Cataract with vision correction, complex cataract surgery and intraocular lens replacement
Cataract changes the focusing lens inside the eye. Initially the lens hardens and then turns yellow or milky which affects the clarity of vision.
Mr Kolb has operated on thousands of patients for cataract. He is experienced in all types of cataract surgery, and with the skills acquired through Vitreoretinal surgical training, he can proficiently treat the most complex of surgeries with excellent visual outcomes. He also trains junior surgeons at Leeds St James' University Hospital to become consultants, proficient in cataract surgery, and takes great pride in this area of his work.
Most surgeries are for age related cataract, however some patients require treatment for traumatic cataract, or cataract secondary to other eye health conditions such as diabetes.
Surgery usually takes around 10 to 15 minutes in most cases, and is usually done with topical anaesthetic drops, where the patient will be aware of surgery but with no pain. The surgery has evolved over decades, and techniques are now very efficient and do not require sutures or extended recoveries. The cataract is removed with microscopic surgical techniques. A modern, custom acrylic lens is inserted in its place. The new lens focuses the light for crisp vision - like glasses or contact lenses would do.
Recovery from surgery is swift with good vision returning after a few hours. Usually vision is corrected with a monofocal intraocular lens, resulting in minimal or no need for distance glasses. This gives the best clarity of vision out of all available intraocular lenses, but does require the use of reading spectacles for fine detail close-up vision in most patients. Some patients will always need spectacle correction for astigmatism (an uneven rugby ball shape to the cornea - the front surface of the eyeball) with separate distance and reading, or a combination bifocal or varifocal glasses. Most patients opt for distance vision correction (useful for driving and every day vision), whilst some patients who are already short sighted and able to read without their distance glasses, may opt to stay short sighted so that they have the ability to take their glasses off to read. Other patients are able to use monovision, where the non dominant eye is able to take a reading prescription intraocular lens. This is uncommon and is worth talking to your optometrist prior to a surgical consultation to see if it is suitable for you. Mr Kolb will discuss all these options with you at the consultation prior to surgery to help you feel comfortable with your personlised surgical plan.
The surgery is very safe with a small risk of complications. Vision can rarely be worse after surgery (in less than 1% of patients). Severe complications are extremely rare (less than 1:1000 with a potential to cause severe sight loss).
Alternative intraocular lenses are available at a premium, including multifocal, astigmatic and combination lenses. These are included in refractive lens surgery packages and work in most (around 80%) of patients, rendering them glasses free for distance and near vision. There is a small risk of visual side effects such as glare. These lenses are best provided by a specially trained and certificated refractive surgeon, and can be inquired through most private eye hospitals. Mr Kolb does not offer these lenses with cataract surgery.
Post operative recovery is usually quick, vision can improve within a few hours for some, a few days for most, and a few weeks rarely. Anti-inflammatory drops are required for 4 weeks. It is advisable to avoid strenuous lifting/activity for 1-2 weeks, you can however return to work as soon as you feel able to. Avoid shampoo, soap etc getting onto the eye from washing for at least a week until the surface of the eye has healed. Driving is legal as long as you are comfortable with the change in vision and can read a number plate with or without glasses at 20.5 metres. After 4 weeks, on stopping the drops you can see your own optician for an update in spectacles. Between first and second eyes and before you see your optician, if your old glasses don't help for reading then a pair of 'ready readers' may be enough to help with reading vision. If there are any concerns post operatively then please contact the hospital urgently for advice.