Which type of cataract surgery is the best?

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My mother needs cataract surgery, and I am still worried that the operation carried a one-in-1,000 risk of severe and permanent sight loss.

 

I've read about the femtosecond laser cataract surgery. It seems more expensive, but is it the best option now?

 

Pls advise.

 

My sincere thanks,

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12 Replies

  • Posted

    I think they only have 2 kinds of surgery. The olsld school one where the scrape and put back ur own lens. And the new one using a probe. The deal is its different to everyone. And you have to be bery miticulous about how you take care of the operated eye. 👍
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    • Posted

      old school where they scrape**

      (My eyes still not functioning)

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    • Posted

      Interesting.  I have practised eye surgery for over 20 years and done thousands of cataract extractions.  Never heard of scraping.  Make sure you see a qulified experienced eye surgeon and avoid anyone who talks of "scraping".  Intracapsular catarct surgery and large incision extracapsular surgery are out moded.  You want small incision phacoemulsification surgery as a daycase. Ask for astigmatism correction at the same time.  If going private consider a multifocal lens implant to enhance near vision as well as distance vision.

      Yes all eye surgery entails some risk including blindness but statistics show most people 98% do very well.  Cataract surgery is now the commonest surgical procedure.

      Femtosecond laser to create incisions takes longer to perform than standard surgery because of the time to set up. It may help to minimise astigmatism but is available in very few eye theatres.

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    • Posted

      I have multi focal lens, did a phocoemulsification, an experiencing what feels like a contact lens that is out of center. I can see it in my outer side. And at night im like looking at a magnefied lens.
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    • Posted

      Some multifocal lenses have a reputation of causing "haloes". Can be a problem with night driving. I don't like the older style lens implants with refractive or diffractive rings. Even monofocal lenses can sometimes cause problems like this.  Most of my patients with Oculentis multifocal implants are very satisfied.  I may use a 1.5 add (termed Comfort) in the first eye and a 3.0 add (termed Mplus) in the second eye. This gives a combination of vision from distance to intermediate to near which they seem to appreciate.  Or else a 2.0 add in both eyes.  It is an expensive implant but most patients are spectacle independent.  (I would still advocate refraction / spectacles to optimise vision to the best potential).  There are new lens implant designs coming out on a regular basis.  The crucial point is all measurents must be done carefully and astigmatism if present should be corrected otherwise there is no point in any fancy multifocal lens implant! 
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    • Posted

      Thank you. May I ask if the use of a femtosecond laser is really safe and superior? I know some private doctors in London apply this technique, but was wondering if it is worth taking.
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    • Posted

      Hi Robert, I have done cataract with IOL insertion. Did the left eye on 17/7/15 all was goodno pain I did believe it when they said is done, and vision had improved. Done the right on Friday 31/7/15 I was in pain I felt the entire surgery, why is that? I closed the left just to see if the right eye Vision is as good I'm disappointed no improvement, why is that? What could have happend?
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    • Posted

      You should ask the surgeon about the poor vision.  He knows your eye and can check.

      Regarding the pain during surgery.  It should not affect the visual outcome.  Pity you did not speak or at least groan during surgery as I am sure a few extra drops at the time could have helped immensely.

      I know some people are terrified to move even to the extent of holding their breath but you should have informed him - discomfort is not expected and is easily fixed.  Sometimes there is a nusrse to hold your hand during surgery and you communicate by squeezing her hand as a signal.

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    • Posted

      Hi Robert,

      Could using a retrobulbar block (needle injection) prevent pain during eye surgery? Or do you recommend this type of anesthesia? My upcoming surgeon says he uses it on half of his patients (ones with dense cataracts like mine). I am not liking what I read about it.

      Thanks so much,

      Tee

       

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  • Posted

    Thank you for your kind replies.

    May I ask if the age of the eye surgeon matters? I found an eye surgeon, who started work in 1972. Judged by his CV, he is one of the most prominent in the field in the UK. However, he has retired from the NHS and now works privately. Should I be worried that due to his age, he may not be as good as before?

    Thank you

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    • Posted

      Hard to know how good he is.  If he has a good reputation and is still busy that probably means he gets good results.  Certainly sounds experienced and some young surgeons are relatively rough.  Working privately means he can avoid the hassles common in the NHS.
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