Cataract surgeon Melbourne

Everything you need to know about cataract and cataract surgery

Cataracts are common, and are caused by clouding of the natural lens in your eye. Cataract surgery replaces your cataract with a clear lens implant, thus restoring your vision so you can see clearly again. 

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In United Kingdom, Switzerland, New Zealand and India

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cataract surgeries
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publications in scientific journals

Cataract disease

What is a cataract?

The eye has a clear natural lens that focuses light onto the retina. Over time, the lens becomes cloudy and more opaque, resulting in less light being focused onto the retina. Having a cataract means having a cloudy and opaque lens in your eye. 

"It is common, normal even, to eventually develop cataracts in your eyes. While not everyone with cataract requires surgery, the great majority of those that do undergo cataract surgery experience a significant improvement in their vision."

Modern cataract surgery will improve your vision by allowing more light to enter the eye and be more sharply focused onto the retina. Depending on the overall health of our eyes, surgery can even restore your vision so you don’t have to wear spectacles. 

You’re not alone. Cataracts are very common and virtually everyone will develop cataracts as they grow older.

Over time, the cataracts worsen and start to interfere with your daily life activities such as driving, reading, working, and your hobbies. If left untreated, cataracts will eventually cause vision impairment and blindness.

Cataract symptoms

The main symptoms are:

  • blurry vision
  • glare

Many patients decide to have cataract surgery once they no longer feel safe when driving or when they are told that their vision no longer fulfils legal driving requirements.

When you have a cataract, a typical landscape will look like this. Move the slider to see how it will look after cataract surgery.

Cataract vision | Brian Ang
Normal vision after treatment | Brian Ang
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A cataract usually develops slowly, thus decreasing your vision gradually. However, there are certain situations where a cataract develops more rapidly, such as following eye surgery or ocular trauma. 

Cataract causes

Age is the most common cause of cataracts. Other causes include previous eye surgery, use of steroid medication, ocular trauma and associated eye diseases.
cataract surgeon Melbourne

Cataract surgery Melbourne

The only way to treat cataracts is with cataract surgery

There is no other way to treat a cataract apart from cataract surgery. Essentially, the cloudy lens is removed and is replaced with a clear artificial lens implant or intraocular lens (IOL). 

Did you know?

The first intraocular lens was implanted in 1949 by Sir Harold Ridley, an English ophthalmologist. During World War II, he treated Royal Air Force pilots with fragments of plastic and glass in their eyes from shattered aircraft cockpit canopies. He observed that these splinters did not trigger inflammation as long as there was no iris touch. This led him to investigate the use of artificial lens implants to replace the cataractous lens.

The current gold standard technique for cataract surgery is phacoemulsification. 

"Your eye will be fully anaesthetised, so you will not feel any pain by the time I start making the first micro-incision in the eye. It is then common to hear a buzzing noise - this is the sound of the high-frequency ultrasound breaking up the cataract into smaller pieces for removal.

Finally, the artificial intraocular lens implant, which has been specifically customised to best suit your eye, will be carefully implanted. During the cataract surgery procedure, you may see bright, swirling colours but don’t worry, you won’t be able to see any sharp needles or instruments coming towards your eye!

Depending on the clinical circumstances, it may be appropriate to use a more traditional technique called ‘manual small incision cataract surgery’. This is where the cataract is removed in its entirety via a larger wound, instead of being broken up into smaller pieces first. 

Once the cataract is removed, the artificial clear lens is implanted. Very occasionally, suturing of the incisions may be necessary.

Brian Ang | Eye Surgeon Melbourne
Dr Brian Ang

Cataract surgeon Melbourne

"After the cloudy lens is replaced with a clear intraocular lens implant, more light is able to enter your eye. You will notice that colours are brighter and your vision becomes sharper. Depending on the overall health of your eye, your vision may even be restored to 20/20 without spectacles. The great majority of patients are delighted with the successful outcome of their cataract surgery. One of the more memorable comments that I have received was: ‘I can see colours so brightly and vividly now - I just wish my wrinkles weren't so clearly seen!’"

Cataract surgery is usually performed in day surgery under local anaesthesia. 

Research

Dr Brian Ang has published scientific papers on both phacoemulsification and manual small incision cataract surgery.

Artificial lenses for cataract surgery

There are 4 main types of artificial lens implants that you can choose for your cataract surgery:

  • Monofocal lens
  • Multifocal lens
  • Extended depth of focus lens
  • Toric lens

Monofocal lens implants:

Monofocal lenses are designed to provide the best vision at one distance (focal point) only, usually for far distance vision. This means that you will need spectacles for both intermediate vision (computer work) and near vision (reading).

After cataract surgery - monofocal lens

Image courtesy of Johnson & Johnson Pty Ltd 

You might decide that you prefer not to wear glasses for your near vision activities, so near vision monofocal lenses can be implanted instead. This means that you will need spectacles for distance vision (driving) and intermediate vision (computer work). 

You might also choose to have monovision, where the monofocal lens in the dominant eye corrects for distance vision, while the other eye is corrected for intermediate/near vision.

Multifocal (trifocal) lens implants:

Multifocal lenses are designed with additional focal points to correct your vision at multiple distances (distance, intermediate, and near). So you will have clear distance vision (for driving), good intermediate vision (for looking at your computer or car dashboard), and comfortable near vision (for reading). Thus multifocal lens implants provide the highest chance of achieving complete spectacle independence.

After cataract surgery - multifocal lens

Image courtesy of Johnson & Johnson Pty Ltd 

However, they are not suitable for everyone and may have visual quality problems, such as glare, haloes, and reduced contrast sensitivity. These problems are difficult to correct with spectacles and often require surgical replacement of the multifocal lens implant with another type of lens implant. 

Extended depth of focus (EDoF) lens implants:

Extended depth of focus lenses are becoming increasingly popular because of the ability to achieve good distance and intermediate vision, but without the visual quality issues associated with multifocal lenses. This means that your vision will be good enough for most day to day activities, such as driving and working on the computer, without the need for spectacles. However, you will still need spectacles for reading and for fine close-up work.

Extended Depth of Focus (EDoF) intraocular lenses

Image courtesy of Johnson & Johnson Pty Ltd 

Toric lens implants:

Toric lenses have an extra built-in correction for corneal astigmatism. You can think of it as having 2 different strengths in the one lens. Having a toric lens implant means that you will have sharper vision without requiring spectacle correction. These lenses may be suitable if you have astigmatism greater than 0.75D. Toric lenses are available in multifocal and extended depth of focus designs.

Brian Ang | Eye Surgeon Melbourne
Dr Brian Ang

Cataract surgery specialist Melbourne

"It’s understandable that you may have a lot of questions about the lens implant options; we will discuss this during your consultation. It’s my job to guide you to the best solution based on your individual needs. Modern cataract surgery has a very high success rate of over 98%. You can rest assured that I will perform my utmost to achieve the best possible outcomes for you."

Cataract surgery recovery

After surgery

There will be a pad and shield placed over your eye, which you can remove a few hours after surgery or the next day. 

When you remove your pad:

  • your vision will be blurry
  • your eye will feel uncomfortable
  • you may notice some double vision

This is a normal part of recovery. You will find that the vision will gradually improve on a daily basis. It can take up to 3 to 4 weeks for the eye to fully heal.

In general, there will be a first postoperative review within 1 week, and then another postoperative review 3 to 4 weeks later.

You will have two different eye drops to use after surgery 4 times daily. The antibiotic can be stopped after 1 week, but the steroid drop needs to be continued until you are instructed to stop. If you use eye drops for other eye conditions, you can continue using them unless you have been informed otherwise. Your individual needs will be discussed with you during your consultation.

Driving, exercising, taking a shower, working?

  • Drive: when you feel comfortable and safe to drive, usually after 1 week
  • Exercise: gentle exercise after 1 week; more vigorous exercise after 1 month
  • Take a shower: the next day
  • Go back to work: depends on the nature of the work, but usually after 1 week

Cataract surgery costs

How much does cataract surgery cost?

The cost of cataract surgery depends on your health fund. There will be an out-of-pocket fee for the initial consultation, as well as for any other tests that may be required during the consultation (such as an A-scan and OCT-scan). 

Benefits of private cataract surgery

The main benefit of having cataract surgery privately is that you know who your surgeon is, and that your surgeon knows you and your individual case and preferences. 

You also have more choices as a private cataract surgery patient:

  • You can choose when you have surgery
  • You can choose the type of artificial lens implant to use

With public hospitals, surgery is free but you cannot choose your surgeon or lens implant, and the waiting time can be long. Most public hospital wait times are at least 1 year at a minimum, with some exceeding 2 years. In contrast, private cataract surgery can be scheduled as early as 3 to 4 weeks.

What patients appreciate about Dr Brian Ang

Patients like the fact that my explanations are clear, concise, and easy to understand. I make sure that I provide enough relevant information so that patients can make the best informed decisions based on their own circumstances. What I will not do is to pressure patients into making decisions that they are not comfortable with. Instead I will respect and support your decisions as we work together to achieve the best clinical outcomes for your eyes.

Multilingual consultations

I am multilingual and fluent in English, conversational Mandarin, Cantonese and Bahasa Malaysia.

Consulting and operating at multiple locations in Melbourne

I work as an associate consultant for these private practices in and around Melbourne.

I operate at multiple locations in and around Melbourne.

  • Royal Victorian Eye & Ear Hospital, East Melbourne
  • St Vincent’s Hospital, Fitzroy
  • Sunshine Private Day Surgery, St Albans
  • Epworth Hospital, Geelong
  • Footscray Day Surgery

To make an appointment, please contact Dr Brian Ang here.

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