Cataract Assessment

• There is no good evidence for medical treatment for cataracts
• Surgery is the best option when cataracts impair your vision

• Most cataracts progress slowly before they interfere with your daily activities
• See an eye doctor regularly – your ophthalmologist will be able to give you advice if there are medical conditions causing your cataracts to progress e.g. diabetes

• Traditionally, there is a belief that we have to wait for cataracts to become ‘ripe’ before it can be operated on
• Improvements in the safety and reliability of modern day cataract surgery have reduced the risk of the procedure making surgery much safer now
• It is a good time to consider surgery when cataracts affect your vision resulting in limitations to the activities you normally enjoy e.g being able to drive at night or travel independently

Micro-incisional cataract surgery – we use ultrasound to liquify the cataract and remove it from the eye through a wound less than 3mm in size

• No sutures are needed
• There is no pain
• Fast recovery

Laser assisted cataract surgery – we use the same technologies as LASIK called a femtosecond laser to create the surgical wounds and fragment the cataract before using ultrasound to liquify the fragments

• Best for complex cataracts
• There is no pain
• No significant benefits of laser surgery for standard cataracts
• Increased cost and time

• Cataract surgery is one of the safest surgical procedures with a risk of complications in 1:1000 patients
• The important but rare complications include:
  • Endophthalmitis – an infection entering the eye during or after cataract surgery which can lead to serious loss of vision if not treated early
  • Posterior capsular rupture (PCR) – the capsular bag holding the lens may be damaged during the surgery resulting in some cataract fragments dropping into the back of the eye. This may require a second surgery to completely remove these fragments
• The more common side effects would include:
  • Posterior capsular opacification – patients may notice blurriness returning a few months to a year after cataract surgery. This happens when remaining cells from the capsular bag grow behind the lens implant. A YAG laser procedure can be used to clean the lens implant and ensure that the PCO does not occur again.
  • Cystoid macular oedema – some patients may develop swelling in the retina usually a month after cataract surgery and this can be treated by using special anti-inflammatory medications

• No
• We provide moderate sedation and also give anaesthesia through eye drops or even small injections when necessary

• Standard cataract surgery in one eye is usually a 20 minute procedure
• There is no need to stay overnight and you will rest in a day surgery ward

• If you are a Singaporean or PR, you can expect to pay about $1300 in a public hospital. However, this price includes only standard cataract surgery with a standard type of lens. Additional costs will be added if the surgery is more complicated or different types of lenses are required.
• If you are a private patient, the average cost of surgery is about $4500 per eye. However this also only includes standard surgery with a standard type of lens.
• If a customized surgery and lens is planned e.g. to correct astigmatism and presbyopia (‘Lao-Hua’) to give you spectacle freedom, the total cost can go up to $10,000 per eye in both public and private hospitals.

• No, cataracts do not recur once removed by surgery.
• However, some patients experience a return of blurriness and this is often caused by a posterior capsular opacification (PCO) forming. The PCO can be treated by a YAG capsulotomy and it does not return.

• If you have monofocal lenses, you may still require to wear reading glasses after surgery
• If you have multifocal lenses, you usually do not need reading glasses after surgery