Cataract Surgery

Cataracts cannot be treated with medication or corrected with eyeglasses. When they begin to negatively affect your daily life, the clouded natural lens must be surgically removed and permanently replaced by a very small implant called an intraocular lens (IOL).

Over 20 million surgeries are performed worldwide every year, producing excellent visual outcomes.

You might find it helpful to talk to other patients who have undergone cataract surgery - perhaps a friend or a relative. Your optometrist is also a valuable resource.

Intraocular lenses (IOLs) are artificial lenses used in modern cataract surgery. They are implanted in the eye’s capsular bag to replace the crystalline lens clouded by the cataract.

IOLs can simulate the refractive properties of the natural lens, but they do not have the ability to adapt their shape to change focus. IOLs are designed to meet additional requirements of the individual patient's vision.

Intraocular lenses are made of a soft, synthetic, and biocompatible plastic (acrylic). A typical IOL measures approximately between 13 mm in diameter. The thickness of the lens can vary, depending on its refractive power.

The corrective power of the lens is individually calculated and may differ for each eye. An IOL is transparent and neither visible nor perceptible in the eye.

Before the cataract surgery is performed, the eye first needs to be measured to find the correct diopter power for the IOL.

This measurement will be performed using the Zeiss IOL Master 700. A comprehensive array of tests will also be performed to assess the health of other structures in the eye.

On the day of surgery, the selected lens will be implanted in the eye. The cataract surgery is performed one eye at a time, usually with 1- 4 weeks in between.

On the day of surgery, come to the hospital on time, wearing no make-up.

You may be asked to wait before you are prepared for surgery. With cataract surgery being a routine procedure, you will see other patients in the hospital having their treatment on the same day.

You will be brought into the operation room lying on a surgical bed, and your head will be placed underneath a surgical microscope.

Directly before surgery, while you are sedated, you will receive an anaesthetic injection under your eye to numb your eye for the procedure.

Normally, the surgery takes between 15 to 20 minutes.

During the procedure you will feel no pain and have minimal or no ability see or move your eye and eyelids. Some patients see some vague movement or lights. During the surgery you will be given intravenous sedation, called twilight sedation. The eyelids and the surrounding skin will be disinfected.

First, the surgeon makes a small 2-2.5 mm incision in your cornea to access the inside of the eye. Next, a jelly-like substance is injected into the eye to protect the cornea and other eye tissues. The surgeon then opens the capsular bag where the natural lens is located. The lens is softened, broken up, and carefully removed with gentle suction (phacoemulsification).

The IOL is carefully positioned where the original lens was before. Usually there is no suture required, which aids a quicker recovery.

Finally, a patch is placed over the eye to protect it. It can be removed the following day after surgery. You will be allowed to go home after a short observation period. As your medication wears off after the procedure, you might feel some minor discomfort for a short time. This can easily be treated with over-the-counter pain medication.

Recovery after cataract surgery is relatively short – it can take anywhere from a few days to a month, depending on the patient.

You will immediately be able to see the following day after the operation. However, for the first few days you will likely experience blurriness and feel some mild discomfort.

It can take a week for the eye to adjust and your vision to improve. Best vision is obtained after 4 weeks. Multifocal intraocular lenses normally require a longer period of adjustment of several weeks or months. For an optimal recovery, follow your doctor's detailed instructions about how to protect your eye after the procedure, and go to your follow-up appointments.

If you need cataract surgery in both eyes, your surgeon will usually wait 1-4 weeks for your first eye to recover before performing the procedure on the second eye. If correcting glasses are still needed after surgery, they should be prescribed only four to six weeks later.

You might be told to wear an eye patch or similar protection for a few days after surgery and to avoid rubbing or pressing your eye.

Your doctor will prescribe eye drops to prevent infection and inflammation and/or to control eye pressure. Make sure you use these medications exactly as prescribed.

The doctors may advise you to relax and avoid strenuous activities, as well as not to overexert your eyes in general for a few weeks. Working at your computer or watching TV for a short amount of time should be possible the following day after your surgery.

Inform your doctor if you experience:

Usually, your eye will be checked the following day after surgery by an orthoptist.

Your vision and eye pressure will be checked, and instructions will be given on how to use the prescribed drops. Your vision might be blurry right afterwards, but it will improve during the first few days after your treatment.

Additional examinations are typically scheduled over the following 1-4 weeks to monitor the healing process until your vision has fully stabilised. The final follow-up appointment will take place with your optometrist about a month after the cataract removal procedure.

After the follow-up examinations, you only need to go to your optometrist for periodic check-ups, just like before your surgery.

While a proven, well-established, and safe procedure, cataract surgery is not completely free of risks and complications.

Some side effects that can occur right after surgery include infection, swelling, increased pressure in the eye, and droopy eyelid.

Other complications include experiencing visual disturbances such as halos or glare around light sources, especially in poor lighting conditions. These phenomena are especially common after implantation of EDoF and multifocal IOLs but diminish within a few weeks or months after surgery.

In rare cases, the lens may become decentered over time.

One common complication of cataract surgery, posterior capsule opacity (PCO) occurs when remaining cells from the removed lens begin to grow over the surface of the capsule surrounding the IOL, causing your vision to become less crisp again. PCO can easily be treated with a special YAG laser in the clinic. This is a quick and painless procedure, with no risk of infection.

As with all surgeries, there is always a risk of complications during and after the cataract procedure. However, this risk is very low, and the advantages of the treatment are incomparably higher than potential side effects.

There is no standard price for cataract surgery. Our prices are clear and transparent and you will be fully informed of the total cost before the surgery.

Cataract surgery can be performed at a private or public hospital. Cataract surgery is covered by private health insurance, so if you have private health insurance, you should have your surgery in a private hospital. Private health insurance covers the cost of the IOL, regardless of the type chosen, so cost should not be a factor in the choice of your IOL. At Northern Sydney Cataract we offer a KNOWN-GAP fee structure for cataract surgery to minimise your out of pocket costs.

If you don’t have private health insurance, you can choose to have your surgery in a private hospital, and have the choice of your surgeon and IOL type. There will considerable out of pocket expenses, as Medicare only provides a small rebate. The alternative is to have the surgery in a public hospital.

In public, there are no fees. You will be placed on a waiting list, and the surgery performed by the doctor allocated by the public hospital. There are usually limited choices of IOLs, with EDoF and multifocal IOLs not available. As public hospitals in Sydney are teaching hospitals, it is likely that the surgery will be performed by the hospital registrar (trainee) under the supervision of the consultant surgeon.