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Cataract and Intraocular Lens Implants
 
 
What is a cataract?

A cataract is a cloudy lens resulting in reduced vision. In a normal eye, the lens is clear and light is clearly focused on the retina enabling clear vision. If the lens is cloudy from cataract, the image formed on the retina is blurred causing reduced vision. In addition to blurred vision, cataract can cause glare, poor night vision, faded colour vision, double vision and frequent changes in glasses prescription.

Cataracts are common in older people accounting for the majority of visual loss in this age group. Twenty five percent of people over 60 years have significant cataracts resulting in poor vision. The risk of cataract increases with age. Other risk factors for cataract include diabetes, smoking, and prolonged exposure to sunlight. Although most cataracts occur in old age, cataract can also affect young people. Causes of cataract in young people include congenital causes, trauma and steroid use.

Cataract is detected through a thorough eye examination by an eye care professional such as an ophthalmologist (eye specialist) or an optometrist. If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years.

How is a cataract treated?

The only effective treatment for cataract is cataract surgery whereby the cloudy lens is removed surgically and is replaced by an intraocular lens implant. To date, non surgical method of treating cataract has not been successful. Cataract surgery is the most commonly performed surgery worldwide. Every year 60,000 cataract procedures are performed in Malaysia alone.

Modern technologies with innovative surgical techniques have made cataract surgery a painless, safe and hassle free procedure with excellent outcome. Most modern cataract surgery are performed as a day care procedure under topical anaesthesia (eye drops only).

There are 2 types of cataract surgery.  

  1. Phacoemulsification or “phaco”. This modern method is commonly but mistakenly known as the “laser” method. A small incision measuring 2 to 2.5 mm is made in the eye. A special device utilizing high frequency ultrasound energy is used to soften and breakdown the cataract so that it can be removed by suction. An experienced surgeon using state of the art phacoemulsification technology can successfully perform the surgery within 10-15 minutes. The procedure is painless, without injection and does not require suturing. Typically the patient can see clearly within one day. New technologies in phacoemulsification have significantly reduced the risks of cataract surgery making cataract surgery one of the safest surgical procedures. 

  2. Extracapsular surgery. This is an older method whereby a larger incision is made in the eye. The cataract is then removed in one piece. In view of the larger wound, suturing is required and therefore the recovery time is longer. Additionally the rate of surgical complication is higher with this older technique.

 

Why do I need a lens implant after cataract surgery?

Since the natural but cloudy lens has been removed, an artificial lens called an intraocular lens (IOL) is inserted into the eye so that light can be focused clearly on the retina. The IOL requires no care and lasts a lifetime. You will not feel or see the new lens.

 

What are the new intraocular lens technologies available?

IOL technology has advanced tremendously over the past few years. The following are some innovative technologies currently available.

  1. Aspheric Technology. By employing aspheric technology in surfacing the IOL, light rays from both the central and the peripheral portions of the IOL are focused on the retina resulting in clearer and crispier vision. The quality of vision can be better even when compared to the natural lens.     

  2. Toric Technology. This technology can correct preexisting astigmatism therefore freeing the patient from the need of wearing glasses after the operation.

  3. Multifocal Technology. Multifocal IOL can focus light from both distance and near therefore allowing patient to be independent of glasses following cataract surgery. Up to 90% of patient with multifocal IOL implantation does not need to wear glasses at all following surgery.

  4. Laser Interferometry Biometry Technology. This technology enhances the precision of lens power calculation so that only the IOL with the appropriate power is inserted into the eye.

 
 
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