information below will give you a better understanding of the nature of
"cataract". It should help you decide whether and when you would like
to have a cataract removed, and also provide you with information about
the operation and what you can expect afterwards.
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Shown is a normal, clear field of view as seen through the clear lens
of the eye. When a cataract is present, vision becomes darkened,
cloudy, yellow and blurred.
What is a cataract?
human eye has a lens to focus light on the retina. This lens must be
clear so that light can pass to the retina, which is at the back of the
eye and is rather like the film of a camera. The retina interprets
different shapes and colours, and passes this information to the brain.
cataract is a cloudiness or opacity of the lens of the eye. It can
obstruct normal vision, may dull contrast and colours and may cause
When should a cataract be removed?
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surgery, the lens is cloudy, causing images to be blurred &
yellowed. Vision is hazy & colors are faded. After surgery, Vision
will vary from person to person. A very active person may want a
cataract removed early, when there is minimal visual disability; others
may choose to wait.
Prior to the introduction of intraocular lenses, patients waited for a cataract to be "ripe" or "mature" before surgery.
With modern surgery, as long as the retina and all other parts of the
eye are healthy, the cataract can be removed as soon as it causes any
symptoms such as glare, blurred or dimmed vision.
The decision about when to remove the cataract is yours, but be aware
that a very advanced cataract will increase surgical risk.
What is an "implant" or "intraocular
the implanted lens cannot change focus for different distances, some
patients may be suitable for a multifocal lens, which assists with
vision at different distances. However, after surgery, glasses are
often still necessary for intensive reading and sometimes also for
cataract surgery, the lens itself must be removed, and an artificial
intraocular lens is then implanted to replace the natural lens. This
implant is permanent and unlike a contact lens, it does not have to be
removed. As far as is known, the implant can stay in the eye
Learn more about intraocular lenses and whether glasses will be needed after surgery.
Determining the power of the
implant for your eye
eye is different, and a scan will be performed to determine as
accurately as possible the power of the implant required for your eye
to provide good focus.
Our state-of-the-art equipment includes the Zeiss IOLMaster, the most
advanced and accurate machine in the world for this measurement. We
also have the conventional ultrasound to use in some cases.
Determining the type of the intraocular lens or implant for your eye
To learn more about intraocular lenses, click here.
What is involved in the surgery?
1. Hospital arrival
will need to arrive at the hospital (Linley Clinic) about two hours
prior to surgery, so that medical records can be made up and more
importantly, so that drops can be given to dilate the pupil. Please
ensure that you have no food for four hours, and nothing to drink for 2
hours, prior to surgery, except enough fluid to take any normal
2. The anesthetic
surgery is normally performed with local anesthetic. The aim of
anesthesia is to provide comfort and safety during surgery.
Our preferred technique, which we use in over 99% of cases, is topical
anesthesia in which the eye is anesthetized with drops alone.
This technique appeals to many patients because there is no injection,
no chance of bruising, no pad required and the eye recovers very
The alternative and more common form of
anesthesia for cataract surgery is injection of local anesthetic near
the eye. For local anesthetic injection, the anesthetist will put you
to sleep for a few minutes while the injection near the eye is given,
so you will neither feel any pain nor be aware of the injection. The
risks of this are minimal, although some bruising around the eye can
regular anesthetists, Dr Karl Alexander or Dr Barbara Heath, are always
present to look after your well-being and comfort at all times. They
are both extremely experienced in anesthesia for eye surgery.
The anesthetist plays a critical role in ensuring that
you are not anxious, that your vital signs such as blood pressure,
heart rate and oxygen levels are all correctly monitored and that you
feel little if any discomfort during the procedure.
Our Patient Satisfaction surveys show an extremely high level of patient satisfaction with Dr Alexander and Dr Heath.
Learn more about our anesthetists by clicking here Our Anesthetists
what you may have heard, cataracts are not completely removed with
laser, but YAG laser is often performed months or years after cataract
surgery to treat thickening of the membrane (the posterior capsule)
deliberately left behind at surgery to support the implant.
We use the most advanced method of cataract surgery presently available.
This is phacoemulsification under topical anesthesia, in which a tiny,
self-sealing incision (3mm) is made into the tissue of the eye, and the
tip of a very sophisticated ultrasound machine is used to break up the
cataract. It is possible to use a laser for parts of the procedure
(Laser-Assisted Cataract Surgery or LACS). Some patients may prefer
this option which Dr Collie is fully certified to perform and will do
so on request. However, there are no studies which demonstrate any
better outcome in the hands of an experienced surgeon and there is a
significant increase in cost in LACS. We therefore do not recommend
LACS as any better than conventional cataract surgery.
When the cataract has been cleared away, the intraocular
lens is implanted, normally in the same position as the original lens
and the self-sealing incision normally requires no sutures.
What happens after the operation?
The procedure normally takes less than ten minutes.
During the operation, you will be covered with protective, sterile
drapes, with plenty of oxygen to breathe. Only the anesthetized eye
will be left uncovered. You will however be awake and alert, and you
may like to bring a Walkman and your favourite music to listen to
during the procedure.
the operation, your eye will not be covered with an eyepad if you had
topical anesthesia (drops alone). However, you will be provided with a
protective shield to wear while sleeping. For the first 12 to 24 hours,
you may feel a foreign body sensation in the eye which resolves
spontaneously and is related to the tiny incisions in the eye. Although
there may be some redness for a few days, there is little if any pain
involved with recovery from normal cataract surgery. You may need two
Panadol four hourly for discomfort, but if this does not provide
relief, you should call Dr Collie.
you can return to all your normal activities within a day or two of
surgery, but avoid any direct danger to the eye (eg wear protective
glasses for tennis).
Eye drops to control
inflammation and prevent infection will be used for a few weeks after
the surgery. After three to four weeks, the eye is stable and a
measurement for any glasses necessary can be made.
Do I go home immediately?
surgery can now be performed safely as a day procedure and you will
usually feel fine to go home immediately after some refreshments. As
you may have some sedation during the procedure, it is preferable if
you have a responsible adult to accompany you home from the hospital
and to stay with you for the first night after surgery. You need to be
able to telephone Dr Collie or the hospital should the need arise after
the operation, and to come to see me the day after surgery.
Follow-up after cataract surgery is usually very straight-forward.
Your vision may be blurred for a day or two especially
while the pupil is still dilated after surgery, and you may notice some
irritation in the eye which may persist while you are using the drops.
Artificial tear drops usually help and these will be provided for you.
You will be seen in the rooms the day after surgery and again about one week after surgery.
Post-op visits are usually very brief examinations to
make sure you are happy with the progress and to examine the eye
particularly to ensure that there is no inflammation and no infection.
How successful is the operation and are there
Collie has performed thousands of cataract operations. He utilises the
latest techniques, the most advanced equipment and a range of
state-of-the-art lens implants to best suit your needs.
The operation is performed at Linley
Clinic (click here to go to Linley)
a boutique private hospital in Canterbury. In most cases, you will be
on your way home less than 2 hours after arrival, in complete comfort,
with no patch over the eye and with very few restrictions on your
In the vast majority of cases, you can
expect to have your sight returned to normal and you will only need
glasses for reading. If there are other co-existent eye problems,
surgery may still improve your vision within the limitations of those
Click here to see our Cataract
Patient Satisfaction Survey»
the operation is very successful, there is, however, a small number of
cases that are complicated by unforeseen problems either during surgery
or in the post-operative period.
may permanently affect sight occur in less than 1% of all cases. These
may include vitreous loss, post-operative wound leak or rupture,
retinal swelling or detachment, glaucoma and displacement of the
natural lens or implant. The most serious complications are severe
haemorrhage or infection, but these occur in less than one in a
Our surgical team will do everything we can to minimize
the chances of complications. In spite of these precautions, problems
may occur, but to improve your vision, some minimal risk must be
will provide you with a written estimate of your surgical costs and
your out-of-pocket expenses. Medicare will cover a proportion of the
surgical and anesthetic costs, and if you are insured privately, your
health insurance will make a further contribution to both the medical
and other costs. However, patients are responsible for ensuring prompt
settlement of their accounts, including the difference between the fee
charged and benefits received.