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expert eye care

Cataract surgery
safe and effective

SCOTLAND’S LEADING PRIVATE EYE SURGERY

Cataract

Cataracts are a very common condition, which occur when the clear lens inside our eyes start to turn cloudy.
Cataract surgery scotland

The first signs of cataract development are often blurred vision, dazzle and glare especially at night time, and a change in the strength of glasses. Cataracts are related to ageing, and usually affect both eyes but to different extents. There are two types, nuclear sclerosis cataracts turns the lens yellow and colour vision changes along with the need to change glasses as you become shorter sighted. Cortical cataracts involve the development of white streaks just under the surface of the lens. When these streaks extend from the periphery of the lens to the centre, they interfere with vision, giving rise to glare and dazzle, especially at night time and when driving.

The only effective treatment for cataracts is surgical removal and replacement with an artificial lens implant. Modern cataract surgery has been refined over 70 years and is now a very safe procedure with a success rate of more than 99%. Laser Vision Scotland surgeons carry out more than 2000 operations every year, and the majority of these procedures are cataract surgery

Multifocal Cataract Surgery

As with refractive lens vision correction surgery, if you are having cataract surgery and wish to reduce your reliance on glasses you may opt for multifocal cataract surgery.

This option is also available to patients with significant astigmatism. In order to get the most out of multifocal cataract surgery, it is better that your eyes are in otherwise good health, with no sign of macular degeneration or glaucoma. In suitable patients multifocal lenses have a high success rate and high levels of patient satisfaction after cataract surgery

Following multifocal cataract surgery, you will often see clearly enough to drive within 1-2 days. However it can take several months for your eyes to fully adapt (a process called neuroadaptation) to your new lenses. During this time colours and hues may seem different, and vision may fluctuate as your brain fine-tunes its focusing mechanisms.

Toric Cataract Surgery

If you wish to achieve the best vision possible after treatment, it is worth considering a toric lens implant.

These lenses correct astigmatism allowing for sharper vision without the need for glasses. A small amount of astigmatism will blur your vision slightly, while larger amounts can cause your vision to be very blurred. Toric lenses have a rugby ball shaped surface contour, which is positioned inside your eye to neutralize existing astigmatism. Toric lenses do not correct your near and distance vision, however it is possible to build toricity into multifocals lenses so that astigmatic eyes can also benefit from multifocals.

Toric lens implants suit patients who have significant amounts of astigmatism, and don’t mind wearing glasses for reading. They may also be a better choice of lens for patients who find it hard to adapt to change or learn new skills. Patients with astigmatism who wish to minimize their reliance on glasses but who are not suitable for multifocal lenses may be well suited to toric mono vision treatment, whereby their dominant eye is made as strong as possible for distance and their non-dominant eye is given good uncorrected near vision.

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Standard Cataract Surgery

Standard lens cataract surgery involves removal of the cloudy lens inside the eye and replacement with a monofocal lens implant. The cataract removal procedure most commonly performed is known as phacoemulsification.

Cataract removal is usually carried out as a day-case under a local anaesthetic. They are removed using a special ultrasound-cutting device that gently removes the cataract as soon as it is fragmented. This procedure does not normally require a general anaesthetic so most people are awake throughout surgery.

The procedure takes around 15 minutes to complete, and during this time you will feel cold water around your eye and see bright lights and colours, but no detail. If you think you will feel anxious about having surgery, we recommend asking for some sedation first.

This will make you feel relaxed and sleepy during treatment.
Cataract surgery is normally carried out on one eye at a time. Following treatment to the first eye, Laser Vision Scotland usually offers cataract surgery to the second eye one or two weeks later.

Laser assisted cataract removal

The femtosecond laser incorporates OCT technology to allow for micron precision laser pulses for increased accuracy and is blade free and needle free. Studies show that Femtosecond laser application in liquefaction, capsulorhexis and corneal incisions was safe and effective.

A corneal incision is made and the precision the optimal location, depth and length of incision required. The precision of this incision is important in reducing the risk of infection and increasing the self-sealing ability of the cornea.

Creating an opening in the eye’s capsule which surrounds the natural lens (anterior capsulotomy). This opening, traditionally created with a small needle has been shown to have greater accuracy and reproducibility when performed with laser.

Cataract fragmentation, usually carried out with the use of ultrasound is instead performed using laser, thus removing the risk of heat build-up in the incision.

The femtosecond laser-assisted cataract procedure for cataract removal is particularly advantageous in difficult cases, precision and reproducibility in cataract procedures.

Your surgeon will always advise you on whether you will benefit from a specific procedure such as laser assisted cataract removal and it is important to remember that whilst laser assisted cataract removal has particular benefits for some difficult case, the standard cataract procedure carried out at Laser Vision Scotland is performed to an exceptional standard with results significantly above the national average for safety and complication rates far below acceptable limits.

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How safe is cataract removal?

All operations carry risks as well as benefits. Possible complications are listed below – in rare cases these can lead to reduced vision or blindness.

  • Heavy bleeding inside your eye
  • Infection of the eye
  • Tearing of the supporting capsule behind the lens.
  • Lens dislocation
  • Posterior capsular opacification

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Your surgeon will explain in more detail how any risks apply to you.

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Patient journey

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Pre-treatment care:

At your initial assessment we encourage you to spend time with your surgeon and discuss your hopes, your concerns and worries. Everyone is apprehensive prior to eye surgery, so part of our job is to earn your trust and confidence in us so we can make the experience as positive as possible. Your initial consultation will provide you and your surgeon with an in-depth understanding of your vision.

Our experienced optometrist will carry out extensive eye tests to ensure your consultant has an exceptional array of the data about your eyes to make an informed decision on the treatment that would be best for you. If it is decided that cataract surgery is right for you, your constant will then be able to advise you on the right kind of lens replacement for you. Once you have decided which type of lens replacement suits you, your consultant will provide with instructions for pre-treatment care and will arrange a mutually agreeable date for treatment.

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Bespoke care

Treatment:

Having your cataract removed involves a half-day in hospital. On arrival you will be offered either a private side room or a seating area in our day lounge. Drops are used to dilate the pupil of your eye, and your surgeon will visit you and ask you to sign some forms. Cataract removal is usually carried out as a day-case under a local anaesthetic. During surgery your eye is numbed and you have to lie on a bed looking at a bright light. You will see colours and movement, but will not be aware of any details of the procedure. Once the anaesthetic has taken effect, your surgeon will make a tiny cut on the surface of your eye. A special ultrasound probe is inserted and used to gently break down and remove the cloudy lens. Your new implant is introduced to the eye and carefully positioned. At the end of the procedure an antibiotic solution is infused into the eye to protect against infection. This usually takes 15 to 20 minutes.

During this time you will feel cold water around your eye and see bright lights and colours, but no detail. If you think you will feel anxious about having surgery, we recommend asking for some sedation first.

With you all the way

Aftercare

After surgery, a clear plastic shield is taped over your eye for one day to protect it. You can see through this straight away, though vision tends to be blurred for the first couple of days. You will be given antibiotic drops to use for one week and steroid drops to use for 4 weeks.

Cataract surgery is normally carried out on one eye at a time. Following treatment to the first eye, Laser Vision Scotland usually offers cataract surgery to the second eye one or two weeks later.

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