Cataract is clouding of the natural crystalline lens inside the eye. Cataract formation usually occurs with age, and can be accelerated by conditions such as diabetes mellitus. Cataracts result in gradual worsening of vision, and can affect one eye or both. Cataracts can also result in the vision becoming ‘cloudy’. A fair number of patients with cataracts complain of seeing glare or haloes around lights (particularly at night). Most people above the age of 60 years have some degree of cataract formation, but this can range from very mild to severe. Despite being a treatable condition, cataracts are still the leading cause of blindness globally (17 million humans). Cataract are also a cause of moderate to severe visual impairment in more than 83 million humans.

At the Harley Vision, we aim to treat the following during Cataract Surgery:

  1. Cloudiness of the natural crystalline lens inside the eye (i.e. cataract)
  2. Short-sightedness or long-sightedness
  3. Astigmatism

The aim of cataract surgery is to treat all of the above 3 conditions. Treatment is tailored to the individual to facilitate the best possible vision that will suit their lifestyle requirements. It is important to bear in mind that there is no perfect solution to match all lifestyle needs. During the consultation, the surgeon will help you pick an option that is most suitable for you.

Possible Causes Leading to Cataract Surgery

Cataracts are usually age-related issues and progress over a while. A multitude of factors affect ageing of the natural lens of the eye leading to cataract formation, including ultraviolet light exposure, smoking, poor nutrition, diabetes, and severe dehydration.

Chronic conditions of the eye may result in cataract formation, such as recurring eye inflammation (uveitis), chronic use of steroids. Injuries, such as trauma (physical injury), radiation or chemical burns  can result in accelerated cataract formation.

Cataracts be also be congenital (hereditary), resulting in cataract formation in childhood or early adulthood. To identify the exact reason that may now require cataract surgery, get in touch with an expert cataract surgeon in London at the Harley Vision.

Early Signs and Symptoms

In some cases, patients start to notice symptoms such as clouded, blurred or dim vision, vision difficulty at night, sensitivity to light and glare, difficultly under low light conditions, Halos around lights, frequent changes of spectacles (glasses) or contact lens prescription, yellowing of colors, dimming of colours, double vision, etc.

The symptoms of cataracts do not start overnight. Cataracts tend to result in gradual blurring of vision, and this tends to worsen over months and years.  

If you are suffering with symptoms of cataracts, you can book a consultation with an ophthalmologist in London who will go through the treatment options with you.

Cataract Surgery

Frequent asked questions (FAQs):

AI has an important and evolving role to play in improving outcomes of cataract/RLE surgery. Accurate lens selection is the key determinant of clarity of vision for a non-complicated operation. The first step at the AI vision clinic is the patient having a discussion with the surgeon and choosing their desired visual outcome. The lens selection is based on AI methods, as well as the surgeon’s experience. The surgery itself is performed by the surgeon. The enables achievement of the best possible visual outcome for the patient. 

NICE guidelines (adopted by Royal College of Ophthalmologists) state: ‘having a PCR rate of approximately 2% or less is widely regarded as an indicator of surgical competence’. (NICE cataract surgery guidelines 2017).

Mukhtar Bizrah has extensive experience in complex cataract surgery, as well as cataract surgery combined with corneal transplantation. Despite managing complex cases, his posterior capsule rupture (PCR) rate is 0.8%, which is one of the lowest nationally. 

Cataract surgery enjoys a high safety profile. Risk of needing another operation is 1 in 100, and risk of permanent loss of vision (due to severe infection or bleeding) is approximately 1 in 1000. About 20% of patients may develop clouding behind the implanted lens, which may require treatment with laser. The laser treatment usually takes a few minutes and recurrence of the problem is very rare.

You vision will depend on the type of artificial lens that you choose to be implanted inside the eye during the surgery. Options include:

  1. Monofocal lens: Many individuals prefer to have excellent vision in the distance, and are happy with the option of wearing spectacles (glasses) for near (reading) vision. A monofocal lens enables excellent clarity and contrast for a chosen distance (distance, intermediate or near vision). It does not allow one to see well for both distance, intermediate and near without spectacles. A monofocal lens is the least likely to result in haloes.
  2. Toric lens:This enables treatment of astigmatism, as well as the cataract. A toric lens is highly recommended for suitable individuals who have a significant degree of astigmatism
  3. Enhanced depth of focus lenses:These enable patients to see well for both distance and intermediate (about 1 metre) vision. For fine near vision, spectacles correction is often needed. They are less likely to result in haloes and glare than trifocal lenses.
  4. Trifocal lenses:These enable individuals to see well for distance, intermediate and near visual activities. The overall contrast of vision is for each distance is not as good as a monofocal lens set for a certain distance. However, these have the major advantage of allowing spectacle independence.
  5. Monovision:This means implanting a monofocal lens to enable distance vision in one eye, and a monofocal lens for near or intermediate vision in the other eye. While the idea sounds complex, a surprising number of patients opt for this and are pleased with the outcomes.

Choice of the lens is based around your preference and lifestyle, as well as the presence of other eye conditions. The above provides a blueprint, and more detailed discussion with an experienced surgeon will help you make the decision that is right for you.

At the AI vision clinic, we utilise 3 key elements in our management of patients:

  1. Patient choice
  2. Clinical and surgical expertise
  3. Evidence-based treatments and artificial intelligence (AI)

Large clinical trials have not shown laser-assisted cataract/RLE surgery to improve patient outcomes nor safety of cataract surgery. At the AI vision clinic, we therefore do not perform this procedure, as we cannot ethically justify the increased cost to the patient.

Previous laser eye surgery does not affect your ability to have cataract surgery. The main challenge in such cases is choosing the correct lens to be implanted inside the eye. Previous laser eye surgery affects accuracy of eye measurements, which in turn affects choice of lens to be implanted inside the eye.

Mukhtar Bizrah trained in one of the highest volume cataract surgery clinics in North America for patients with previous laser eye surgery (e.g. LASIK or PRK). Using his vast experience in this field, he is able to optimise visual outcomes and minimise risks of unexpected surgical results.

Yes, at the Harley Vision, cataract surgery can be performed on both eyes on the same day.

Cataract surgery, whether performed privately or in the NHS, results in fantastic visual outcomes. Dr Mukhtar Bizrah operates on patients with standard and complex cataracts in private and Imperial College Hospital NHS Trusts.

The main difference between cataract surgery in the NHS and private sector is the use of premium intraocular lenses privately. These multifocal and toric lenses enable patients to see well for more distances (e.g., distance, intermediate, and near) rather than one distance only. i.e., the difference between spectacles that correct distance only and varifocal or bifocal spectacles that accurate vision for a range of lengths. Premium intraocular lenses give patients more independence from spectacles. There has been a massive leap in premium intraocular lenses technology over the last five years, resulting in better vision and less undesirable symptoms.

There is enormous variability in the quality and price of the different multifocal intraocular lenses. At the Harley Vision in London, we use some of the most advanced intraocular lenses in the world to correct vision during cataract surgery regardless of the cost of these lenses. Don’t hesitate to contact the Harley Vision in London for more information about the latest intraocular lenses used by Dr Bizrah for cataract surgery and refractive lens exchange.

Cataract surgery is not painful because of the anesthesia administered before the surgery. The surgery can be done under local anesthetic (most common), sedation, or rarely general anesthesia. After the cataract surgery, it is common to feel occasional mild discomfort or foreign body sensation. This resolves with time. At the Harley Vision in London, the keyhole incisions (usually 2.2mm for the most extensive incision) and advanced technology mean that most patients do not feel any pain and recover remarkably fast. You can expect to get discharged on the same day. At Harley Vision, we make the whole cataract surgery process painless and hassle-free for you.

It is advisable not to drive on the day of your cataract surgery. It’s better to ask someone to pick you up after cataract surgery and drive you home safely. The vision usually improves within 24 hours of cataract surgery. While legally, nothing is stopping you from moving as soon as your vision is within legal limits for driving, it is advisable to give yourself time to adjust to your change in vision.

Nothing is stopping from walking immediately after the surgery. It is advised to refrain from any heavy exercise for at least a week after the cataract surgery. If you have had a premium toric intraocular lens implanted, it is advisable to avoid heavy exercise for 3-4 weeks to avoid rotation of the lens. A toric intraocular lens is aligned at a particular axis (0-360 degrees) to correct astigmatism and can result in marvelous vision after cataract surgery. However, even mild rotation of an intraocular lens can lead to a suboptimal visual correction.

In cataract surgery, the cloudy natural lens is removed by the surgeon and replaced with an artificial IOL or intraocular lens. Nowadays, most types of cataract surgery in London involve using a high-frequency ultrasound device that is painless and quick to break the cloudy lens into a number of pieces that are gently removed via suction by the surgeon. A good clinic in London with advanced modalities can make your surgery a hassle-free affair.

There are a lot of methods for removing a cataract; the modalities will vary from one clinic to another in London. Some of them include Phacoemulsification, Manual Extrascapular Cataract surgery, Manual Small incision cataract surgery, Femtosecond Laser-Assisted Cataract Surgery, and Intracapsular Cataract surgery. Make sure to ask about these options to your doctor while shortlisting clinics for cataract surgery in London.

A major surgery includes opening the body, accessing the area, and treating the cause. It involves extensive life-threatening cases like heart surgery, organ and joint replacements, and cesarean sections. Thanks to advanced technologies in London, Cataract surgery has become a simple procedure, unlike it was twenty years before. It is painless and takes a very short time. You can expect to get discharged and return home the same day without any complications; thus, it’s an effective Outpatient Surgery.

Irrespective of the clinic you choose in London, The cataract surgery does not take more than 20- 45 minutes. However, the pre-procedure takes 3-4 hours, including getting the preoperative care, administering drops, etc. Even after the cataract surgery gets over, you can go home only after your ocular parameters like vision and intraocular pressure have been recorded and monitored by the surgeon.

If a cataract is left untreated, your symptoms will worsen, leading to the point of complete blindness. Often a swollen cataractous lens may block your aqueous pathway leading to a surge in the intraocular pressure which will need emergency treatment to subside. Avoiding cataract surgery for too long will make cataracts hyper mature, leading to complications in the surgery and a substandard outcome after it. It is best to get your cataracts operated on at the right time to prevent such complications.

Your vision will be blurry right after the surgery, and it’s normal to experience such post-operation complications. Within 24 hours, you will start noticing improvements in your vision. At first, the change might seem a bit raw to you. Normal light will feel like too much, and colors will look too bright. But it is because of living with a cataractous lens for a long time. You will get used to the new clear lens in a few weeks. You can resume your normal routine like driving and exercising within two weeks of surgery, provided your parameters are normal.

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