Cataract Surgery: Myths, Realities, and Expectations

Cataracts, a common age-related eye condition, affect a significant portion of Singapore’s population, impacting quality of life as we age. While cataract surgery shows high success rates thanks to ongoing advancements in technology, many individuals understandably harbour concerns about the possibility of cataracts returning after surgery.

The National Eye Centre in Singapore reports a 99% success rate in achieving good visual acuity after cataract surgery, a testament to the high standards of care available. However, navigating the array of options and making well-informed decisions can feel daunting. This article aims to empower you on your cataract journey by dispelling myths, explaining potential post-surgery complications, and guiding you toward selecting the most suitable cataract surgeon in Singapore to help you.

Meet our Medical Director: Dr Lim Wei Kheong Jimmy

MBBS, MMed (Ophth), MRCSEd (Ophth), FRCSEd (Ophth), FAMS

The Myth of Recurring Cataracts: Setting the Record Straight

One of the most persistent myths surrounding cataract surgery is the idea that cataracts can grow back. Let’s be clear: this is simply not true. Once the natural lens of your eye (which is where cataracts form) is removed during surgery, it cannot regenerate.  

Think of it like this: during cataract surgery, the cloudy natural lens is removed, similar to removing the yolk from an egg. The lens capsule, a thin membrane that surrounds the natural lens, is left intact, much like the eggshell. This capsule serves as a support structure for the artificial lens implant (IOL).

So, if cataracts can’t return, why do some people experience cloudy vision after surgery? This is where Posterior Capsule Opacification (PCO) becomes a factor. PCO, sometimes referred to as a “secondary cataract,” is not a true recurrence of the cataract. Instead, it occurs when cells left behind during surgery grow on the lens capsule, causing it to become cloudy over time. This can interfere with light passing through to the retina, leading to blurred or hazy vision.

POSTERIOR CAPSULE OPACIFICATION: Signs & Treatment

While PCO might mimic some symptoms of cataracts, it’s crucial to understand that it’s a separate condition with a different cause and a different treatment. Studies indicate that PCO affects approximately 20% of patients within five years of cataract surgery (Source: American Academy of Ophthalmology). 

PCO is a common occurrence after cataract surgery and is not an indication of a failed procedure or a recurring cataract. With prompt diagnosis and treatment, you can regain sharp vision and continue to enjoy the benefits of your cataract surgery.

How can you tell if you have PCO? Be on the lookout for these telltale signs:

• Blurred or hazy vision, making it difficult to see fine details.
• Glare and halos around lights, especially bothersome at night.
• Faded or dull colours, appearing less vibrant.
• Double vision (diplopia), particularly when looking at objects up close.

If you experience any of these symptoms after cataract surgery, consult your ophthalmologist soonest. They will perform a detailed eye examination to confirm the diagnosis and rule out other potential causes.

Fortunately, PCO is easily and effectively treated with a YAG laser capsulotomy. It is an outpatient procedure that uses a highly focused laser to create a small opening in the clouded posterior capsule, allowing light to pass through unimpeded. The procedure typically takes only a few minutes to perform. 

 

Cataract Surgeon Selection: Prerequisites for Good Outcomes

Choosing the right surgeon is a personal decision, and a crucial one for achieving optimal results and peace of mind. 

Before entrusting your vision to a surgeon, it’s essential to confirm their credentials and expertise. Here’s what to look for:

• Accreditation: Verify that your surgeon is accredited by the Ministry of Health (MOH) Singapore and possesses the necessary qualifications and certifications.

• Specialisation: Choose a surgeon with specialised expertise in cataract surgery and a proven track record of successful procedures.
  
•  

• Experience and Track Record: A surgeon’s experience plays a vital role in the success of your surgery. Consider these factors:

• • Surgical Volume: Inquire about the number of cataract surgeries the surgeon performs annually. A higher volume often indicates a wealth of experience.
  • Success Rates: Don’t hesitate to ask about the surgeon’s success rates and complication rates. Reputable surgeons are transparent about their outcomes.
  • Patient Reviews: Seek out online reviews and testimonials from previous patients to get a sense of their experiences.

How Technology Is Continually Improving Cataract Surgery

1. Phacoemulsification

• Advances in Phaco Technology: Improved ultrasound power modulation and fluid control enhance safety and efficiency. (Source: Advances in cataract surgery – Barraquer) 

2. Advanced Intraocular Lenses (IOLs):

• Multifocal and Extended Depth of Focus (EDOF) IOLs: These lenses provide clear vision at multiple distances, reducing the need for glasses after surgery. (Source: Revolutionary Advances in Cataract Surgery: Laser & IOL Innovations – Dr Simon Skalicky)  
• Toric IOLs: These lenses correct astigmatism, further customising vision correction. (Source: Revolutionary Advances in Cataract Surgery: Laser & IOL Innovations – Dr Simon Skalicky)  
• Adjustable IOLs: Still under development, these lenses offer the potential for postoperative adjustments to fine-tune vision. (Source: The Evolution of Cataract Surgery – PMC) 

3. Improved Visualisation and Biometry:

• Advanced Biometry: Improved IOL calculation formulas enhance the accuracy of lens power selection for better refractive outcomes. (Source: The Evolution of Cataract Surgery – Space Coast Ophthalmology)  

These advancements have transformed cataract surgery into a highly sophisticated and successful procedure, offering patients improved vision, faster recovery, and reduced dependence on glasses.

Cataract Surgery In Singapore

The cost of cataract surgery in Singapore varies depending on several factors, including:

• Type of IOL: Premium IOLs, such as multifocal or toric IOLs, generally cost more than standard monofocal IOLs.
• Surgical technique: Femtosecond laser-assisted cataract surgery (FLACS) may have a higher cost than traditional surgery.
• Hospital and surgeon fees: Fees can vary based on the hospital and surgeon you choose.
• Insurance coverage: MediShield Life and private insurance plans can help cover some of the costs.

Most patients experience a relatively quick recovery after cataract surgery. You can typically expect to return to most normal activities within a few days. However, complete healing may take several weeks.  Your surgeon will provide you with specific post-operative instructions to ensure a smooth recovery.

• Cataract surgery is generally a safe procedure with a high success rate. Although, like any surgery, it carries some potential risks and complications, including:
• Infection: This is rare but can be serious.
• Inflammation: Some degree of inflammation is normal after surgery, but excessive inflammation can cause discomfort and vision problems.
• Posterior capsule opacification (PCO): As discussed, PCO can occur months or years after surgery but is easily treatable with a YAG laser capsulotomy.

You can usually resume most normal activities, such as reading and watching TV, within a few days after surgery. Your surgeon may advise you to avoid strenuous activities, swimming, and rubbing your eyes for a few weeks.It’s imperative to follow surgeon’s instructions regarding driving and other activities that require clear vision.

Here at JL Eye Specialists, we understand fully that each patient comes with their unique concerns. We customise our approach to ensure that we provide each patient with the appropriate treatment to address their needs. Please do note that this blog is intended for educational and informational purposes only. It does not substitute for professional medical advice from a qualified healthcare provider. If you or anyone you know needs help and medical guidance with cataracts, please feel free to  schedule a consultation or call us at 6258-8966.