Customised Cataract Surgery

The plethora of techniques, instrumentation and choice of lens implants today allows for a fully customised approach for patients undergoing Cataract surgery. Standard NHS cataract treatments are perfectly adequate for some, but for those who wish to use the once in a lifetime opportunity of cataract surgery to reduce or eliminate glasses for distance viewing (eg driving) and even for close range vision (eg reading & using computers) a more personalised, customised approach to cataract surgery is essential.

Advanced fully customised cataract surgery is now available here in Yorkshire - a more sophisticated service than will be found even in most standard private clinics. Learn for yourself the potential benefits of true customised cataract surgery - you can even take a simple online test to determine how suited you may be to a fully customised cataract procedure.

Until now, glasses wearers still needed to depend on their spectacles after cataract treatment. Standard surgery involves inserting a 'standard' lens implant to restore general focus and improve the overall quality of vision which works reasonably well but we can now offer treatments with lenses which can either reduce dependence on spectacles or allow them to dispose of glasses completely following their cataract treatment! Customised techniques using a highly targeted approach can effectively minimise the need for distance & reading spectacles in the vast majority of patients.

In fact over 95% of patients can meet the legal standard for driving in the UK without the need for glasses or contact lenses and it is not unusual to see patients in their 70s and 80s who are seeing better than they have ever done before.

In order to ensure the best possible outcome to meet the patient’s individual requirements and expectations, I work very closely with the patient to select the lens best for them and tailor this to the patient and their lifestyle – there is no longer any need to "fit the patient around the lens" - in fact I take very much the opposite view in that the lens implant must work best for the patients specific visual requirements. Many surgeons still offer a standard service today but this is not, in my view, the most effective way to ensure satisfaction for the patient.

If you are interested in customised cataract treatment, the best way forward is for you to complete the simple questionairre below and press submit. This information enables me to know as much about you, your lifestyle and your needs prior to any consultation.

The consultation itself can then be much more about you and your treatment which will help to streamline the process and ensure you receive the lens implant that best suits you, with the ultimate aim of providing you with the vision that you would like to see.

How can a fully customised cataract procedure Benefit the Patient ?

Custom targeting for lens implant "strength" can accurately minimise or eliminate the need for spectacles for distance viewing eg for car driving, golf etc.

Custom lens implant selection can reduce or eliminate the need for spectacles for close work and reading as well (see next page for more details).

Customised surgical techniques & lens implants can help to optimise vision by controlling and reducing astigmatism.

Customised lens implant selection can help to reduce spherical aberration "the fourth dimension" of vision (see below) which can enhance visual performance in dimmer or more challenging lighting conditions.

In short a better-chance of better-sight.

Modern customised cataract surgery is performed under simple eye-drop anaesthesia - long gone are the days of several days recovering in a hospital after a general anaesthetic ! In fact most patients are up and about the very next day after such treatment. Vision stabilisation also occurs much more quickly, most patients enjoying stable good quality vision within a couple of days.

Mature Couple Reading Paper

A recent introduction for the benefit of patients is an inclusive treatment package called the refractive package. This allows for fine focus adjustments to be made using Laser vision correction techology (LASIK, LASEK, or EpiLASIK) post operatively at the two to three month stage at no further cost to the patient. The added security & reassurance of being able to achieve precisley the desired optical state best suited to your personal requirement is comforting for both patient & surgeon.

Learn more about specialised lens implants

Aberration Correcting Single Focus Lens implants

The implants below are specifically designed to help control "spherical aberration" when used as part of a customised approach in cataract / refractive lens exchange surgery. Learn more about the "fourth dimension" in vision correction and how it can be of help to the patient;

^{Up until now spherical aberration has been the cinderella of vision targeting in cataract / lens replacement treatments. Read below to help understand why it may be important for you.}

^{Glasses and contact lenses can only correct what we term lower order aberrations - that comprise defocus - this can be minus (short sight) , plus (long sight) or astigmatism. If you wear glasses they will be correcting only these "lower order aberrations" Just try taking your distance glasses off this gives a good idea for you personally what lower order aberrations do!}

^{The most common and the most important 'higher order visual aberration" - one that cannot be corrected by glasses or contact lenses is termed spherical aberration. This causes a general decline in sharpness of vision. Spherical aberration is lowest in most people at age 19 years and tends to decline thereafter. That is why most people enjoy their best vision (with glasses/contacts as required) at around that age. By taking into account spherical aberration when it comes to cataract surgery or refractive lens exchange surgery for vision correction we can attempt to restore the kind of sharp visual quality that we enjoyed in our youth. Studies have also shown that lower levels of spherical aberration can improve dim light visual performance and can make a significant positive impact on driving vision especially when in poor light or foggy conditions. The implants outlined below can, when custom matched carefully, help to control the degree of spherical aberration after cataract / lens exchange surgery - ultimately providing the missing dimension in customised cataract surgery.}

^{Tecnis ZCB00: http://www.amo-inc.com/products/cataract/monofocal-iols/tecnis-1-piece-iol}

^{This is a monofocal, beautifully engineered lens. Its raison d'etre is that it is designed to counteract the “positive spherical corneal aberrations” that exist in the majority of people. The Tecnis ZCB00 is designed to provide the same type of “negative spherical aberration” as the human lens at age 19 years. This lens has been proven to improve “contrast sensitivity” - this is the ability to be able to discriminate objects in dim light and has shown a positive effect with respect to stopping distances in simulated driving tests.}

^{Physical Properties : Negative spherical aberration of -0.27um Made from Hydrophobic Acrylic, Optic size 6.0mm Overall size 12.5mm, Cartridge injectable.}

^{Summary : An excellent, injectable, monofocal lens implant that adds a further dimension to customised cataract surgery and lens replacement for vision correction. I think this lens has special relevance to people who have previously had Laser vision correction for short sight and for those who have positive corneal spherical aberrations on custom testing.}

^{Acrysof SA60-IQ: http://www.uk.alcon.com/surgical/cataract.asp}

^{This is a monofocal implant made from the celebrated Acrysof material that has a long established safety and biocompatibility record. The special feature of this implant is that the optical portion of the implant is designed to produce zero spherical aberration. This implant is one that I often use in patients who dont have notable spherical aberrations on custom testing so that we help to maintain a sharp visual system.
Physical Properties : Zero spherical aberration. Made from Hydrophobic Acrylic (Acrysof tm), Optic size 6.0mm Overall size 12.5mm, Cartridge injectable.

Summary : An excellent, injectable, monofocal lens implant that provides further flexibility to customised cataract surgery and lens replacement for vision correction. I think this lens has special relevance to people who have little or no pre-existing spherical aberrations on custom testing.}

Astigmatism Correcting Single Focus Lens implant

At present I generally use this lens implant whether in monofocal or bifocal format for the correction of astigmatism.

^{Acricomfort Toric Monofocal Implant: http://zeiss.acritec.eu/index.php?id=45&L=1}

AT Lisa Toric 909M ^{This lens is part of the Acritec family of lens implants. I call upon this implant on a regular basis for the correction of high predicted astigmatism in cataract or refractive lens exchange surgery. The lens is monofocal - ie corrects for distance sight and has proven itself well in my practice. It offers safety and predictability of insertion via a cartridge device and has shown excellent rotational stability. In addition it can be inserted through a very small incision to help minimise the induction of further astigmatism.}

^{Physical Properties : Hydrophilic Acrylic, Bitoric optic configuration Optic Size 6.0mm, Total size 11.0mm, Aspheric optics, cartridge injectable}

^{Summary : An excellent astigmatism correcting, monofocal lens implant with proven rotational stability which is extremely important in this type of custom lens implant.}