Cataract surgery remains the most frequently performed NHS surgical procedure in the UK with approximately 400,000 operations undertaken in England alone in a year.

What are cataracts?

Cataracts are when the lens in your eyes show signs of ageing and becomes cloudy and loose its transparency. When we are young, our lenses are usually clear like glass, allowing light to be focused on the retina and for us to see through them. As we age, they start to become frosted and begin to limit our vision.

Who is affected by cataract?

As cataracts are a sign of natural ageing, most people above the age of 60 years would have some degree of cataracts. However, it can also be seen in younger people with a history of previous eye surgery, injury, inflammation, diabetes or a family history. Occasionally it can be present from birth.

How is it treated?

In the early stages, vision can be improved with glasses. However, as time goes on symptoms of blurring and glare become worse to a point that glasses make no difference and surgery is required. With the advent of modern instrumentation and techniques, cataract surgery has become one of the safest procedures to have. 

When is surgery necessary?

There is no clear answer to this as every patients need is individual. Some patients find their lifestyle compromised by their vision they are unable to read or drive due to their symptoms. In such cases, surgery would be recommended.

What does cataract surgery involve?

Surgery is normally done under local anaesthetic either with just drops alone or occasionally with a small injection around the corner of the eye. A small incision is made on your cornea and ultrasound (phacoemulsification) is used to break up and remove the lens prior to insertion of an intraocular lens. The surgery last for 20 – 30 minutes and is done with the patient lying down flat on their back. Patients go home on the same day after the procedure with typically a set of drops prescribed for 4 weeks alongside a follow up appointment arranged for in a few weeks’ time.

Are there risks with cataract surgery?

In rare cases cataracts may be more complicated to remove than the routine ones. This is normally the case if the zonules (small hair like strands of collagen that keep the lens suspended in the eye) are weak from a pre-existing condition or from previous trauma or if there is pre-existing weakness with the capsular bag (the bag which houses the lens). The complication rate is quoted at 2% but can be higher in such cases. The most serious risk for cataract surgery is an infection or intraocular bleeding which can lead to loss of sight. These risks are quoted to be less than 1 in 1000. Your initial consultation will cover this in detail for you.

Advantages of cataract surgery with a Vitreoretinal Surgeon?

The benefit from having your cataract surgery done by a vitreoretinal surgeon is that in addition to having high skills in routine cataract surgery, they are equipped to deal with most complications that may arise from surgery (such as the lens material falling to the back of the eye) immediately upon them occurring, resulting in a better outcome. A non-vitreoretinal surgeon may have to refer you to a vitreoretinal specialist at a future date as they are unable to deal with this particular complication if it occurres during your surgery.

Kirti Jasani has been extensively trained in performing cataract surgeries with phacoemulsification and also conducts charity camps across Asia using other varied techniques suited to his individual patient.


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