Transform cloudy to clear vision with laser cataract surgery in Brisbane

Up to 20% of people undergoing cataract surgery will have low-level focusing problems following cataract surgery, resulting in a dependence on glasses. This may interfere with their satisfaction with their vision following surgery. These people would benefit from laser cataract surgery.

Laser cataract surgery uses the latest techniques in cataract surgery and laser vision correction to maximise your freedom from glasses after cataract removal.

Laser cataract surgery can be broken down into two steps:

Step 1: We use a laser to access the capsule the natural lens sits in and remove the cataract.
Step 2: We replace the cataract lens with a new advanced lens.

A critical part of step 1 is creating a capsulotomy or opening the capsule which contains the cataract. In standard cataract surgery, the surgeon makes the incision manually. In laser cataract surgery, a laser makes the incision. This method is more precise and has higher repeatability⁴Dick, H. B., & Schultz, T. (2017). A Review of Laser-Assisted Versus Traditional Phacoemulsification Cataract Surgery. Ophthalmology and therapy, 6(1), 7–18. https://doi.org/10.1007/s40123-017-0080-z.

The laser capsulotomy technique also enables us to use more advanced extended depth of focus (EDOF) implants designed explicitly for laser cataract surgery. This improves the stability of multifocal implants. Your surgeon can position these lenses with a much higher degree of accuracy, resulting in improved visual outcomes⁵Dick, H. B., & Schultz, T. (2017). A Review of Laser-Assisted Versus Traditional Phacoemulsification Cataract Surgery. Ophthalmology and therapy, 6(1), 7–18. https://doi.org/10.1007/s40123-017-0080-z.

The specific type of lens that will best suit you depends on your vision needs and preoperative testing. At your assessment, we conduct extensive analysis to determine which lens will meet your lifestyle requirements.

Sometimes after cataract surgery, the eye needs laser vision correction to fine-tune the focus. Using LASIK and SmartSurface technology, we can refine the focus of your eye and the quality of your vision following surgery.

Our surgeons have a laser vision correction background. This gives them a specific skill set to consider your quality of vision after the removal of cataracts.

The lenses

There is no single “best” lens that would meet the needs of everyone. Intraocular lenses vary as much we differ as individuals with our own vision and lifestyle needs. We have a complete range of the latest lens types and laser vision correction techniques available. These will help you achieve the vision that will best suit your lifestyle and vision needs after surgery.

We can use a lens implant (Intraocular lenses) to give a range of vision, from distance to close. We calculate the lens power using scans taken at your initial assessment for surgery that assess the abilities of your natural lens.

At this assessment, your ophthalmologist will discuss lens options with you and the target focus for your eyes after surgery. This enables us to select the best implant and focus target for your needs. Some possibilities include:

Multifocal lens implant combined with extended-depth-of-focus (EDOF) lenses – reduces your dependence on glasses, readers, and bifocals for most day-to-day distance tasks.
EDOF lens implant – reduces your dependence on glasses, readers, and bifocals for most day-to-day near and distance tasks
Astigmatic/Toric lenses – Some patients have a high degree of astigmatism. Fortunately, we can correct this with a toric lens, enabling you to see well without glasses or contact lenses for distance and close-up tasks.

Advantages

• Cataract surgery is the most commonly performed surgery in Australia;⁶2021. Cataract surgery hospitalisations 40 years and over – Australian Commission on Safety and Quality in Health Care [online] Available at: <https://www.safetyandquality.gov.au/sites/default/files/migrated/4.6-Cataract-surgery.pdf> [Accessed 1 July 2021].the procedure typically takes less than half an hour and does not require an overnight stay⁷Healthline. 2021. Cataract surgery preparation, procedure, costs, aftercare, recovery. [online] Available at: <https://www.healthline.com/health/eye-health/cataract-surgery#the-procedure> [Accessed 1 July 2021].
• Cataract surgery is one of the safest surgeries performed on the human body. Generally, your recovery will be short and uneventful, and you will be kept informed at every stage⁸All About Vision. 2021. 8 Ways to Minimize Cataract Surgery Recovery Time. [online] Available at: <https://www.allaboutvision.com/en-gb/conditions/cataract-surgery-recovery/> [Accessed 1 July 2021].
• Vision is usually improved the day after surgery. Maximum improvement is usually achieved with EDOF, trifocal and toric lenses.⁹Zeiss.com. 2021. Choosing a Cataract Lens. [online] Available at: <https://www.zeiss.com/vision-care/int/better-vision/health-prevention/choosing-a-cataract-lens.html> [Accessed 1 July 2021].
• The lens implants are permanent and ordinarily do not need to be replaced – they are good for the life of the patient¹⁰Beiko, G. H., & Grzybowski, A. (2015). Intraocular lens implants: Do they come with a life time guaranty? Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society, 29(4), 247–248. https://doi.org/10.1016/j.sjopt.2015.10.002[online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625136/> [Accessed 1 July 2021].

Disadvantages

• Mild discomfort: After surgery, it is normal to feel mild discomfort, irritation, or a stingy sensation. If you experience these symptoms you can take paracetamol (such as Panadol, Panamax, Dymadon, or Panadeine). Mild mucous, a small amount of bloody discharge, and watering of the eye is also considered normal
• Laser cataract surgery is more costly than Standard or Lifestyle Cataract surgery
• Driving is not permitted for 24 hours following surgery, due to the sedation used
• Light sensitivity: It is also quite normal to be sensitive to light after surgery. You will be given a pair of dark glasses after your procedure
• You must avoid:
  • Rubbing your eyes
  • Engaging in strenuous activity/exercise, gardening, or heavy lifting (greater than 10kg) for two weeks
  • Wearing eye make-up for one week
  • Swimming for two weeks
  • Allowing water/shampoo to come into direct contact with the eye for two weeks

The operation to replace a clouded lens is low-risk.¹¹Harvard Health. 2021. Considering cataract surgery? What you should know – Harvard Health. [online] Available at: <https://www.health.harvard.edu/diseases-and-conditions/considering-cataract-surgery-what-you-should-know> [Accessed 1 July 2021].

The risks of not having cataract surgery

In certain people, the growth of a cataract can make them prone to primary angle-closure glaucoma. This is where the drainage channel in the front of the eye (trabecular meshwork) is gradually narrowed by the increasing size of the crystalline lens. Eventually, the drainage channel can become completely blocked, resulting in a rapid increase in the pressure within the eyeball and a painful red eye. Long-sighted patients are more likely to be at risk of angle-closure glaucoma.¹²Ling JD, Bell NP. Role of Cataract Surgery in the Management of Glaucoma. Int Ophthalmol Clin. 2018;58(3):87-100. doi:10.1097/IIO.0000000000000234[online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992498/> [Accessed 1 July 2021].

Your eye specialist will be able to assess if you are at risk of primary angle-closure glaucoma and whether you would benefit from cataract extraction or another treatment to prevent this serious condition.

An alternative to laser cataract surgery is:

• Lifestyle cataract surgery – Restore clarity of vision AND reduce your dependence on glasses to suit your active lifestyle
• Standard cataract surgery – An ideal treatment for someone who is happy to not be free from glasses after the treatment

Does a non-surgical treatment exist?

The only way to treat a cataract is to surgically remove it and implant an artificial lens in its place¹³Davis, G., 2021. The Evolution of Cataract Surgery. [online] PubMed Central (PMC). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139750/> [Accessed 1 July 2021].

We perform laser cataract surgery in a 20-minute minimally invasive day surgery procedure. We perform the procedure under intravenous sedation and local anaesthesia. Because of the sedation, most patients aren’t aware of the surgery taking place. They recover from the sedation and return home usually within 40 minutes of the operation.¹⁴Verywell Health. 2021. What to Expect With Laser Cataract Surgery. [online] Available at: <https://www.verywellhealth.com/laser-cataract-surgery-3421943> [Accessed 1 July 2021].

Step one: We use local anaesthesia in the form of eye drops and light (twilight) sedation. We make a tiny incision in the cornea – the transparent membrane on the surface of the eye.

Step two: Once we have removed the cataract, we implant the selected artificial lens (intraocular lens or IOL) using a special lens injector. In the majority of cases, the intraocular lenses or IOL will sit within the natural ‘bag’ that held the original lens, and the incision heals on its own.

Step three: Once the surgery is complete, we place a clear shield over the eye, which stays on for four hours post-surgery and reduces the risk of infection. We will ask you to commence the use of postoperative drops which consist of an antibiotic drop and two anti-inflammatory drops.

The total time at the hospital is approximately three hours.

Most patients can return to many routine daily activities, including driving within two or three days of their surgery.¹⁵Verywell Health. 2021. What to Expect With Laser Cataract Surgery. [online] Available at: <https://www.verywellhealth.com/laser-cataract-surgery-3421943> [Accessed 1 July 2021].

Following laser cataract surgery, you’ll have a higher level of glasses independence for both near and distance tasks.¹⁶Kanellopoulos AJ. Topography-guided LASIK versus small incision lenticule extraction (SMILE) for myopia and myopic astigmatism: a randomized, prospective, contralateral eye study. J Refract Surg.2017;33:306 – 312 [online] Available at: <https://pubmed.ncbi.nlm.nih.gov/28486721/> [Accessed 21 June 2021].

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

An informative guide on what lens replacement is, and what procedures are most commonly used. Click here for more information.

An article that explains why lens replacement surgery may become the most successful refractive procedure. Click here for more information.

A published, scientific article that provides an overview of intraocular lenses, their safety and effectiveness. Click here for more information.

An example of an FDA approved ICL lens, what it can accomplish and how it works. Click here for more information about Visian ICL.

A cataract is clouding of the lens in parts of the eye that may affect your eyesight. Symptoms include:

• Worsening of vision which may appear cloudy, fuzzy or misty
• Difficult reading
• Glares and halos from light

Click here to read more about cataract surgery in England and Wales 

The use of femtosecond lasers within cataract surgery is becoming more common. Femtosecond lasers are used to minimise the use of surgical blades and needles providing precision and micron accuracy. Click here to read more about cataract surgery in London.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Cataracts eventually occur in everyone. The majority of cataract surgeries are undertaken for patients in their 60’s and 70’s, but surgery can be performed sooner or later than this. Click here to read more about cataract surgery in Wales and Bristol.