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Cataract Surgery in Singapore

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Cataract Surgery in Singapore

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.

The Common Types Of Cataracts

There are several types of cataracts, including:

1. Nuclear Cataracts

This type of cataract forms in the centre (nucleus) of the lens and is typically associated with ageing. Nuclear cataracts may cause changes in near vision, colour perception, and overall vision clarity.

2. Posterior Subcapsular Cataracts

Subcapsular cataracts occur at the back of the lens, near the lens capsule. They are more common in patients with diabetes, those taking high doses of steroids, or people with certain medical conditions. Subcapsular cataracts may lead to glare, halos, and difficulty with reading or near vision.

3. Cortical Cataracts

Cortical cataracts develop in the lens cortex, the outer part of the lens that surrounds the nucleus. These cataracts often start as whitish, wedge-shaped opacities and may extend to the centre of the lens over time. Cortical cataracts can cause glare, halos around lights, and difficulty with contrast sensitivity.

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.

Preventing Cataracts From Developing

While there is no scientifically proven method to prevent cataracts, you can take steps to delay early onset cataracts.

  • Safeguard your eyes from the sun – Wear sunglasses and/or a hat with a brim to block ultraviolet (UV) light from the sun.
  • Maintain a healthy, well-balanced diet – Eat plenty of healthy food, like fruits and vegetables, whole grains, nuts, and leafy greens.
  • Refrain from smoking – If you need help quitting, you can call the Health Promotion Board’s Quit Smoking helpline (1-800-438-2000) to speak to a Quit Advisor.
  • Protect your eyes from injury – When operating a power tool or playing specific sports, wear protective eyewear to safeguard your eyes from getting accidentally injured.

How Our Eye Doctor Check for Cataracts

During a routine check-up for cataracts, our eye doctor will generally perform a slit lamp examination to look for signs of cataracts, as well as for any other eye conditions. 

The process involves the use of eye drops to dilate the pupil of your eye. Once dilated, our doctor will use a slit lamp – a specialised microscope with a bright light – to examine the structures of your eye, including the lens. 

This allows them to detect any clouding or opacities in the lens, which are characteristic of cataracts. If cataracts are present, a photograph will be taken for further evaluation.

Once the test is completed, our doctor will schedule a consultation to share the test results and discuss your condition and the treatment options available to you.

Causes and Risk Factors of Cataract

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.

Cataract Treatment

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.

How much is cataract surgery in Singapore?

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.

Understanding the cost of cataract surgery in Singapore is essential for individuals considering this procedure. Here are key points to consider.

Medisave Coverage:

Cataract surgery in Singapore is eligible for coverage under Medisave, providing financial assistance for individuals undergoing this procedure.

Average Cost of Cataract Surgery in Singapore:

The cost of cataract surgery varies among different eye centres in Singapore. On average, the cost to perform cataract surgery on one eye typically ranges from $3,000 to $8,000. It’s important to note that this range can vary based on factors such as the specific clinic, the surgeon’s expertise, and the technology used during the procedure. Refer to the fee benchmarks set by the Ministry of Health here for cataract surgery with laser at private clinics in Singapore.

Factors Affecting the Cost of Cataract Surgery:

  1. Surgical Technique: Different surgical techniques can influence the cost. Laser-assisted procedures may incur additional expenses.
  2. Clinic Reputation and Surgeon’s Expertise: Clinics with experienced surgeons may charge higher fees based on their reputation and success rates.
  3. Technology Used: The type of technology and equipment used during cataract surgery, such as premium laser systems, can impact the overall cost.
  4. Pre- and Post-Operative Care: Some clinics include comprehensive pre-operative assessments and post-operative care in the overall cost, ensuring thorough patient care throughout the entire process.

Understanding these factors and discussing them with the chosen eye centre can provide you with a clearer picture of the overall cost and potential variations. Get in touch with our team at Nova Eye Centre to obtain detailed information tailored to specific needs and preferences.

What to Expect During and After Your Cataract Surgery?

Cataract surgery for each eye is generally performed on separate days to avoid potential complications that may arise by having surgery done on both eyes simultaneously. Each procedure usually takes around 30 minutes and is often performed under local anaesthesia as a day surgery.

You are expected to fast for at least 6 hours before your cataract surgery. Avoid driving to the hospital for your procedure, as you will not be fit to drive after treatment. Instead, we recommend arranging for someone to bring you home or you can consider taking a cab after the surgery. It is also advisable to bring a pair of sunglasses and wear them after the surgery, as your eyes may be sensitive to bright lights.

During the cataract surgery, an anaesthetist will administer intravenous sedation to help you relax or fall asleep. To ensure you are suitable for sedation, you must undergo a pre-op ECG and blood test prior to your surgery. 

Rest assured that the entire procedure is relatively painless, as anaesthetic eye drops will be applied beforehand to numb your eye. Nevertheless, some patients may experience slight discomfort and a sensation of coldness and pressure on the eye and around the eyelids throughout the cataract surgery

Please note that in rare cases during surgery, a monofocal IOL will be used instead if it is discovered that a multifocal IOL is unsuitable for the patient.

In the following days after your cataract surgery, you may notice your vision fluctuating. However, rest assured that this is normal, and it may take around 3 months for your vision to fully stabilise. Nevertheless, most patients will be able to resume work the week after surgery, although it will take around a month for your eyes to recover completely.

In addition, you are required to attend a post-op consultation the day after your operation. By this time, you can expect about 75% of your vision to be restored. Your post-op reviews are typically scheduled 1 day, 1 week, and 1 month after your cataract surgery.

What Are the Risks of Cataract Surgery?

Like any surgical procedure, cataract surgery carries specific risks, such as infection and bleeding. Another possible complication that may occur during cataract surgery is the rupture of the lens capsule (bag) supporting the lens. 

Due to this element of risk, the artificial lens implant may have to be inserted in a suitable alternative position, different from the original intended location. This may be performed during the same surgery or arranged as a separate procedure.

Other possible complications that may arise after cataract surgery include:

  • Cloudiness of the cornea
  • Displacement of the lens implant
  • Droopy eyelids
  • High eye pressure for a few days
  • Infection (Endophthalmitis)
  • Inflammation
  • Leaking wound which may require stitching
  • Retinal detachment
  • Sensitivity to eye drops
  • Swelling of the retina

You may require another surgery to correct these issues if any of the above complications were to occur.

What Is The Best Age To Have Cataract Surgery?

There is no ideal age to have cataract surgery. With that said, the procedure carries increased risk as one age, especially if the patient has other age-related medical conditions to contend with. Therefore, we recommend scheduling your cataract surgery as soon as possible if your eye doctor recommends the procedure.

Frequently Asked Questions

Cataract surgery in Singapore is a relatively quick procedure, lasting around 30 to 45 minutes on an outpatient basis. Most patients should be able to go home on the same day after the surgery has been completed.

After undergoing cataract surgery in Singapore, there are certain practices patients are recommended to follow as shown below.

 

Do:

Follow any advice given to you by your eye specialist in Singapore.

Wear sunglasses on bright days for at least a year after surgery.

Avoid swimming to minimise your risk of infections.

Use eye drops prescribed your eye doctor in Singapore.

 

Do Not:

Drive until after the first day of your cataract surgery.

Perform strenuous activities.

Rub your eyes.

Wear eye make up if possible.

Cataract surgery in Singapore should not be painful. Though patients are awake during the surgery, local anesthesia is used to numb the area resulting in little to no pain or discomfort. Experiencing pain after the procedure is rare as well, but mild to moderate discomfort is common and should fade in time.

The lens implanted by your eye specialist during cataract surgery is durable and should last a lifetime. However, diabetes and glaucoma are other conditions that may affect your eyes, resulting in limited vision irrespective of successful cataract surgery. In addition, the capsule holding the lens may also become cloudy at times, in which case, a laser is used to correct the cloudiness.

The side effects of cataract surgery typically improve within a few days, however, it can take up to 4 to 6 weeks for complete recovery. During this stage, it is vital to closely heed the instructions of your eye doctor to ensure a smooth and seamless recovery process.

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