Things to know before choosing cataract surgery
BEFORE you make a decision on whether to have cataract surgery there are several issues you should become familiar with.
Because you have cataracts doesn't mean you have to have surgery says cataract and retinal surgeon Dr Simon Chen from Vision Eye Institute. He suggests glasses may be a solution, to start, but once the cataracts reach a certain point where you no longer have the quality of vision that you want, then it's probably time you have surgery to remove them.
An eye specialist will talk you through the pre-surgery steps. They will look at what level of vision you have and your lifestyle to determine if you need to have cataract surgery. You will also be assessed for suitability based on your general health, whether you have other issues with your eyes and what is the cause of the cataracts.
"Most cataracts are typically related to age," Dr Chen said. But sometimes they can be related to underlying health conditions which will influence the treatment choice.
Pre-surgery eye health
If you have the common problem of dry eyes, the accuracy of the critical measurements being taken pre-surgery can be affected, so a specialist is likely to treat that condition firstly.
"When you have cataract surgery we take a range of measurements and they are used to calculate the power of lens that is going to be put in your eye, like a pair of glasses, but it goes inside the eye permanently," Dr Chen said.
There are two choices of surgery - manual or laser-assisted.
With the commonly used manual operation the surgeon uses a scalpel to make an incision into the eye and then uses other devices to remove the cataract.
"Even the best surgeon in the world when they have a blade in their hand, not every operation is going to be exactly the same," Dr Chen said. "So, there is a little element of unpredictability in surgery no matter how good the surgeon is."
In laser-assisted surgery the first few key steps are performed by computer guided laser. "It removes some element of human error," Dr Chen said. It also increases the predictability of the surgery outcomes.
The choice of this laser surgery is often limited by cost and availability.
Many seniors have both cataracts and macular degeneration. "If you have macular degeneration, that will limit the improvement you get (from surgery)," Dr Chen said. "Even if you have a perfectly performed operation, you will probably see a lot better, but you may not see perfectly afterwards. It's important to ask your surgeon what sort of outcome you are expecting."
"For a lot of people who have additional eye conditions such as glaucoma or macular degeneration, there is increasingly a wide range of different procedures we can do at the same time as cataract surgery," Dr Chen added.
There is no one-size when it comes to lens choices. It comes down to what is your lifestyle.
The most common choice is long distance vision with glasses worn for reading. Or you can choose a reading lens and then wear glasses for long distance. The third choice is a multifocal lens so no glasses are required, but there are limitations with your sight at night when driving.
"Not any good ones," Dr Chen said. He adds those on offer can't reverse the cataract nor stop them getting worse.
It may be possible to delay cataract surgery and choose to update your glasses and change your lifestyle such as stop driving or stop working.
"Once it starts to deteriorate and it starts to have a negative impact on your quality of life, then you should consider surgery," Dr Chen said. "The longer you leave it, the more advanced the cataract becomes and so the higher the risk of complications during surgery."
Dr Chen said cataract surgery is a very common and for many seniors, it's almost inevitable the surgery will be needed. He believes after surgery a person's quality of life improves, there is less likelihood of falls and the opportunity to maintain an independent lifestyle increases.