A cataract is a condition in which the lens in the eye becomes cloudy. It is the leading cause of blindness worldwide. A cataract can occur in either one or both eyes. Cataracts can cause blurry vision and glare. If left untreated, severe cataracts significantly impair one's vision. Poor vision will have a negative impact on one's quality of life. A person with significant cataracts may face difficulties with everyday activities, such as reading, driving, and even walking safely. Cataracts have been associated with an increase in falls and depression.
Cataracts tend to develop because of ageing or when injury changes the tissue that makes up the eye’s lens. Proteins and fibres in the lens break down and clump together, causing the lens to become cloudy and your vision to become hazy.
Most cataracts in Singapore are caused by the natural ageing process. However, these factors increase the risk of developing cataracts at an early age:
Early cataracts which do not affect your vision significantly do not require treatment. Update your spectacles prescription regularly so that you can achieve the best possible vision. You can also make slight changes to your home and work environment to alleviate the symptoms of cataracts, including using magnifying lenses and brighter light for reading and other activities.
When cataract progresses and affects your daily activities despite these simple measures, you may require cataract surgery. Surgery is the only way to get rid of a cataract.
Cataract surgery is the most commonly performed eye surgery in Singapore. The surgeon removes the cloudy natural lens of the eye and replaces it with an artificial lens.
Cataract surgery is a day surgery procedure, and you can usually go home on the same day. An eye drop or an injection around the eye is used to numb your eye, so that you would not feel any pain during the surgery. You may also receive intravenous medications which would help you to be relaxed and comfortable. Most patients share that they do not feel much pain during cataract surgery, though they may experience a sensation of pressure on the eye.
Most cataracts are removed by phacoemulsification. The natural lens in the eye is contained in a lens capsule. In phacoemulsification, an opening is made in the front part of the lens capsule. Ultrasound is used to break up the cloudy lens into tiny fragments which are then suctioned and removed. An artificial lens is then inserted within the lens capsule. The incision for phacoemulsification is very small and most of the time, stitches are not required.
A much less common procedure for removing the cataracts is called extracapsular cataract extraction. This technique is used when the cataract is very advanced and dense, or if there are complications during phacoemulsification, e.g. if the back of the lens capsule has a defect, or if the lens capsule is unstable. In this procedure, a larger incision allows the cataract to be removed in one piece. An artificial lens is then inserted to replace the natural lens and stitches are required to close the larger incision. Recovery from this type of cataract surgery is usually slower.
Dr Chelvin Sng is trained and accredited in complex cataract surgery, including phacomorphic lenses, small pupils, floppy iris syndrome, angle-closure, dense / white cataracts, lens subluxation, and scleral-fixation of intraocular lens.
Bladeless cataract surgery (also called laser cataract surgery) uses femtosecond laser to create corneal incisions and to break up the cataractous lens. Dr Chelvin Sng was amongst the first surgeons in Singapore to be accredited in laser cataract surgery.
Dr Chelvin Sng specializes in Cataract PLUS and was one of the earliest surgeons in Asia to perform Cataract PLUS in glaucoma patients (minimally invasive glaucoma surgery).
To improve your quality of life, cataract surgery can be combined with other procedures:
Cataract PLUS has these benefits over two separate surgical procedures:
✓ Faster recovery
✓ Lower cost
The success rate of improving your vision after cataract surgery is high at more than 98%. You may still require spectacles after cataract surgery, but your vision will be clearer with spectacles.
However, as with any surgery, cataract surgery has potential risks. So, make sure you discuss these in detail with your eye doctor. Fortunately, the risk of complications resulting in significant vision loss is exceedingly low after cataract surgery, occurring in only 1 in a thousand procedures. For the vast majority, cataract surgery is an effective and safe procedure which improves the vision and quality of life of millions of people worldwide each year.