Cataract Surgery

What is a cataract?

Conventional cataract Surgery

Laser Assisted Cataract Surgery (LACS)

What is a cataract?

A cataract is an opacity or mistiness in the lens within the eye. The lens is located immediately behind the iris or coloured part of the eye and it helps to focus light on the retina at the back of the eye. The lens should be transparent (like clean glass) but if a cataract forms it loses transparency and interferes with the passage of light through that lens (imagine looking through a dirty windscreen at interferes with the passage of light through the lens (imagine looking through a dirty windscreen at sunset). Cataracts often form slowly and visual changes may not be noticed. Once it is removed the improvement can be dramatic. 

Different sorts of cataracts can produce different symptoms. Glare sensitivity and blur are most common. Sometimes the cataract can cause the spectacle prescription to continually change, necessitating regular updates of your glasses.
It is no longer true that the cataract needs to be "ripe" before it can be removed. As soon as symptoms start to interfere with your enjoyment of life, an opinion should be sought to determine if removal of the cataract is likely to be of benefit. If you are unsure, you should have your eyes examined to see if a cataract is affecting your vision. Many people think that their eyesight is “OK for someone my age”. It may be there is a cataract present and removal could make life both easier and safer.

Cataract surgery is required to remove cataracts. It is performed under local anaesthetic with sedation provided by a specialist anaesthetist. Conventional cataract surgery is the standard of care in Australia and is by far the commonest way the surgery is performed. Laser assisted cataract surgery (LACS) is also available.

Conventional cataract Surgery

Cataract surgery involves removing the cloudy natural lens and replacing it with a clear plastic lens. This is done through a tiny incision, often smaller than 2.5 mm. The cloudy lens is broken up using ultrasound and sucked out of the eye. A special lens, tailored to your specific needs, is placed in the space where the old lens was. New technology allows this lens to be folded, rather like a taco, so that a lens 6 mm in diameter can be inserted through a 2.4 mm incision.

The new plastic lens can neutralise your pre-existing spectacle prescription, including astigmatism. This will reduce your dependence on glasses. You may still need to wear reading glasses, but even this can be addressed with the newer premium intra-ocular lenses. Ask if your eyes are suitable for this technology.

All cataract surgery performed by NBEC surgeons is microsurgery using an operating microscope. It is micro-incision, sutureless surgery with injectable intra-ocular lenses. We use laser interferometry to measure the eye which is accurate to 1/100th of a millimetre and we routinely use three formulae to do the calculation of lens power to act as a cross check. The results are loaded into a special computer programme for audit and analysis to ensure that we continually are striving for ever more accurate outcomes. 

The latest advance in cataract surgery is laser assisted cataract surgery (LACS). Read more.

Laser Assisted Cataract Surgery (LACS)

Laser Assisted Cataract Surgery (LACS) is now available. The first femtosecond laser has been installed in Victoria and a small group of surgeons have trained to use it. Dr Workman was the third surgeon in Victoria to perform laser assisted cataract surgery.
A femtosecond is one thousand million millionths of a second – about the time that a beam of light takes to cross a human hair. A femtosecond is to a second, what a second is to 32 million years! By using such a short pulse duration, very high powers are achievable with low energy, making the laser safe and accurate. It fires about 200,000 times a second.

Conventional cataract surgery using ultrasound is still the standard of care, but laser assisted cataract surgery raises the accuracy appreciably. It replaces several steps previously performed by hand. It has been shown to improve safety, accuracy, predictability and stability. There are fewer internal optical aberrations following laser assisted cataract surgery compared to conventional cataract surgery.

It is especially valuable when premium intra-ocular lenses are used, such as those that correct astigmatism or multi-focal lenses.

See a real laser being performed