A cataract is not a growth, but rather a clouding of the normally transparent and flexible lens of the eye. This condition usually develops over some time and interferes with light entering the eye, which affects a person’s ability to see clearly. If left untreated, people with cataracts may eventually go blind. Both eyes may be affected, although not usually to the same extent.
Cataracts are mainly diagnosed in people over 60 but can occur at any age (some babies may even be born with congenital cataracts). Age is the major risk factor for developing cataracts. However, a cataract can also be associated with eye trauma, prolonged use of steroids, or previous inflammation and infection in the eye.
Early cataracts are often managed with a change in your glasses or contact lens prescription. When this stops working and/or you can’t perform your daily tasks, then it could be time to consider cataract surgery. This involves replacing the dysfunctional lens with an artificial one. The same procedure can also be used as an alternative to laser eye surgery to correct vision, regardless of whether cataracts are present. If the person does not have cataracts, it is referred to as refractive lens exchange or clear lens surgery.
Cataracts are not painful and often don’t cause noticeable changes in the early stages.
As the condition progresses, symptoms can include:
Your ophthalmologist will perform a thorough assessment of your eyes and will help you determine which replacement lens option best matches your needs and lifestyle. These lenses vary in design and offer clear vision at either one, two or three distances. They can be customised to correct short-sightedness, long-sightedness and/or astigmatism, even allowing some people to have normal vision without the need for glasses after the surgery.
Some, but not all, of the costs of cataract surgery are covered by Medicare and also by private health insurance (depending on the type of cover you have). The gap payment will depend on several factors, including your level of private health cover and the replacement lens option you choose.
Unfortunately, due to the variability in patient private health cover and replacement lens selection, it isn’t possible to provide accurate costs of cataract surgery online. Your ophthalmologist will be able to provide you with the full cost during your consultation, once you have chosen your preferred lens option. You will need to contact your private health insurer directly to find out whether your cover includes cataract surgery and if there is any excess.
This is one of the most frequently performed surgical procedures in the world. The surgery involves:
The new lens can’t be felt once placed inside the eye. When a lens is replaced, it is not possible to develop another cataract.
The operation itself takes less than 30 minutes and can be performed in a day surgery or in hospital. At Vision Eye Institute, your procedure will be performed in one of our fully equipped, accredited, state-of-the-art day surgeries.
The latest advance in cataract surgery is the use of a femtosecond laser to complete the first three steps that the surgeon would otherwise perform manually. This is performed in the laser suite and includes the opening incision in the cornea, cutting into the capsule containing the affected lens and breaking up the lens for removal. The remaining steps are completed in the operating theatre.
Using a pre-programmed laser may reduce the risk of complications during and after the surgery, and studies support the benefits of using laser cataract surgery where possible. However, both laser-assisted and traditional cataract surgery are highly successful and generally safe procedures.
Several of Vision Eye Institute’s surgeons reviewed the published data on cataract surgery using the LenSx system, a high-precision, image-guided laser used in several of our clinics, and published their findings in the Clinical Ophthalmology journal. They found that the current LenSx laser system is more advanced, safer and faster than previous versions and laser cataract surgery offers a consistent and precise surgical outcome, which many patients can benefit from. However, patients should always consider the experience of the surgeon in performing laser cataract surgery.
This is also known as clear lens extraction or lens replacement surgery. Using the same technique as for cataract surgery, the dysfunctional natural lens (with no cataract present) is removed and replaced with an artificial intraocular lens (IOL) to correct vision. Most surgeons recommend using a laser when performing refractive lens exchange.
People under 45 are usually not suitable candidates for this type of procedure. This is because the body’s natural lenses are better than any of the replacement lens options that are currently available. A laser eye surgery procedure is usually the better option in these cases. Your ophthalmologist will discuss the vision correction options best for you.
Artificial intraocular lenses (IOLs) are made of soft, flexible plastic and are used to replace your body’s natural lens. They can also be used to correct pre-existing refractive errors, such as short-sightedness, long-sightedness and/or astigmatism (blurry vision due to an abnormally shaped cornea or lens).
There are a number of replacement lens options available – the lens you choose will determine whether you still require glasses for certain activities following surgery.
A premium lens refers to the more sophisticated lenses that offer greater flexibility and individual customisation. Trifocal lenses are a good example of a premium lens. Patients should note that bifocal and trifocal lenses involve some visual compromise, meaning that they aren’t ideal for everybody. If you are quick to notice visual imperfections or don’t mind wearing glasses, monofocal lenses are usually a better choice.
Toric lenses are used to correct astigmatism, where an abnormally shaped cornea or lens causes blurry or distorted vision.
Your ophthalmologist will discuss the advantages and disadvantages of each lens type and help you select the right one for your needs.
Implantable lenses (sometimes called implantable contact lenses) are tiny, flexible lenses designed to be placed semi-permanently within the eye. The lens is inserted via a tiny incision in the cornea – once inside it unravels and sits in front of the natural crystalline lens. Sutures are not required and the eye heals in a few weeks.
This procedure is reversible – the implantable lens can be removed at a later stage should another lens procedure (such as cataract surgery) be required. People who have a high degree of short- or long-sightedness may not be suitable for laser eye surgery. But, if their eyes are otherwise healthy and they are between 18 and 50 years old, implantable lenses may be an option.
These lenses cannot be felt, require no maintenance and can achieve good quality vision. Yearly check-ups are required to ensure that the lens stays in position, the pressure inside your eye remains normal and your natural lens is healthy. The surgery to fit implantable lenses is more involved than that for laser eye surgery so the benefits/risks must be considered carefully before proceeding.
This involves correcting one (usually the dominant) eye for distance vision and the other eye for reading/near vision. When looking into the distance, your brain pays more attention to the eye that is focussed for distance and vice versa when looking at close objects (i.e. your brain relies more on the eye that is focussed for near distance). Overall, the images from both eyes are processed by your brain as one blended image.
Most people who have monovision find that they adjust within a matter of days and many can get rid of their glasses. Before proceeding with surgery, your ophthalmologist will usually get you to trial a set of contact lenses to make sure you can adapt to the change.
Monovision can be achieved using laser eye surgery (e.g. LASIK or ASLA) or artificial lenses (e.g. replacement lenses or implantable phakic lenses).
Cataract and lens surgeries are performed as day procedures at one of our dedicated day surgery facilities. You will receive detailed instructions about fasting and taking medications prior to your surgery.
On the day of your surgery, your pupil will be dilated using eye drops and your eye will be prepped for surgery. You may also be given a mild sedative. A local anaesthetic will be applied to your eye and you will be operated on in the laser suite and/or operating theatre. Once the surgery is complete, a protective cover will be placed over your eye.
You will then be moved to the recovery area and offered something to eat and drink. After resting, you will be able to go home – you will not allowed to drive home or take public transport so remember to arrange for someone to pick you up. You will be discharged with eye drops and instructions on how to use them and also how to clean around your eye. It’s normal to experience some discomfort, including itching, sensitivity to light and a slight discharge. If you have had a previous allergic reaction to eye drops, let your surgeon know.
A follow-up appointment is normally scheduled within 48 hours of the operation to make sure your eye is healing properly.
Once the affected lens is replaced, it is not possible to develop another cataract. However, a further enhancement procedure may sometimes be recommended to achieve even clearer vision.
The most common potential complication of cataract and lens surgery is posterior capsule opacification (PCO), a thickening of the back of the capsule that the lens sits in. This can also cause cloudy vision but is easily treated as an outpatient using a YAG laser and eye drops.
Other complications include dislocation of the replacement lens, inflammation of the eye, sensitivity to light, droopy eyelid (ptosis), swelling of the cornea, bleeding in the front of the eye and swelling of the part of the retina responsible for central vision (macular oedema). Most of these are minor/temporary and can be treated with no long-term effect on vision. Serious complications from cataract surgery are possible but unlikely.
Your doctor will discuss the benefits and risks with you so that you can make an informed decision about surgery.
Our mission is to remain at the forefront of technology and clinical research to ensure the best outcomes for our patients. As the largest provider of ophthalmic services in Australia, we are able to ensure that our clinics are equipped with the latest state-of-the-art technology. The Vision Eye Institute research unit is overseen by a full-time research coordinator. Our ophthalmologists are regularly invited to participate in international trials and present at international conferences.
Vision Eye Institute surgeons were the first in the Southern Hemisphere to use the state-of-the-art LenSx laser to perform laser cataract surgery. Within the first six months of installing this laser, our surgeons had performed the most laser cataract surgeries in the world. They have also published numerous peer-reviewed articles in this area.