Eye Cataract Treatment – How Does It Really Work?

Have you just been told you have a cataract in your eye? Cataract treatment is a safe, effective surgical procedure. Because cataracts are typically associated with ageing, in Australia with our ageing population, that makes cataract surgery one of the topmost commonly performed operations in our country.

What is the Best Treatment for a Cataract?

Currently, the only definitive eye cataract treatment we have available is through surgical cataract extraction. In Australia, cataract surgery can be accessed either through the public system or performed by an ophthalmologist in the private system.

If you go through the public system, the operation will be free but you will likely be on a waiting list for several months, depending on the particular hospital. This has implications for timing based on your eye cataract symptoms. If there are no other health concerns with your eye and your cataract symptoms are still tolerable, it may not be an issue for you to wait 6 months or even a year to have your cataract operation. Conversely, if your vision has deteriorated to a point where you are unable to drive safely, you may consider a private eye surgeon to be able to access eye cataract treatment more promptly.

As a cataract develops in the eye, cataract symptoms will gradually become more noticeable. The point that you may want to pursue cataract surgery will differ from individual to individual. For example, if one person’s hobby is bird watching, they may be more bothered by a mild deterioration to their vision from a cataract compared to another person who enjoys gaming. By attending your scheduled eye examinations with your optometrist or ophthalmologist, your eye care provider will be able to guide you as to when your cataracts may be ready for surgery.

How Eye Cataract Treatment Works?

Cataract extraction through surgery is associated with high rates of success in Australia. The aim of a cataract operation is to remove the cloudy lens from the eye and replace it with a clear artificial lens implant known as an intraocular lens.

Before you go into surgery, you will have at least one or two consultations with the eye specialist. During these appointments, the doctor will perform a thorough eye examination to assess the cataract and its effect on your vision. The examination will also aim to detect any other eye diseases or conditions that may make the cataract operation more complicated or limit the final result. For example, if you also have a retinal condition such as age-related macular degeneration that is affecting your vision, your eye doctor will explain that the improvement to your vision after cataract surgery may be limited by this macular disease.

During one of your pre-operation consultations, the eye specialist will also discuss your options for intraocular lenses. Intraocular lenses can be monofocal, multifocal, extended depth of focus, or accommodative. There are also toric intraocular lenses that correct for astigmatism. An intraocular lens is like a spectacle lens implanted in the eye; it can be chosen based on your eye’s prescription and what you want to achieve with your vision after the surgery. For example, some people choose monofocal intraocular lenses – this corrects your eye for one viewing distance, such as far sight; you will then use reading glasses for all near work, like reading or computer work. Conversely, people who spend a lot of time on near viewing may prefer to have intraocular lens implants that allow them to read without glasses and instead put glasses on for long-distance vision. A multifocal lens implant is designed to provide you with some degree of functional long and near vision without glasses. These types of intraocular lenses, as well as extended depth of focus or accommodative lenses, will often need some adaptation. Not all patients are suitable for these types of intraocular lenses, so it’s best to discuss this with your eye surgeon.

Cataract surgery is performed under local anaesthesia, either an injection around the eye or with topical eye drops. The eye surgeon will create a small incision at the edge of your cornea, which is the clear dome of tissue at the front of the eye. The incision can either be made using a handheld instrument or with a laser tool, known as a femtosecond laser. Femtosecond laser-assisted cataract surgery is a newer technique that utilises the laser for several steps that are usually performed by hand during conventional cataract surgery. During laser-assisted surgery, the femtosecond laser is also used to open the membrane bag which holds the lens in the eye as well as to soften the cataract for fragmentation. During conventional cataract surgery, handheld tools are used to open the
membrane bag and then an ultrasound probe is applied to break up the cataract into pieces. Laser-assisted surgery also uses the ultrasound probe to fragment the cataract but typically uses less ultrasound energy as the cataract is already softened with the laser beforehand. The pieces of the cataract are then suctioned out of the eye in both techniques. Both femtosecond laser-assisted cataract surgery and conventional cataract surgery are considered safe and effective methods of removing a cataract.

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