Surgery is the only treatment option for cataracts—they are not preventable or treatable with medications. Cataracts are treated with surgery to remove the clouded lens, and are replaced with a new, clear intraocular lens implant. The surgery is performed through a tiny incision on the side of the cornea. In some cases, our surgeons may use a laser to perform some of the elements of the surgery resulting in an even gentler, more precise procedure. After the cataract is completely removed, the surgeon replaces it with a prosthetic intraocular lens or IOL, which allows light to focus clearly again.
2. Trifocal Implant Lens for Cataract Patients New
A new trifocal lens implant that offers near, intermediate and distance vision, is revolutionizing the treatment of cataracts.
Implantation of an intraocular lens (IOL) after surgical removal of cataract via phacoemulsification surgery is the standard of care for cataracts, an age-related condition that results in clouding of the eye’s natural lens.
Although monofocal IOLs result in excellent distance acuity, patients usually require corrective spectacles for intermediate and near distances.
The goal of multifocal intraocular lenses (IOLs) was to provide clear and comfortable vision to patients at all viewing distances; this is often difficult to achieve. Vision at near and distance has been generally reported to be satisfactory, but intermediate vision was often problematic. Intermediate vision has become an increasing concern for patients as a result of the proliferation of handheld devices and the increasing use of computers and tablets in daily life. This means that many patients who had traditional diffractive multifocal artificial lenses inserted into their eyes found they had good near vision and could see far away, but their middle-distance vision, for instance when they looked at a computer screen, was blurry. Many still had to use glasses and contact lenses to fill this gap. In addition, traditional multifocal lenses also cause too much glare for many people.
The trifocal implant has the advantage of offering clear intermediate as well as distance and near vision with minimal glare and haloes at night. The trifocal intraocular lens were designed such that the dioptric power of the near focal point was twice the dioptric power of the intermediate focal point.
Advantages of Trifocal Lens
Outstanding intermediate visual acuity
The trifocal implant significantly improves intermediate visual acuity enabling patients to feel more comfortable performing their intermediate distances activities.
High resolution under all light conditions
The trifocal implant produces images with high resolution for all distances under all light conditions. Patients will be able to switch back and forth between targets at different distances without the need to put on corrective glasses.
Singapore Cataract Clinic by Dr Leo Adult & Paediatric Eye specialist is now one of the few clinics in Singapore that is able to offer you the next generation of multifocal intraocular lenses (IOL’s) – the trifocal.
Book your consultation with our experienced Cataract surgeon.
3. Bladeless Laser Surgery
Yes, it is now possible to perform laser cataract surgery in Singapore. The FDA-approved LenSx® laser system is based on the same femtosecond technology used during bladeless LASIK procedures. The system uses integrated optical coherence tomography (OCT) which captures precise, hi-res images of the patient’s eyes.
It gives the eye surgeon image –guided control and the ability to plan and customize each procedure to the unique characteristics of the patient’s eye.The femtosecond laser has replaced many of the steps in the cataract surgery that were previously performed by human hands, i.e., resulting in less surgical error and better predictability of outcomes. Results are more precise than any other previous or current methods of cataract surgery.
At the Mt Elizabeth Hospital, Dr Leo Seo Wei uses the femtosecond laser to make the corneal incisions, create a perfect size capsulotomy and break apart the cloudy cataract lens. She is one of the few eye specialists in Singapore doing bladeless cataract surgery.
Benefits of Bladeless Surgery
Bladeless surgery offers more advantages and benefits than conventional surgery.
- More architecturally round and centred openings created
Femtosecond lasers emit optical pulses of extremely short duration (one-quadrillionth of second). This allows tissue to be cut more precisely with negligible heat. The femtosecond laser consistently makes a perfectly centred, optimally sized, circular opening in the front of the lens capsule. This is important to keep the IOL well-positioned and stable for better visual outcomes.
- Less energy required for lens phacoemulsification
Laser reduces the amount of ultrasound energy used during phacoemulsification, lessening the risk of injury and complications. This is particularly important in denser or more challenging cataracts.
- More precise cornea cuts
The femtosecond laser increases control, accuracy and allows customisation of the cornea incisions such as additional small cuts to correct astigmatism. It allows for more predictable outcomes.
Note - Bladeless cataract surgery is suitable for most people except those with cornea disease, glaucoma, poorly dilating pupils or those who cannot tolerate the suction used to stabilise the eye
4. Vision Correction & Lens Selection
During cataract surgery, new and different types of IoLs can also now be inserted to correct the various types of refractive errors. This new approach is more aptly called cataract refractive surgery.
The most common type of IoL is placed behind the iris within the lens capsule (the elastic bag where the natural lens used to be). The IoL acts just like the natural lens to focus light onto the back of the eye (the light-sensitive retina). Conventionally, monofocal IoLs provided a set focal point, usually for distance vision. This means cataract surgery patients, while being able to see clearly within a range, will require glasses for reading. The surgeon may choose to insert an IoL in one eye for near vision and an IoL in the other eye for distance vision. This technique requires adaptation, since each eye will then be oriented towards different needs.
Multifocal IoLs, or advanced technology IoLs, are a newer type of lens that treats multiple focal points and reduces or eliminates the need for eyeglasses or contact lenses after cataract surgery. This is possible through highly specialised optics that divide light and focus it on more than one point to provide a range from near to far eyesight. Some IoLs can also correct astigmatism and minimise the need for distance vision glasses after surgery.
No single lens works best for everyone. The eye surgeon will determine the most appropriate option for the patient. With appropriate IoL selection, high-precision bladeless cataract refractive surgery has become a reality!