Cataract Surgery

Cataracts is the age-related clouding of the natural lens in our eyes. Once cataracts develop, they can cause significant vision problems that affect daily activities. This can include blurred vision, difficulty seeing in low light, and increased glare/haloes.

How it Works

Cataract surgery is a highly safe and effective procedure. It is also painless. In fact, it is the most common surgery in the world, with millions of cases performed each year! The surgery involves removing the cloudy lens and replacing it with artificial intraocular lens (IOL) to restore clear vision. These artificial lenses can also be ‘customized’ to your eyes, taking your glasses prescription into account, to help you lessen or even eliminate the need for glasses after surgery.

The most common method for cataract surgery is phacoemulsification, which uses ultrasound waves to break up the cloudy lens in smaller fragments, which are then suctioned out. However, a more advanced technology, called Laser-assisted cataract surgery (LACS), which uses ultra-short pulses of laser energy, can also help perform certain aspects of the cataract surgery procedure. LACS can reduce the amount of ultrasound energy used during cataract surgery and also address astigmatism more reliably. Ultimately, LACS aims to enhance precision, predictability, and safety of cataract surgery, leading to improved postoperative vision.

Steps for Cataract Surgery

When I'm not in the operating room or immersed in research, I relish quality moments with my loving family and friends. Sports are my jam, with soccer and tennis being my favourites. I also can't resist the thrill of exploring the world through travel, photography, and deep-sea diving.​

1. Preoperative Assessment:

A comprehensive eye examination and testing is conducted to measure the size and shape of the eye, determine the power of the IOL needed, and assess overall eye health.

2. Anesthesia:

Cataract surgery is typically performed under local anesthesia, which numbs the eye. Patients may also receive a mild sedative (via the veins or via an oral pill) to help them relax.

3. Cataract Surgery:

Cataract surgery (+/- LACS) is performed to break up and remove the cloudy lens. An artificial lens is inserted through a small incision and is positioned in the eye to replace the natural lens and restore clear vision.

4. Postoperative Care:

Patients are monitored for a short period after surgery and are prescribed eye drops to prevent infection and control inflammation. Vision recovery is usually quick, within days. However, full recovery and vision stability may take a few weeks; Most people are fully functional during this period.

Safety

Generally, cataract surgery is highly safe and effective, but like any surgery, there are potential risks and complications. The risk of complications is often related to the severity of cataracts, but also other underlying ocular or systemic conditions. The surgeon considers the patient's overall health and medical history to assess the risks and benefits of the surgery. It is therefore crucial to consult with an eye care professional to determine if cataract surgery is right for you, based on your unique circumstances and vision goals.

Intraocular Lens Options

Monofocal IOL
What it Does:

This lens helps you see clearly at one specific distance. It's like having a camera set to focus on one specific thing – either far away or up close, but not both.

Benefits:
  • After surgery, your vision (typically for distance) will be very good and predictable

  • Less risk of glare and halos

  • Suitable for patients with other co-existing eye diseases (age-related macular degeneration, glaucoma, diabetes in the eyes)

  • Ideal for those who prioritize vision quality rather than glasses independence

Limitations:
  • You will likely still need glasses for some things (typically readers)

Toric IOL (Astigmatism)
What it Does:

This lens not only clears up cataracts but also fixes any blurry vision caused by astigmatism. Astigmatism is when the front part of the eye, called the cornea, is curved differently in one direction than in the other (shaped more oval like a football rather than round like a basketball).

  • All types of IOLs have a toric version that helps correct for astigmatism

Benefits:
  • Toric lens can correct astigmatism, improve those distorted images and help you see more clearly without glasses

Limitations:
  • slightly increased cost, but otherwise none

Monofocal + IOLs
What it Does:

These lenses are primarily focused on the distance, but do provide a little extra boost for seeing at intermediate (arm’s length vision).

Benefits:
  • Enjoy better vision for everyday tasks, with less need for glasses for activities like computer use or seeing the dashboard of a car.

  • Minimal glare and haloes compared to multifocal IOL’s

  • Can be combined with monovision (see below) to improve glasses independence even further

Limitations:
  • If both eyes targeted for distance: You will likely still need glasses for near work (reading, cellphone etc).

  • If monovision: may take some time to adapt to the slight difference in vision between the two eyes (one for far, one for near)

Extended Depth of Focus (EDOF) IOLs
What it Does:

This lens is like having a broader focus range – you can see far, mid-range, and sometimes up close without needing lots of glasses.

Benefits:
  • Less dependence on glasses than monofocal lenses

  • Less glare or halos compared to multifocal lenses

Limitations:
  • You might occasionally still need reading glasses

  • Occasional glare and haloes

Trifocal IOLs
What it Does:

Multifocal IOLs are designed to provide clear vision at different distances, thus potentially reducing or eliminating the need for glasses.

  • Multifocal IOLs have different zones with varying prescriptions, whereby each zone focuses light at a specific distance: near, intermediate, and far

Benefits:
  • Increased independence from glasses and contact lenses in daily activities

Limitations:
  • Increased risk of glare, halos or reduced contrast sensitivity, especially in low-light conditions. This can affect the overall quality of vision

  • May not be suitable for individuals with certain eye conditions, such as macular degeneration or corneal irregularities

Light Adjustable Lens (LAL)
What it Does:

This innovative lens allows for fine-tuning AFTER surgery to give you the clearest vision possible.

  • The LAL can be adjusted with a special light, allowing for prescription changes as desired. This will enable you to “test-drive” and ultimately choose the vision that fits your lifestyle and preferences before locking it in

Benefits:
  • This lens can be customized just for you, and adjustments are made to get your vision exactly right

  • The most results for patients who have previously had laser refractive surgery (LASIK, SMILE, PRK, RK) or have irregular corneas (keratoconus, corneal scars)

  • Excellent quality of vision for the chosen distance (far or near)

  • Monovision can be adopted to minimize the need for readers

Limitations:
  • A period of post-op healing/stability (usually 3-4 weeks) is required before light adjustments can be performed

  • In order to prevent unexpected changes to vision during the healing period from accidental exposure to UV light, patients are required to wear special UV-blocking glasses for a few weeks until the adjustment process is complete.

Not sure which option is right for you? Check out more surgery options and see what you may be a candidate for.