Health - Countering cateracts

By: Mark Donaldson

Over the last decade, many locals have benefited from having their cataract surgery reliably undertaken at the Rodney Surgical Centre. Since cataract surgery commenced in Warkworth in 2010, there have been quite a few refinements. Ten years ago, all surgery was done using a local anaesthetic injection, which meant there was a small but uncomfortable wound to heal in the skin of the eye and often temporary uncomfortable double vision. These would resolve with time, however it meant that an eye patch was necessary for the first day.

The local anaesthetic injection is used infrequently now. Instead, the eye is put to sleep by applying a local anaesthetic jelly. Because of this refinement in anaesthesia there is no double vision and no eye patch. In fact, it is often hard to tell which eye has had the surgery, the healing is swifter and the vision achieves its potential sooner than with the older anaesthetic techniques.

Antibiotics are routinely administered at the end of cataract surgery. This used to be by an injection under the conjunctiva (the skin of the eye) and was sometimes painful. Today, the antibiotic injection at the end is not given and the operation is more congenial as a result. Instead, a small amount of antibiotic is simply left in the eye at the end of the operation.

This is another refinement that makes for comfortable surgery and swifter recovery.

The Swiss-made laser used for calculating the power of the artificial lens has been upgraded several times. Accurate pre-operative measurements and lens-power calculations are crucial to the success of the cataract operation and reliable measurements can be made with even the densest cataracts. The latest formulae are always used to calculate the required lens power and the outcomes are very reliable.

The eye is shaped like a ball. The eye is usually an evenly spherical ball, but in some people the eye is shaped more like a rugby ball. Rugby-ball shaped eyes are said to have astigmatism and do not see as well as spherical eyes. Poor vision resulting from astigmatism can be fixed by a pair of spectacles. At the time of cataract surgery, astigmatism can be reduced by choosing an astigmatism-reducing “toric” lens. The result of using such a lens is improved focus and reduced need for spectacles.

Over the last 10 years it has become possible to treat lesser degrees of astigmatism because of an expanded range of “toric” lenses and the greater accuracy of the upgraded measuring laser. The standard lens ranges have been very stable over 10 years and have not changed.

There is an ongoing effort to make a lens that can give near vision and distance vision. Lenses that do this are multifocal lenses and they cost significantly more than the standard lens. The multifocal lens is not a “dynamic” lens like the youthful human lens, which changes its shape to focus close or far away. Multifocal lenses are not for everyone because of unwanted visual effects that occur because of having two focal points, but multifocals can be an attractive option especially for patients who do not place high demands on their eyesight.

Dr Mark Donaldson, Rodney Surgical Centre


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