Pros and Cons of Cataract Surgery

Is blurry or cloudy vision making everyday tasks more difficult?

You’re not alone. Cataracts are one of the most common age-related eye conditions, affecting many older adults in Singapore. Over time, the eye’s natural lens becomes cloudy, causing blurred vision, faded colours, and difficulty seeing clearly—especially in bright light or at night.

The good news is that cataract surgery is a clinically proven and widely performed procedure that can help improve visual clarity. Modern techniques have made the surgery more precise and efficient, allowing many patients to regain clearer vision and enjoy daily activities more comfortably.

However, although the procedure improves visual acuity in up to 99% of patients, it can also lead to complications. Serious complications from cataract surgery are rare, occurring in about less than 1% of cases.

This article explores the benefits and possible risks of cataract surgery, offering insights to help you make an informed and confident decision about your eye health.

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The Evolution of Cataract Surgery Technology

The pioneering work by Charles Kelman in 1967, which introduced phacoemulsification, marked a revolutionary shift in cataract surgery. This method uses ultrasound to fragment the lens into miniscule bits, to be extracted through a tiny cut—dramatically reducing incision sizes from 10mm to less than 3mm. Today’s procedures leverage advancements in fluidics and phacodynamics to enhance precision and outcomes.

Patients now benefit from a wide array of intraocular lens (IOL) options, including mono-focal, toric, multifocal, trifocal, extended-depth-of-focus (EDOF), and Eyhance IOLs. These choices cater to individual vision correction needs, often eliminating the dependency on prescription glasses post-surgery.

The global impact of cataract surgery is profound, with over 500 million procedures performed since 1995, significantly improving the quality of life for approximately 130 million people. In Singapore, the safety and efficacy of these surgeries are well-documented, with 25,000 cases performed annually.

Looking ahead, the integration of artificial intelligence (AI) and virtual reality (VR) technologies promises to further enhance surgical accuracy and patient care. AI, for instance, is being explored for its potential to provide surgeons with real-time, precise information during procedures, improving outcomes. 

Step-by-Step Cataract Surgery Process: What Happens Before, During, and After Surgery

Cataract surgery is a day surgical procedure, which means patients can go home on the same day. However, they should arrange for transportation since driving is not recommended immediately after surgery.

The process begins with administering anaesthesia to ensure the patient’s comfort; a sedative may also be provided to help them relax, as they will be awake during the procedure.

An eye surgeon then views the eye under a special microscope and creates small incisions at the edge of the cornea using a fine blade. This step allows access to the lens. The surgeon breaks the clouded, cataract-affected lens into tiny pieces and removes them through suction.

An artificial lens is then implanted in the eye. The incisions made are self-sealing, healing naturally without the need for stitches. Post-surgery, the eye is shielded for protection, aiding the healing. Patients have a short recovery and can usually leave for home on the same day.

Why You May Need Cataract Surgery: 3 Common Reasons

Cataract surgery offers significant benefits, including long-lasting results, minimal downtime, and a high success rate. The procedure permanently removes cataracts, ensuring the clearer vision that resulted from the surgery is maintained over time, barring any unrelated eye conditions. 

Most patients enjoy a quick recovery, often resuming daily activities within a few days, with the surgery’s efficiency minimising disruption to personal and professional life. Additionally, the procedure’s reliability and safety, backed by a high success rate, make it a preferred treatment for restoring vision.

1. To Improve Eyesight: The primary goal of cataract surgery is to treat cataracts and replace the clouded lens with a clear artificial lens to restore clear vision. Your eye specialist may recommend cataract surgery if your vision impairment affects daily tasks such as reading, driving, or watching television. The process will improve your vision significantly.
2. For Patient’s Safety: Cataracts impair vision and increase the risk of accidents and falls, especially among older adults. Among other benefits, cataract surgery allows patients to return to their daily activities and live more independently.
3. Better Quality of Life: Visual impairment due to cataracts can hinder daily activities such as reading, driving, social activities, and enjoying hobbies. A successful surgery improves both the physical and emotional health of patients, helping them enjoy life more fully.

What Are the Risks of Cataract Surgery?

While cataract surgery is generally safe and successful, understanding its potential risks is important because all surgeries carry some level of risk. Some of the most common risks are:

• • Uneasiness or Discomfort. After cataract surgery, some patients may experience these, manifesting as a foreign body presence in the eye, mild irritation, or fluctuations in vision clarity during the recovery period. While these symptoms are often temporary and resolve as the eye heals, they can cause temporary discomfort for some individuals following cataract surgery.

• • Infection. Although rare, the infection can occur after cataract surgery. Proper pre-operative preparation and post-operative care can significantly reduce this risk.

• • Inflammation and Swelling. While most inflammation after routine cataract surgery is minimal and resolves relatively quickly, persistent inflammation is a complication reported in 0.24% to 7.3% of cases, according to a report by Review of Ophthalmology. Swelling of the cornea or retina can also occur, temporarily affecting vision. However, it typically resolves with medication prescribed by the surgeon. Patients with more extensive, denser and firmer cataracts are more likely to experience more inflammation.

• • Blurred Vision. Experiencing blurry or unclear vision in the days and occasionally weeks following cataract removal is quite common.

• • Dryness or Irritation. Following tissue healing, dryness and itchiness are typical. The patient may notice itching, grittiness, or dryness in the eyes. Depending on the assessment, the doctor may use lubricating eye drops to alleviate these symptoms.

• • Pressure in the Eye. Approximately half of individuals undergoing cataract surgery may encounter a temporary rise in eye pressure post-procedure, although these levels typically normalise within 24 hours. Persistent issues concerning elevated or reduced eye pressure following surgery might be associated with other eye conditions, such as glaucoma

Cataract Surgery in Singapore

If you are considering cataract surgery, it’s wise to seek advice from an eye surgeon with ample experience, and who can provide guidance tailored to your specific needs. Additionally, familiarise yourself with the surgery process, from pre-operative preparation to post-operative care, to have a grasp of what to expect at each stage. Your doctor should discuss the potential risks and benefits of the surgery and address any questions or concerns you may have.

JL Eye Specialists, a well-regarded clinic in Singapore, has a successful track record in cataract surgery and other eye services. We provide comprehensive care that spans initial evaluations to post-operative follow-ups, ensuring personalised attention for each patient throughout their treatment. 

Our Medical Director, Dr. Jimmy Lim, is an experienced ophthalmologist with extensive experience in cataracts, refractive surgery (LASIK), and corneal conditions. Having held senior consultancy and deputy head roles at the National Healthcare Group Eye Institute, and completed fellowships in the US and Switzerland, Dr. Lim brings over 20 years of practice and a wealth of knowledge to the clinic. 

If you have concerns about cataract, we encourage you to schedule a consultation or call us at 6258-8966 so we can better assist you.