CATARACT SURGERY WITH TRIFOCAL IMPLANTS, TORIC IMPLANTS & MONOFOCAL IMPLANTS
What is a cataract
A cataract is due to a clouding of the natural crystalline lens inside the eye. In the majority of cases, it is an age related process, however, there can be other causes as well. Cataracts usually develop around the age of 40, but since they develop slowly and do not impair vision until much later, most people do not experience symptoms until after they are 60 years old. There is no medical treatment for cataracts and the definitive means of correction is cataract surgery. Regular eye examinations are important to detect such conditions before they worsen.
Signs and Symptoms of Cataracts
Cataracts come with several symptoms but as mentioned above, since this eye disease deteriorates slowly, the signs may not be apparent until it has reached the later stages. Below are some of the common signs and symptoms.
Blurry vision – The scattering and blocking of light by cataracts prevents sharply defined images from reaching the retina, which results in blurry vision.
Yellow tinge – As we age, cataracts alter the colour of our crystalline lenses, and light entering the eyes is reflected in a yellow hue.
Light sensitivity and halos – Cataracts can also cause sensitivity to bright light and glare, compromising on vision, especially at night.
Double vision – Even with one eye open, cataracts can cause images to appear double, with the second image positioned horizontally, vertically, or diagonally to the original.
Keep in mind that the above are not definitive indicators of cataracts and it is recommended to consult an expert rather than self-diagnosing. Depending on your condition and diagnosis, your eye doctor may advise cataract surgery.
Causes and Risk Factors
Apart from ageing, there are other causes and risk factors of cataracts, some of which can be controlled while others may not. Controllable aspects revolve around lifestyle choices. For instance, diabetes, excessive exposure to sunlight, smoking, obesity and high blood pressure have been shown to be closely associated with cataracts. By exercising regularly, maintaining a healthy diet and living an overall healthier lifestyle, we can reduce health risks such as diabetes, obesity and high blood pressure, which in turn, may decrease our chances of contracting cataracts and having to undergo cataract surgery.
On the other hand, uncontrollable elements tend to centre on biology including age and family history.
Today, thousands of cataract extractions are performed with a high success rate. Typically, cataract surgery in Singapore is performed under local anaesthesia with sedation and takes 30 minutes on average. There are many choices of intra-ocular implants available today (Monofocal, Monofocal Toric, Multifocal, Multifocal Toric) and the choice of implant depends on your condition and preference. Apart from the implants, it is also important to consider the cataract surgery cost.
In general, monofocal implants provide good distance visual in the absence of astigmatism but reading glasses will still be needed unless monovision is opted for. Monovision is a situation where the master eye is set for distance vision while the other is set for near vision. Not everyone is suitable for this procedure and a monovision trial is necessary beforehand.
Toric implants are able to correct pre-existing astigmatism and are useful in correcting the visual distortion that it causes. Lastly, multifocal implants are used to alleviate the symptoms of presbyopia or ‘lao hua’. In general, patients with multifocal implants enjoy good functional vision without the need for reading glasses, although side effects of glare and halos may occur in dim light conditions.
Fortunately, these visual side effects tend to get better with time. A newer method of cataract surgery where a femtosecond laser is used for part of the procedure is also available (FLACS or Femtosecond Laser Assisted Cataract Surgery). The downtime after cataract surgery lasts around 3-4 weeks and prescribed medicated eye drops are required for about 6 weeks. Vision usually becomes clear on the first day but may take about a week to improve in some cases.
The cataract surgery cost in Singapore varies according to eye clinics, therefore, it is best to explore your options and talk to different eye specialists before making a decision.
Types of Intraocular implants
Simulated vision with a ‘standard’ or ‘monofocal’ implant. Distance vision is good but near vision is blurred.
Simulated vision with ‘trifocal’ implant for the correction of presbyopia or ‘lao hua’. Good vision for both distance and near. However, in dim light conditions, there may be ‘haloes’ and ‘glare’.
Cataract surgery is usually performed with local anaesthetic and sedation.
Cataract surgery involves the removal of the cataract via a small incision and the insertion of an artificial implant which is designed to stay in the eye permanently.
Dr Eugene Tay
Senior Consultant Ophthalmologist
Eye Specialist Clinic in Singapore
Over 20 years of clinical experience
He graduated from St Bartholomew’s Hospital Medical College of the University of London in 1997 and is one of few surgeons to have received all basic, advanced and sub-specialty/fellowship training at the internationally renowned Moorfields Eye Hospital in London. Therefore, he is well positioned to own his very own eye clinic in Singapore. He trained to sub-specialist fellowship levels in laser refractive and anterior segment surgery at the Gimbel Eye Centre in Canada and also Oculoplastic surgery at Moorfields Eye Hospital. With Dr Tay’s unrivalled expertise, Nova Eye Centre is the eye specialist clinic of choice in Singapore.