Cataract

Cataracts, which usually form slowly over a few years, cause gradual vision blurring. Thus, corrective glasses are not sufficient for visual correction. In some cases, the deterioration of vision is rapid. Cataracts may also cause glares and the formation of multiple images in the retina of the affected eye, markedly affecting visual acuity and complicating daily activities, such as reading, driving, and recognising faces.

Cataracts are diagnosed by ophthalmologists during routine eye examinations. To confirm the diagnosis, the following examinations can be performed:

• Visual acuity test to indicate the sharpness of vision.
• Slit-lamp examination to closely examine the structures at the front of the eye (cornea, iris, lens) and spot abnormalities in the lens that may indicate cataracts.
• Retinal exam, where the doctor dilates the pupils with special eye drops to examine the retina using a slit-lamp or ophthalmoscope for identifying cataracts and assessing any damage to the retina.
• Refraction and contrast sensitivity tests to measure how the cataract is affecting vision and to check for other refractive errors, such as myopia, hyperopia, or astigmatism.

Currently, automated eye surgery, one of the most prolific hallmarks of advanced eye care, represents the primary method for treating cataracts (to remove the cataract). During the cataract surgery, the natural lens, which has turned cloudy and opaque, is replaced with an intraocular lens (a clear, artificial lens). This is a safe, painless, and routine outpatient surgery. Cataract surgeries are performed on a day-care basis, where the admission, surgery, and discharge happen on the same day. Cataract surgeries are of the following two types:

• Refractive surgery: This is the most common cataract treatment. It involves a refractive lens exchange operation to replace the cloudy lens with an intraocular lens. The procedure is quick, takes 20–30 minutes, and can greatly improve vision.
• Laser cataract surgery: For this procedure, a femtosecond laser is used to partially break down the cataract. The subsequent procedure is similar to that of conventional (non-laser) cataract surgery. Currently available evidence shows that both conventional and laser cataract surgery are equivalent in terms of vision and safety.

In recent years, precision surgery, such as that using the Alcon Lens Laser (a cutting-edge technology used in ophthalmology for precise and automated cataract surgery), and advanced robotic surgery have also emerged as efficient surgical modalities for cataract removal. These advanced techniques are associated with high accuracy and rapid treatment and recovery, resulting in reduced levels of stress for patients, increased levels of comfort, and enhanced cataract surgery outcomes.

Cataract surgery recovery durations differ for every person. Usually, outpatient recovery is possible. Most patients recover quickly within approximately 3–4 days. During recovery, it is normal for vision to take a few days to improve. The eyes may also be sore, scratchy, and light-sensitive. Antibiotic and anti-inflammatory drops are initiated the day after surgery. Patients can return to work a few days after surgery. However, if a job is physically demanding, recovery may require a longer duration. The treating physician determines the recovery duration.

Once the cloudy (cataractous) lens has been removed in surgery, it does not recur. However, after a few months or years after cataract surgery, the thin membrane behind the new lens implant (posterior capsule) may become opaque. This creates a “filter effect” and can cause the deterioration of vision. A simple laser treatment (YAG laser capsulotomy), which is usually an outpatient procedure, can be performed to clear this membrane and restore vision.