Cataract Surgery
A cataract is caused by clouding or opacity of the natural lens within the eye. This lens is suspended within the centre of the eyeball which consists mostly of water and protein. As we age the lens oxidises and changes colour resulting in blurred vision, glare and a loss of contrast sensitivity in dark or shadowy conditions.
Skillful microsurgical techniques using ultrasound can surgically remove the lens and replace it with an optically advanced polymer which improves the focus.
As with all surgery there are risks involved. These risks, as described below, are important to understand and individuals should always seek qualified expert opinions before undergoing microsurgery to the eye.
CATARACT FEES _ Private Health Insurance
GOLD Health Fund coverage
SURGEON FEE
Known Gap
SILVER Health Fund coverage
Most Health Fund policies do not cover Cataract Surgery on the Silver Tier Level.
Patients need to contact their fund for clarification.
BRONZE & BASIC Health Fund Coverage
Not covered for Cataract Surgery
KNOWN GAP: The Known Gap is the patient out of pocket amount. This is the difference between the allowable surgeon fee and the Health Fund and Medicare Rebates.
Note: Anaesthetist’s fees and any applicable hospital excess will be charged separately.
After Care: Patients consulting fees during the first 4 weeks after surgery are not Medicare Rebatable.
CATARACT FEES _ Self – Insured
Self-Funded Private patients with visually significant cataracts who require small incision cataract surgery in an accredited Day Hospital receive gold standard care which costs: Medicare Rebate + $3,850 per operation (this includes the day surgery facility fee, theatre staff, highly skilled experienced ophthalmic surgeon, highly qualified specialist anaesthetist, mono-focal hydrophobic acrylic intraocular lens and dual purpose implantation gel).
Self-Insured Aged Full Pensioner patients with visually significant cataracts who require affordable small incision cataract surgery in an accredited Day Hospital receive gold standard care which costs: Medicare Rebate + $2,700 per operation (this includes the day surgery facility fee, theatre staff, highly skilled experienced ophthalmic surgeon, highly qualified specialist anaesthetist, standard mono-focal hydrophobic acrylic intraocular lens and dual purpose implantation gel).
Patients who are non-residents, or not covered by Medicare, such as those requesting Presbyopia Lens Exchange, will receive detailed cost estimates after individual needs are assessed.
The symptoms of a cataract vary from minimal to marked disability and include:
- Cloudy or blurred vision
- Problems with glare and image halos around Objects
- Poor night vision for driving
- Colours faded and washed out
- Frequent prescription changes in your glasses or contact lenses
The early symptoms of cataract may be improved with a new glasses prescription, brighter lighting, sunglasses or magnifying lenses. If these measures do no not help then surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an intraocular lens.
The decision to operate on your cataract is made only after careful consideration.
Sometimes a cataract should be removed even if it does not interfere with your vision. For example a cataract should be removed if it prevents examination or treatment of another eye problem such as macular degeneration or diabetic retinopathy. You should discuss your options with your ophthalmologist.
Modern cataract surgery is a day procedure and is performed under local anaesthesia. You will be required to fast prior to your surgery, this means no food or drink whatsoever for at least six hours prior to your arrival to the day hospital. You may take your normal medications with a sip of water. Diabetic medication should not be taken on day of surgery but bring it with you to the hospital.
After arrival to the hospital and before the surgery a series of drops will be placed in your eye. The anaesthetist will see you before the surgery. to arrange the anaesthetic to numb your eye, normally with intravenous sedation and a series of anaesthetic eye drops.
The skin around your eye will be thoroughly cleansed and sterile coverings will be placed around your head. A small incision, less the 3mm, is made and a small instrument is entered into the eye which uses high pitched ultrasound vibrations to break the cataract into smaller pieces which are then removed by suction. This process is called Phakoemulsification. The intraocular lens implant is then inserted into the eye through the same wound and positioned behind the iris. Usually no stitches are required as the small wound self seals.
The final step is to administer antibiotics to help prevent infection and your eyelid may be taped. You will then be moved to a recovery area in the hospital where you will be monitored for a period of time. Most people can go home within two or three hours.
You will need someone to drive you home. For your own comfort, it is important to leave the tape on your eye to keep it partly closed until your see your doctor the next day for a post operative check. You may require time off work and still need spectacles after surgery. Discuss expectations with the surgeon.
Sometimes, months or years after cataract surgery, the original capsule behind the artificial lens can become cloudy. This is called posterior capsule opacification. This is common following cataract surgery and can cause blurring of your vision. It is easily treated with a painless laser procedure called a YAG laser capsulotomy that is performed in our rooms.
Additional costs would be associated with this treatment. You are welcome to contact our rooms for further information.
Over 98% of cataract surgeries are successfully completed without surgical complications, and more than 95% of patients have improved vision. However complications, though rare, can occur and may result in permanent loss of vision.
They include:
Endophthalmitis – infection inside the eye which can cause permanent vision impairment.
Cystoid Macula Oedema – swelling of the macula away from its normal position causing blurring vision.
Posteriorly dislocated lens material – lens material may fall into the vitreous cavity causing pressure pain and blurred vision.
Choroidal Haemorrhage – bleeding in the retina causing permanent visual blurring.
Post-operative Glaucoma – increased pressure inside the eye causing pain and smokey vision.
Unexpected refractive outcome – the focus of the eye requires spectacles for sharpness
Details regarding risks and complications will be provided by your treating ophthalmologist when discussing surgery and proceeding with consent. At this time, your Brisbane Eye Clinic Ophthalmologist will be pleased to answer any queries you may have.
Wound Care: How should I take care of my eye after cataract surgery?
After cataract surgery, you should remove the Perspex shield 6 hours after the operation is completed and resume using the prescribed eye drops. You may gently clean your eye with salty water using a clean tissue. Keep using your eye drops for two weeks after surgery or as instructed by your eye surgeon. Do not rub or apply pressure to the operative eye at any time in the 4 weeks following your eye operation.
Can I drive after cataract surgery?
Please do not drive for 48 hours following eye surgery.
How much time will I need off work?
You can resume work 48 hours after cataract surgery. However, you cannot operate heavy machinery, sign important documents or make important decisions for 24 hours following surgery.
What about exercise?
You may resume exercise 48 hours after your surgery. All other activities including bending and lifting may resume immediately.
What further appointments will be needed after surgery?
After the 1 day post-operative appointment, you will be advised regarding your next appointment. Typically the next follow up appointment will range between 10 days to 4 weeks post cataract surgery. Dilation of the pupil/s will be required and transport from these appointments is required.
What symptoms should I be concerned about?
If the eye feels irritated, sandy or gritty – bathe the eye with a tissue using salty water (1 teaspoon salt in 1 cup of warm water). Use lubricating drops as necessary for comfort.
It is normal to experience the following symptoms:
a) Red, watery eyes with some discomfort (grittiness or itchy feeling).
b) Swollen eyelids – use crushed ice in a small zip lock bag wrapped in a moist cloth for up to 10 minutes per hour for 24 hours.
c) Sensitivity to light.
d) Blurred vision.
Continue using your eye drops for two weeks after surgery or as instructed by your eye surgeon. Take the tablets prescribed as per the Pain Management instructions.
If significant pain persists after these medications have been taken, or if you have concerns and wish to speak to a Surgeon, please contact Brisbane Eye Clinic.
Office: 3832 1700 ALL HOURS, 7 DAYS
Dr Groeneveld: 0412 234 222
Dr Chan: 0423 848 813
What about the other medications I take?
Please take all other medications as normal including blood thinners and aspirin.
Use all your eye drops on the morning of surgery (including your glaucoma drops if applicable).
DIABETIC PATIENTS -Please follow the protocol provided by our clinic which gives instructions on how to manage your medications. Please ensure you take all diabetic medications with you to the hospital.
Do not consume alcohol for at least 24 hours before and after your surgery.
Will I need glasses after Cataract surgery?
The primary goal of Cataract Surgery is to achieve successful surgical removal of the diseased lens which is inside the middle compartment of the eye. Replacement of this sick lens is an essential step in the procedure. The choice of lens, precise measurements, exact calculations and prediction of outcomes using modern mathematical formulae are all critical elements which effect the outcome and clarity of the vision, and spectacle independence, following eye surgery. This requires accurate determination with cutting edge equipment, operated by highly skilled staff, using state of the art technology. The choice of manufacturer and materials _ hydrophobic versus hydrophilic _ remains a critical determinant of the optical outcome.
Glasses or contact lenses may still be required for some activities however more than 80% of patients will be spectacle independent for 80% of their day. Actual results are a spread of refractive outcomes which represent plus and minus tolerances that fall under a bell curve distribution. About 97% of cases fall within 1 dioptre of the refraction target so a few patients may still prefer spectacles or contact lenses to see clearly. Our results are on par with global best practice.
For Cataract Surgery in Brisbane call us today (07) 3832 1700