Premium Cataract Surgery

About Premium Cataract/Lens Replacement Surgery

A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil. The lens helps focus light onto the retina at the back of the eye, allowing you to see clearly.

When a cataract develops, the lens becomes cloudy or opaque, causing vision to become blurry, dim, or less colourful. Cataracts usually develop slowly and are common as people age, but they can also result from injury, certain medications, or medical conditions like diabetes.

Kent Eye Centre offers a variety of lens options, which are discussed during your clinical appointment to help achieve the best possible surgical outcome and reduce the need for glasses following surgery.

Symptoms

Symptoms of a cataract can include:

• Reduced vision
• Blurred or misty vision
• Reduced contrast leading to difficulty seeing in low light
• Lights appearing too bright or glaring
• Altered colour vision or faded colours

Diagnosis

The diagnosis is mainly clinical, based on your symptoms and the physical examination of the lens and other eye structures. If a cataract is affecting vision and daily activities, the doctor may recommend surgery.

Treatment

When cataracts interfere significantly with daily activities or quality of life, surgery is the only effective treatment.

During surgery, the cloudy natural lens is removed and replaced with a clear artificial lens called an intraocular lens (IOL).

Most people choose to have a lens implanted in the eye that allows them clear distance vision without glasses but with the placement of a “standard” intraocular lens, patients would almost certainly require reading glasses for close work. Furthermore if the patients have pre-existing astigmatism (irregular shape of the cornea) they would require distance and reading glasses after cataract surgery as the standard lens does not affect the amount of astigmatism. Unfortunately the NHS is currently providing “standard” intraocular lenses only.

One of the benefits of Private cataract/ lens Replacement Surgery at Kent Eye Centre is the ability to choose what kind of lens is implanted. There are three main types of premium intraocular lenses that may be suitable for you. These lenses can increase the likelihood of reducing or eliminating your need for glasses after surgery. The different lens options to consider are:

Toric Lenses:

When most people think of an eyes shape they think of a round structure, like a basketball. In truth, most eyes are more rugby ball shaped, with the eye being a little squashed in one direction. This irregularity is known as astigmatism and is usually easily corrected with glasses. However, if it is significant, a patient’s vision without glasses may be quite poor.

A toric IOL is a bespoke lens placed inside an eye to correct a patient’s astigmatism, at the same time reducing the patient’s short or long sightedness.

After surgery, the chance of needed glasses for distance is greatly reduced, although without the simultaneous placement of a multifocal lens (“toric multifocal”), patients should still expect to need reading glasses.

Cataract surgery in patients with marked astigmatism using standard, non-toric IOLs does typically lead to improvements in vision, but patients will typically need glasses for distance and near vision following surgery.

Multifocal Lenses:

Multifocal lens implants feature a patented “apodized diffactive” design that optimally distributes light to distance, intermediate and near focal points, depending on the amount of ambient light available. This optimises image quality in all lighting conditions.

With such lenses, about 90% of people achieve day-to day spectacle independence, meaning that typically they can both drive, use their smartphone and read e.g a restaurant menu without glasses. For more prolonged reading, such as a novel, however, many patients still choose to wear reading glasses. In the dark, some patients do complain of halos around lights; however these tend to subside with time due to the neuroadaptive effect of the human brain.

Toric Multifocal Lenses:

These lenses combine the benefits of both toric and multifocal lenses ie simultaneously improving astigmatism and aiming to achieve spectacle-independence for distance and near.

EDoF Lenses (Extended depth of field):

A newer design of intraocular lens is the “extended depth of focus” (abbreviated to EDoF). These lenses use advanced optical properties.

Multifocal lenses are not the same as extended depth of focus lenses, although some manufacturers have confusingly re-termed some multifocal lenses as EDoF lenses to try to move away from the stigma of high glare/halos associated with historic multifocal lens designs.

EDoF lenses are therefore an excellent choice for aptients not willing to compromise on optical quality who want good distance and intermendiate vision and are happy to accept they will need reading glasses for most near tasks other than larger print. In order to improve the depth of focus, EDoF lenses are usually used with the mini-monovision technique.

Mini-monovision, also known as modified monovision, is a technique in which the dominant eye is treated with a lens to enable clear distance vision while under-correcting the non-dominant eye. Mini-monovision utilises a smaller interocular dioptric power difference between the two eyes compared to traditional monovision and improves the depth of focus, so that most patients will only need glasses for reading small print after surgery.

Examples of EDoF lenses include the Johnson and Johnson Tecnis Eyhance lens or the Alcon Vivity lens. These lenses are designed to give high-quality distance and improved intermediate vision to make everyday tasks easier, with reading glasses typically needed for smaller print or fine near work activities.

Costs

A consultation including comprehensive assessment is at a cost of £350.  The cost of any surgical treatment required will be discussed at the consultation appointment.

The Process

1. Medical and Vision History

The Ophthalmologist asks about your symptoms, vision changes, and any risk factors (age, injury, medications, medical conditions).

2. Visual Acuity Test

This test measures how well you can see at various distances using an eye chart.

3. Slit-Lamp Examination

Using a special microscope with a bright light, the doctor examines the structures at the front of your eye, including the cornea, iris, lens, and the space between them, to check for cloudiness in the lens.

4. Retinal Examination

After dilating your pupils with eye drops, the doctor examines the retina and optic nerve at the back of the eye to rule out other causes of vision problems.

5. Tonometry

Measures the pressure inside the eye to check for glaucoma, which can sometimes accompany cataracts.