better outcome.
This requires a detailed examination and measurement of the eye. On your visit to the IOL-VIP specialist you will be tested on a simulator to see if you significantly gain vision in which case the IOL-VIP is likely to be of benefit to you.
Yes. The IOL-VIP has magnification of around 30% and will change your glasses prescription which you should continue to wear. You should have your glasses checked and be reassessed for magnification aids following the IOL-VIP surgery to gain the best benefit.
No this is not possible.
Currently the IOL-VIP is not available on the NHS. We are hopeful that further research will allow the National Institute for Health and Clinical Excellence (NICE) to agree that it should be used in NHS hospital for the benefit of patients but this process can take a long time.
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Both cataract operations were completed without pain or discomfort and the immense benefits were almost instantaneous.
David Dixon. Bilateral Cataract Surgery.See more