Dr. Natasha Lim Eye Centre – Laser Cataract & LASIK Surgery Singapore

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Laser Cataract and Traditional Cataract – Which is better for me?

Laser Cataract surgery is one of the most common and successful operations performed today with about 50,000 cases per year in Singapore. For a certain subset of patients, however, bladeless laser cataract surgery has some advantages. So, how do you know which type of cataract surgery is right for you? Here are five facts about both types of cataract surgery that you probably didn’t know.

Consult your ophthalmologist to decide which is best for you. Do seek the advice of an eye surgeon who has the skills and facility for both types of cataract surgery in order to discuss unbiasedly on their pros and cons.

1. How Cataract Surgery as it is known (Phacoemulsification) is performed and its benefits

Traditional cataract surgery in Singapore is known as Manual phacoemulsification. Most people do not know this but with a knife, the cataract surgeon makes a tiny incision in your cornea. Next, the surgeon uses a needle to make an opening on the lens capsule inside the eye.

The cataractous lens is enclosed inside the lens capsule. After the circular opening on the lens capsule has been made, a pen-shaped ultrasound probe is inserted into the eye. The cloudy lens is cut up by the probe inside the eye into several pieces, and the broken fragments are sucked out of the eye. Finally, an artificial intraocular lens (IOL) is inserted into the eye.

Phacoemulsification Benefits

  • Effective
  • Safe
  • Cost-Effective

2. How Cataract Surgery Without Blades (Bladeless Femtosecond technology) is performed and its benefits

The FDA-approved (2010)  Femtosecond laser Cataract device uses the same femtosecond technology that is used in iDesign bladeless iLASIK. Integrated optical coherence tomography (OCT) is used in the method to obtain accurate, high-resolution images of the patient’s eyes so that from the start to the finish of the surgery, there is real-time scans monitoring the depth and length of the lens that is being cut by cold femtosecond laser. 

It allows the eye surgeon to prepare and tailor each procedure based on the specific characteristics of the patient’s eye using real-time image guidance. Many steps in cataract surgery that were traditionally performed by human hands such as the knife making corneal incision, needle inside the eye making the lens capsule opening, manual cutting of the lens into several pieces, have been replaced by the bladeless femtosecond laser. As the cuts are customised to the dimensions of the cataractous lens and the lens capsule, this results in less surgical error and greater predictability of outcomes. The results for final intraocular lens implant position inside the eye are more accurate than any previous or current cataract surgery procedure. The latter affects end result as the better the centration of the lens implant, the better the visual quality achievable.

The femtosecond laser is used by eye surgeons to make corneal incisions, produce a flawless capsulotomy, and soften and divide the cloudy cataract lens, all 100% blade-free. As less energy is used, recovery is quicker and surgical outcomes more precise.Bladeless laser cataract surgery is performed by few Ophthalmologists  in Singapore due to high equipment cost and steep learning curve.

Bladeless Surgery Benefits

  • Cataract removed quicker and requires less energy resulting in faster visual recovery
  • Corneal cuts that are more accurate
  • Architecturally more centred and round openings for improved lens implant centration.
  • Helpful for complicated cases such as extremely mature cataracts or those with unstable lens capsule etc..

Note: Bladeless cataract surgery is ideal for the majority of people, with the exception of those who have corneal scars or poorly dilating pupils.

Bladeless Surgery Disadvantage

  • High Cost of the laser and procedure.
  • Steep learning curve hence fewer providers.
  • Disposables for surgery

3. Cataract Treatment in the 21st Century and steps for treatment

Medication or eyeglasses are not able to cure or fix a cataract. Surgical removal of the cloudy cataract lens is needed. Cataract surgery is the most common surgical procedure in the world, and it is generally considered to be both safe and successful. Most people think that after the surgery you just go home but actually no, you will have to get checked to see if the eye is healing as well as to check for any complications.

Step 1: Preparation for Surgery

To calculate the intraocular lens correctly, measurements of your eyes are taken.

Step 2: Surgery on an outpatient basis

A local anaesthetic, such as eye drops and injections, is used in a same-day treatment.

Step 3: Visits to Follow-Up

The first day after surgery, and then for about a month, if necessary

Step 4: Typical Observation Your eye doctor (lasik surgeon) can examine you on a regular basis.

4. Some of the risks associated with cataract surgery and how it can be treated successfully

After cataract surgery, complications are rare, and the majority of them can be treated successfully however there are still some risks you may not be aware of. These complications occur in less than 1%.

Risks

  • Detachment of the retina
  • Bleeding
  • Infections may develop
  • Swelling of the cornea or macula
  • Artificial lens dislocation
  • Eyelids start to droop
  • Inflammation
  • Glaucoma
  • Visual loss

5. Causes of blurred vision and cataracts

What Exactly Is A Cataract?

cataract is a clouding of the lens of the eye, which is usually translucent. Cataracts are hidden within the eye and can only be seen with a special microscope.

As a result, they have little impact on the appearance of the eye and cause no discomfort. Changes can be so subtle that you are unaware of the impact of a cataract at first.

  1. Causes of blurred vision

A cloudy lens inside the eye causes blurred vision in the same way as fingerprints on a camera lens cause blurry pictures regardless of our attempts to focus. A cataract occurs when the human lens becomes cloudy or hazy to the point of obstructing vision. The blur caused by a cataract will not be helped by adjusting glasses (focus).

  1. Causes of Cataracts

Birth defects, trauma, diabetes, and long-term use of some drugs, such as steroids, may all cause cataracts. Cataracts can grow in patients who are extremely nearsighted at a younger age. The majority of cataracts, on the other hand, are caused by the human lens’s normal aging process. Cataracts, like grey hair, do not affect everybody at the same age or at the same pace.

If you have any severe eye disorder or a severe medical problem such as very poorly controlled diabetes or hypermature cataracts, the chance of complications may be higher. In cases of very severe underlying eye damage from conditions such as glaucoma or macular degeneration, cataract surgery may sometimes fail to improve vision. Before deciding on cataract surgery or getting cataract surgery in Singapore, it’s a good idea to assess and treat other eye conditions if at all possible. Ensure that your eye doctor provides near post-surgery follow-up to ensure that your eyes regain full vision quickly and that your recovery goes smoothly. 

Not all cataracts require surgery. They will, however, continue to evolve and impair your vision if left untreated. Get medical attention to determine the seriousness of the cataracts.