What Is Cataract?
Cataract is the clouding of the clear natural lenses inside the eyes. It blocks or scatters the light entering the eye, resulting in impaired vision. Statistics show that more than 60% of eyes have cataracts by age 60, and by 75, about 95% of eyes have cataracts.
How Do You Know If You Have A Cataract?
Symptoms of cataract include:
- Blurred vision
- Glare or haloes around bright lights
- Reduction or loss of colour perception
- Difficulty with vision at night or in dim light
- Spectacle prescription changes but glasses no longer improve the vision to a normal standard
Cataract develops slowly and is often not noticed initially. However, the vision will be affected and may become fuzzy over time. Colours might appear less vivid and washed out. At least 20% of cataracts get worse after a year and 65% worsen over 5 years.
What Is The Treatment For Cataract?
Cataract cannot be treated with medication, thus the only treatment option for cataract is surgery. Cataract surgery is one of the most common elective surgical procedures done worldwide and takes about 15 minutes only. It is typically performed on an outpatient basis and does not require an overnight stay in hospital. In about 90% of the cases, people who has cataract surgery have better vision afterward. In recent years, advances in technology are unleashing a new age where artificial intelligence (AI) is applied in cataract treatment with the introduction of the 100% Bladeless Femtosecond Laser Cataract Surgery and Computer-Guided Intraocular Lens Implantation technology.
Traditional Manual Phacoemulsification Cataract Surgery
Traditionally, for more than 50 years, all incisions are made manually by surgeons with knives and sharp instruments inside the eye. It is followed by ultrasonic energy to aspirate and remove the cataract. Though the incision size is now a lot smaller (around 2.8 mm) than it used to be 50 years ago, certain aspects of manual phacoemulsification are still performed with limited precision and still has room for human errors to occur which might cause vision loss.
Schematic diagram of the standard manual cataract surgery.
The surgeon uses a knife to make a corneal incision. A sharp micro-forcep enters the eye to tear the capsule surrounding the cataract (Capsulorrhexis). The cataract is then sculpted manually using higher ultrasound energy levels. A clear intraocular lens is implanted to the capsular bag to correct vision of patient after surgery.
Advanced Cataract Surgery – 100% Bladeless Femtosecond Laser Cataract Surgery & Computer-Guided Intraocular Lens Implants
Femtosecond laser involves the emission of optical pulses within an extremely short duration in the domain of femtoseconds, as short as one-quadrillionth of a second (10-15 sec) duration. The use of femtosecond laser in modern advanced cataract surgery allows precision cutting of tissues with cold laser only, no knives or any sharp instruments inside of the eye involved. Dr Natasha Lim, in association with NOVENA Bladeless Cataract Surgery & Eye Specialist Centre, are the first clinic in Singapore to offer a start-to-finish, fully automated and computer-guided cataract journey by using the combination of ZEISS Callisto Eye® and CATALYS® Femtosecond Laser. This 100% bladeless cataract surgery technique safeguards some of the most traditionally challenging steps of the cataract surgery and improves on the effectiveness, precision, safety and outcome of manual phaco-emulsification cataract surgery. This method enables Dr Natasha Lim and her team to create a 3D blueprint of your eye and plan a treatment that’s personalized for you.
Uniqueness of Advanced Cataract Surgery
Integral Guidance Technology @ CATALYS®
Achieve excellent outcomes with automatic surface-mapping and guided-delivery maps surface using anatomical landmarks. Precisely positions the incision orientation and depth, including safety zones, based on the treatment plan, once all relevant structures have been mapped.
Real Time 3D Optical Coherence Tomography (OCT) @ CATALYS®
Delivers real-time visualization of the eye without disruption through the entire treatment plan. Performs > 10,000 individuals A-scans to capture high-resolution data for the full volume of the anterior segment. Completed scans provide the axial and sagittal cross-sections, enabling precise landmark and incision positioning. Automatic tilt detection further optimizes lens fragmentation.
AXIAL AND SAGITTAL CROSS SECTIONS
LENS TILT CAPTURED
Novel Liquid Optics Interface @ CATALYS®
Clear optical path for precise imaging and laser treatment by filling in corneal surface’s irregularities with liquid. Gentle dock for patient with minimal haemorrhaging and intraocular pressure (IOP) rise. No corneal distortion or induced folds.
Computer-Guided Lens Implantation @ ZEISS CALLISTO Eye®
Transfers all preoperative data from the IOL Master 700, thus reducing procedure time and eliminating transcription errors. Eliminates the need to manually mark the eye and ensures proper alignment of overlays with the built-in eye registration function, regardless of eye movement and rotation. Provides accurate centration and alignment of both the Capsulorrhexis and the IOL.
Benefits Of Advanced Cataract Surgery
Planned specifically for your unique eye
Aligned precisely and delivered accurately
Easy preparation and procedure
Each step delivered in a matter of seconds
Reduced risk of intraoperative complications
When Should I Undergo Cataract Surgery?
The time to consider cataract surgery is when the effects of cataract start to interfere with your daily activities. When your quality of life starts to be affected, you should undergo cataract surgery to restore your vision. At the same time, it is also a golden opportunity for you to correct any pre-existing myopia (short-sightedness), hyperopia (long-sightedness), presbyopia (“lao hua”) and astigmatism. In the hands of Dr Natasha Lim and her team, these refractive errors can be completely treated or reduced to enable spectacle freedom post-operatively.
What Affects The Outcome Of Your Cataract Surgery?
- The skills and expertise of the surgeon
- The accuracy of measurements and calculations of the lens implant power (biometry)
- The types of lens implant used
- The cataract surgery equipment and technology used
- The co-operation of the patient during the procedure
- The natural healing process of the eye itself
- The presence of other eye diseases may affect the prognosis of cataract surgery
Financial Concerns for Cataract Surgery
It is undebatable that bladeless femtosecond laser cataract surgery is superior to manual phacoemulsification and the only concern is the cost. At Dr Natasha Lim Eye Centre, there will not be a very big price difference between manual phacoemulsification and bladeless femtosecond laser cataract surgery because we have our own in-house Ambulatory EYE Surgery Operating Theatres, therefore the prices are not inflated.
According to the guidelines by Ministry of Health (MOH) Singapore, the maximum withdrawal limits for cataract surgery (under table code 4A) is SGD 2,450.00 per eye. MediShield Life claim limits are subjected to the Schemes And Subsidies guideline from MOH, which differs on individual basis. Our eye centre will help patients do electronic-fillings after their surgery to claim personal insurance (if any) and the percentage of coverage depends on the type of insurance policy plan that each patient holds onto.
Treatment of Meibomian Gland Dysfunction can improve Cataract Surgery outcomes
Authored by: Dr Natasha Lim