Cataract Operation

WARNING! The following information is intended for my patients who are having cataract surgery. It may not be relevant if you are under the care of another ophthalmologist.

WHAT IS A CATARACT OPERATION?

A cataract operation can be performed under local anaesthesia (awake) or general anaesthesia (unconsciousness). Techniques of local anaesthesia have improved dramatically in recent years and, unless there are specific medical reasons, all of my patients will have their operation under local anaesthesia.

This means the operation can usually be done as a 'day case'. This has many advantages for the patient, such as shortening the time in hospital and reducing expense. Local anaesthesia also avoids the postoperative 'hangover' from a general anaesthetic, as well as avoiding the risks of an anaesthetic - for example, in those patients with heart problems. The majority of my patients now have their operation done using only anaesthetic drops on the eye (topical anaesthesia). For a few other patients, an injection into the eyelid may be needed but, whatever type of anaesthesia you have, a consultant anaesthetist is always present during the operation in case of emergencies. Your eye is fully anaesthetised, but otherwise you are completely conscious. The surgical procedure takes about 15 minutes.

Many patients worry that they will see what is happening during the operation, but this concern is groundless. You may see a bright light and swirling colours during the operation, but you cannot see the actual instruments. Furthermore, although you have to lie fairly still, there is no need to be rigidly immobile; you can adjust your position or even cough or sneeze, providing you warn me first. These days, age or infirmity is no longer a bar to successful cataract surgery.

In recent years, there have been enormous surgical advances that have made cataract surgery safer and have improved the visual outcome. My research at St Thomas' Hospital has played some part in this. In my Practice, I have an uncompromising attitude to the highest quality of surgical care, using only what I consider are the best materials and equipment, regardless of cost. During the operation (which is done under a microscope) I make a tiny opening in the eye and remove the human lens. There is a popular misconception that this is done using a laser; it isn't. Although lasers are used widely in ophthalmology, and are sometimes used to open a thickened membrane in the eye after a cataract operation, they cannot be used for the actual operation itself. Instead, cataract surgery is done using a fine ultrasonic (very high frequency sound) probe. This technique, known as phacoemulsification, is a major surgical advance because it allows the cataract to be removed through an opening so tiny that sutures (or stitches) are no longer routinely required.

Following removal of the human lens, a new lens is inserted. This is made of foldable plastic and is carefully selected to fit your eye (using computerised measurements taken before the operation). An advantage of having the surgery under topical anaesthesia is that patients no longer need to have an eye pad on the eye after surgery.

Cataract operations are 'high tech' surgery, and you will be pleased to know that the equipment at King Edward VII's and Parkside Hospitals is superb. Furthermore, we are particularly fortunate in having a dedicated team of trained Eye Nurses.

All content copyright © Professor David Spalton 2001