Cataract surgery / Refractive lens exchange
A cataract is a condition affecting the lens of the eye causing the normally clear vision to become cloudy. It restricts the amount of light that is able to enter the eye causing blurred vision and often dazzle and glare.
The only way a cataract can be treated is by an operation to remove the cloudy lens. A lens implant is inserted into the eye to replace the natural lens.
The operation is normally carried out with a local anaesthetic and premium intraocular lenses can minimize the need for glasses for distance and near postoperatively. In carefully selected cases, lens exchange can be performed even in the absence of visually significant cataract to correct any refractive errors postoperatively.
Instructions after the Operation
- Do not rub or touch your eye.
- Avoid situations where the eye could be knocked.
- Avoid any dust, steam or dirt in the eye.
- Avoid contact sports and swimming for about a month.
- Reading and watching the TV will do the eye NO harm.
- Protect the eye at nighttime and when washing your face.
- Sunglasses may be helpful if the eye is sensitive to light.
- Keep putting the prescribed eye drops as instructed.
- Attend your clinic appointment 2-3 weeks after the operation, further appointments may be necessary.
Intraocular lens dislocation
The intraocular lens placed during cataract surgery can sometimes move out of place (dislocate), especially if there is a previous complication during cataract surgery. This causes your vision to become blurred and out of focus. The extent to which your vision is affected depends on the severity of the dislocation.
If the intraocular lens dislocation is significant and affecting your vision, then surgery will help restore your vision and prevent any further complications.
The Carlevale intraocular lens is a specially designed lens that can be fixated in the sclera of the eye. It is the best option available for intraocular lens fixation in the absence of capsular support.
Retinal detachment
The retina is the light sensitive film at the back of the eye and retinal detachment is a condition where the retina peels away from the inner wall of the eye. In most cases the retina detaches because a hole or a tear has formed in the retina allowing fluid to pass underneath the retina.
The treatment involves surgery and the main aim of surgery is to seal holes in the retina and reattach the retina.
A vitrectomy involves removing the vitreous gel (that has caused the retinal tear) from inside the eye. Then to seal the tear either laser or a freezing probe are used to make a scar around the tear. A gas or silicone oil bubble is then inserted into the eye to support the retina while it heals. A gas bubble slowly absorbs over 2 to 8 weeks but a silicone oil bubble will need a small operation to remove it at a later date. Your vision will be very blurred initially due to the presence of the gas or oil bubble.
After surgery, you will be given posturing instructions to follow. You can bath or shower but avoid splashing water near the eye. Most people choose not to drive over the first few weeks.
You must not fly until the gas bubble has gone and you must inform the anaesthetist if you require a general anaesthetic for any operation while there is gas in your eye.
Macular hole
A macular hole is a small, circular gap which opens at the centre of the retina. This causes blurred vision and often distorted vision where straight lines or letters look wavy or bowed. There may also be a patch of missing vision at the centre.
A macular hole can often be repaired by an operation called a vitrectomy, peel and gas. Extra steps may be done during this surgery depending on the type of macular hole that is present.
The vitreous jelly is removed (vitrectomy), and then a very delicate layer (the inner limiting membrane) is carefully peeled off the surface of the retina around the hole to release the traction forces that keep the hole open. In complex cases, the inner limiting membrane may be used to fill the macular hole and improve closure. The eye is then filled with a temporary gas bubble, which presses against the hole to help it seal. The bubble of gas blocks the vision whilst it is present, but slowly disappears over a period of about 2-8 weeks.
After surgery, you may be given posturing instructions to follow. You can bath or shower but avoid splashing water near the eye. Most people choose not to drive over the first few weeks. You must not fly until the gas bubble has gone and you must inform the anaesthetist if you require a general anaesthetic for any operation while there is gas in your eye.
Epiretinal membrane
An epiretinal membrane is a condition where scar tissue forms on the surface of the retina, where the vision is sharpest. The part of the eye affected by the epiretinal membrane is called the macula. This can be resulting in distorted and/or blurred vision.
If an epiretinal membrane affects vision, the only way to treat it is to remove the membrane surgically. This is achieved during an operation called a vitrectomy, where specialised instruments remove the jelly-like substance that normally fills the centre of the eye, called vitreous.
Following surgery, you will be given eye drops to use for a few weeks, which will help the eye settle from surgery. You can do most daily activities although you should abstain from unhygienic environments and anything that puts the eye at risk of injury.
