Modern cataract surgery is a technical and advanced procedure carried out under a microscope. Miss Crawley has a lot of experience in this process. She performs both routine and complex cases in her role as a cataract and glaucoma surgeon at The Western Eye Hospital, Imperial College Healthcare NHS Trust.
The specialist uses 2-3 micro-incisions, 1.5 to 2.7mm in size. The cataract is held within a capsule support structure attached to the wall of the eye with micro-springs called zonules. The specialist will disassemble and emulsify the cataract with a particular technique (phacoemulsification). Then the specialist removes the cataract leaving the capsule intact. An artificial lens is then placed into the capsule. This new lens is selected for the individual patient. Most often no sutures are required in non-complex cases. The specialist will apply a dressing with a clear shield for protection.
This may require temporary treatment with drops after the procedureCystoid macular oedema- inflammatory fluid in the retina. It is more common for patients with diabetes. Your specialist will prescribe an extra drop for 2-3 months to reduce the chance of this happening. Nepafenac drops have been successful in reducing this and are excellent approved.
Refractive surprise- Detailed measurements are known as biometry are carried out as part of the pre-operative assessment. Measurements of the length and curvature of the eye are important in choosing the correct lens. Rarely, despite the best measurements the prescription is different from that expected. It may be that spectacle correction is still required in such cases. Sometimes the implanted lens may be exchanged, but this is uncommon.
Allergy to post-operative drops. Most people tolerate the post-operative drops well. Some patients are sensitive to the preservative within the bottle rather than the active drug ingredient. Should this be the case, your specialist will prescribe you preservative free drops.
Corneal decompensation- The cornea is the window at the front of the eye. micro pumps on the inner surface maintain the clarity. As we get older, the number and function of these pumps declines. Cataract surgery can disturb the function of the pumps causing the cornea to cloud. In the majority of cases, this is temporary and settles with time or extra drops. In some cases, further surgery to replace part of the cornea may be required.
Retinal detachment- this is uncommon after routine cataract surgery.