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Posterior polar plaque (PPP) cataracts are a variant of cortical cataracts. They involve clouding of the back surface of the lens, in the central area. PPP cataracts tend to have a marked effect on vision even in the early stages.
There are other more rare cataracts such as congenital, traumatic, polychromatic and metabolic types.
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
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.
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.
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.
All operations carry risks as well as benefits. Possible complications of cataract surgery are listed below – in rare cases these can lead to reduced vision or blindness.
Posterior capsular opacification happens when the supporting capsule behind the lens thickens, resulting in reduced vision. The condition develops in up to one in five people within five years of the operation. Simple laser treatment can be used to correct this. The other complications can be treated with further surgery or antibiotics.
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.
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. During surgery your eye is numbed and you have to lie on a bed for 15 minutes, looking at a bright light. You will see colors and movement, but will not be aware of any details of the procedure. Please note – modern cataract surgery does not involve the use of needles!
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 through a 2-millimeter incision and used to gently break down and remove the cloudy lens, and then your new imkplant 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.
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.