FAQs

Many patients have questions before they embark on cataract surgery. Here Mr Radford answers some of the common queries.

What is a cataract?

A cataract is a clouding of the natural internal lens of the eye which reduces eyesight clarity. Gradually you become aware of problems, which may include reading, driving (particularly at night), recognising faces, seeing the TV clearly (especially subtitles) using a phone or taking part in hobbies. Most cataracts occur as we get older. By age 65, around a third of people have a significant cataract. Younger people can have cataracts too, due to illness, medicines or family history. The clouding of the lens means less light enters the eye causing a blurred image, or light is scattered by the cataract causing glare or multiple blurred images to form. Most cataracts get worse slowly and it usually takes years for this to become a problem, however, some can reduce vision in just a few months and develop quickly.

When is the right time to have surgery?

The right time is when you feel your symptoms from your cataract are interfering with your daily living needs and you are prepared to accept the small risks of surgery. For drivers, the decision to have surgery often comes when they can no longer read a numberplate at the required distance of 20.5m (67ft) or their vision is less than 6/12.

Other people have vision better than driving standard but are troubled by symptoms such as glare, problems seeing clearly at night or reading difficulties. Your optician or general practitioner may help inform you about the extent of your cataract and whether it is worth considering surgery. If still in doubt, Mr Radford can offer further help so you make a decision that is right for you. Booking an appointment is easy, click here. Surgery is only planned when you are happy that you understand the risks and benefits for your eyes and lifestyle.

What is it like having cataract surgery while awake?

It is surprisingly straightforward. Most people are understandably a little anxious before, however, the commonest thing heard as the operation finishes is: “Is that it, is it finished? Amazing, that was so much better than I expected.”

Mr Radford knows exactly what you are going through having gone through cataract surgery himself. His eyesight has been wonderful ever since and he fully appreciates for each patient just what it means every time he performs surgery. It is a hugely positive experience to be able to give each patient the same lifechanging clarity in a relaxed supportive theatre with excellent caring colleagues who really look after everyone.

During surgery you will be aware of lights and sometimes interesting light patterns and the sensation of cool water on your eye. Your eye is gently kept open by a small guard, so although you may feel you are blinking you can’t. You are kept comfortable by the anaeasthetic drops and protective gels so you won’t feel like you want to blink.

Will cataract surgery be painful?

Cataract surgery should be painless in experienced hands, takes 8-15 minutes depending on the cataract density and other factors. Read what the patients who have had surgery with Mr Radford say. Appreciating each person’s needs and using appropriate anaesthetic measures should result in a comfortable and reassuring experience. You can have as much anaesthetic as required to keep you relaxed.Most patients are amazed to have felt nothing and feel fine immediately. For patients with a phobia of hospitals or anything to do with eyes, sedation or general anaesthesia is available. You will be looked after.

How long will I wait to have surgery?

If you choose to self-fund your surgery/go private, you can expect to have your cataract operation done within two to three weeks. Most patients find that what they thought was their better eye now seems blurred in comparison to the ‘new’ operated eye. Your other eye can be operated on immediately after the first eye or any time afterwards. It is usually recommended that this takes place between one and four weeks after the first operation. Private self-funding patients pay a fixed fee package set by each hospital, which covers all the costs of the operation and follow up.

For patients referred as NHS patients you will be seen within the government target times, although the aim is to do this quicker than standard waiting times.

How successful is cataract surgery and what are the main risks?

Modern cataract surgery is very safe and is improving constantly. Having your operation with a highly experienced and specialist cataract surgeon means it is safer still. Overall, considering the risks both during surgery and post-operatively, 98% of surgery is straightforward with excellent results. You can read comments from patients in the feedback section.

The most serious risks are rare, but include; a loss of vision (less than 1 in 4000), the need for additional surgery (less than 1 in 1000) or residual blurring of vision. If you are considering cataract surgery, a careful discussion will take place so that you are fully confident that surgery is right for you. The results of modern cataract surgery are excellent, with over 80% of people driving without glasses in a few days.

What happens to the 2% of patients who experience problems?

Modern cataract surgery is very safe and is improving constantly. Most problems after surgery get better within a few weeks with additional treatment.

The commonest issues are:

• Inflammation in the eye, which gets better with administering drops more often so that almost all patients make a full recovery.
• Swelling of the retina at the back of the eye, called CMO (cystoid macula oedema). This gets better naturally in half of patients. With additional drops, 95% of patients fully recover. Occasionally further long-term or different treatment is needed. In very rare cases (less than 1 in 5000), the swelling can be persistent and vision remains blurry.
• Swelling of the cornea (front window of the eye). In about 1 in 100 cases temporary swelling of the cornea will cause blurry vision for a few days to a week. A more dense cataract often takes a little longer to remove, meaning swelling is more likely. However, in most patients the cornea is able to repair itself and clear again. Patients who already have changes in the cornea are more at risk of swelling. Specific gels are used in all cases to prevent swelling.  In very rare cases when the cornea does not fully recover, the depleted inner layer of the cornea can be replaced to allow recovery.
• Rarely patients experience visual disturbances, including the sensation of blinkers or a dark arc in their outer peripheral vision. Straight ahead vision is normal. This effect usually goes away by itself in two to six weeks and is the result of an optical effect of the thin new clear lens that has replaced the naturally thicker cataract lens.

Do lens implants last forever?

Intraocular lens implants have improved over the last 70 years so that they can now be implanted very safety and are expected to last a lifetime. The lenses are used in cataract surgery for small children and babies. With a tried and trusted monofocal type lens, there is little chance of problems.

Do lens implants go cloudy?

There have been reports of specific models or brands of lens implants that have gone cloudy and had to be removed and a new lens used. Mr Radford has never used these brands of lenses.   

Why do some people have a laser after cataract surgery?

This is due to the transparent capsular bag that holds the lens going cloudy. Though modern lens implants are designed to reduce the risk of the capsular bag wrinkling or going cloudy, this can happen in 3-10% of cases, any time after surgery. However, this can be quickly and painlessly fixed with a YAG laser capsulotomy, which takes just a few minutes.

Will I need to wear glasses after cataract surgery?

Depending on what you choose and how healthy your eyes are, then you may not need to wear glasses at all, for any task. This depends on what you decide before the surgery about your glasses preference, what lens implant power is used in your eye and the accuracy of the measuring machine used to predict the power. This will be discussed and explained so you understand the options as clearly as possible.

How accurate is the new lens power prediction for my eye?

The power of the new lens is predicted by a computer that performs painless measurements of your eye, known as biometry. Biometry machines have improved continuously over the years, with reports taken across Europe revealing patients receive a result close to the predicted outcome. Mr Radford works with experienced colleagues who are extremely knowledgeable about biometry so that fine tuning and checking is carried out.   

What about different types of lenses such as multifocals, trifocals and EDOF?

Less than 5% of cataract surgeries globally use these different sorts of lenses with the aim of reducing spectacle wear after surgery, though this is not always achieved. The main downside, even with the latest designs, is that patients with these lenses can suffer new visual problems such as glare halos, loss of clarity, ‘Vaseline vision blur’, poor reading vision and starbursts. The most common reason for removing an implant is because it was a ‘special’ or ‘premium’ lens and the patient is unhappy with the effects on their vision. These lenses are more expensive and take up more time to explain. While improvements are being made, Mr Radford does not currently use these lenses, mostly because excellent, predictable and often spectacle-free vision is possible with monofocal lenses. It is very rare that patients have issues with monofocal lenses.

How will you be looked after?

Mr Radford will:

• Put you at ease immediately.
• Listen to your concerns.
• Take time to explain everything clearly so you understand your care.
• Agree any treatment and plan this carefully with you.
• Give you confidence so you feel in control of what is happening and make the right decision for yourself.
• Agree any costs at your first visit.
• Make sure you get the best care available.
• Aim to make you leave smiling, happy and confident so you can clearly see your way ahead.

So many people remain frightened at the prospect of having an eye operation so that even when their vision is becoming blurred they delay seeking help. Modern cataract surgery is a painless five-to-15-minute procedure that is carried out every day for thousands of patients, giving them better vision than they have often ever had previously.

99% of patients are very happy with drop anaesthesia (no needles are needed). If you are frightened, then sedation will mean you are unaware and relaxed during the operation. Patients having sedation are always delighted to remember nothing of the operation

Cataract surgery can result in no longer needing glasses, amazing for short-sighted and very long-sighted people who have often had a lifetime of glasses or contact lenses.