Restore your vision with laser cataract surgery in Brisbane

There are two ways to perform laser cataract surgery.

In the first, we can perform lifestyle cataract surgery and then apply a laser eye surgery enhancement to your eyes so that we can correct any remaining astigmatism or short or long-sightedness. This service is available now in Brisbane in association with our sister clinic, OKKO.

The second way to perform laser cataract surgery is to perform the incision aspect of the procedure with a laser. Unlike standard cataract surgery which involves the use of a blade to access and break-down your cataracts, laser cataract surgery uses a laser. Much of the content on this page refers to the second type of laser cataract surgery just described. This service requires a special laser that will be available in Brisbane Autumn 2021.

In either case, the only way to treat a cataract is to surgically remove the natural lens and implant an artificial lens in its place.

We use local anaesthesia (in the form of eye drops) and light (twilight) sedation. The surgeon makes a tiny incision in the cornea, the clear membrane on the surface of the eye. Then, he’ll insert a fine instrument through the incision which uses ultrasound vibrations to break up the lens into a fine pulp. Then, we carefully remove this pulp under microscopic guidance.

Once the cataract has been completely removed, your surgeon will implant the artificial lens (intraocular lens or IOL) using a special lens injector. In the majority of cases, the IOL will sit within the natural ‘bag’ that held the original crystalline lens, and sutures are not usually required.

The surgery takes less than an hour, and generally, the total time at the hospital is approximately three hours. Once the surgery is complete, a clear shield will be placed over the eye, which stays on for four hours post-surgery. At this stage, post-operative drops (which consist of an antibiotic drop and two anti-inflammatory drops) will be commenced.

Usually, the dominant eye is operated on first. Then, a minimum of five days later, the second eye can be operated on.

The lenses

The implanted lens can be designed to give a range of vision, from distance to close. The lens power will be calculated using scans performed at your initial consult for surgery. At this consult, clinical staff will discuss the available options and work with you to decide what vision range will work best.

Advantages

• Cataract surgery is the most commonly performed surgery in Australia; the procedure typically takes less than an hour and does not require an overnight stay.
• Vision is usually improved the day after cataract surgery. Maximum improvement is usually achieved with toric or multifocal lenses. We can even top-up the procedure with a laser to give you spectacularly accurate results.
• Cataract removal is one of the safest surgeries. Generally, your recovery will be short and uneventful, and you will be kept informed at every stage.
• The lens implants are permanent and ordinarily do not need to be replaced – they are good for the life of the patient.
• Medicare and health insurance usually cover basic cataract surgery. Laser cataract surgery will incur additional fees to cover premium lenses and possible laser enhancements.

Disadvantages

• While most patients experience improved vision as soon as one day after surgery, you may still need to wear reading or prescription glasses at times. Laser cataract surgery tends to reduce this likelihood because it treats your prescription in addition to your cataract at the same time. The clinical team will discuss this with you prior to the procedure, as well as advise you on the appropriate eye care required.
• After surgery, it is normal to feel mild discomfort, irritation or a stinging 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.
• Driving is not permitted for 24 hours following surgery, due to the sedation used.
• It is also quite normal to be sensitive to light after surgery. You will be given a pair of dark glasses to aid with this if necessary. It is important to not rub the eye after cataract surgery. For two weeks following surgery, it is also advised to avoid:
  • Engaging in strenuous activity/exercise, gardening or heavy lifting (greater than 10kg)
  • Wearing makeup directly on the eyelids
  • Swimming
  • Allowing water/shampoo to come into direct contact with the eye

There is a 98 – 99% likelihood of undergoing laser-assisted cataract surgery without complications that may permanently affect your best possible vision.

You may experience mild grittiness and dry eye symptoms following surgery. This can last for a few weeks and, in some cases, several months. Some people may experience fleeting sharp pain related to dryness of the eye. These symptoms are usually manageable with lubricating eyedrops. If you are noted to have dry eye at your preoperative assessment, your surgeon may recommend you commence use of artificial tears or eye drops prior to surgery.

The only way to treat a cataract is to surgically remove it and implant an artificial lens in its place.

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. 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 other treatments to prevent this serious condition.

An alternative to laser cataract surgery is basic cataract surgery, which is an ideal treatment for someone who has no astigmatism or other refractive error (only ±30% of the population). Furthermore, laser cataract surgery can help you reduce your dependency on reading glasses. Basic cataract surgery will not.

1. We make a small (2-2.5mm) self-sealing incision on the side of the cornea, the clear membrane on the surface of the eye.
2. Then, we insert a fine ultrasound (phaco) handpiece. Vibrations from the tip of the phaco probe will fragment and emulsify the cataract into a pulp.
3. These fragments of cataract are then carefully removed under microscopic guidance.
4. Following this, we insert a plastic intraocular lens (IOL) implant that has been specifically preselected for your eye to replace the crystalline lens. Your surgeon rolls the implant up in a special lens injector and gently guides it into place. In the majority of cases, the IOL will sit within the natural bag that originally held the crystalline lens (the capsule), and sutures are not usually required to position the IOL.

After surgery, you’ll have a greatly reduced need for glasses or contact lenses. You may find you no longer need them at all.1Kanellopoulos AJ. Topography-guided LASIK versus small incisionlenticule extraction (SMILE) for myopia and myopic astigmatism: a randomized, prospective, contralateral eye study. J Refract Surg.2017;33:306 – 312

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.

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.