Cataract Surgery Explained

Cataracts might be the most common cause of poor vision today, but here are ten things you probably did not know about this common ophthalmic surgery.

One- It is much quicker than you would think. If it is straightforward cataract surgery, the procedure only takes about 10-15 minutes.  If it is straightforward cataract surgery, the procedure only takes about 10-15 minutes.  

Two- The surgery is done with topical drops or a spray.

Three- You will see a kaleidoscope of images during the surgery. Patients see only beautiful lights during the surgery because the eye topical anaesthetic distorts their images, displaying a kaleidoscope of colourful lights.

Four- Cataract surgery gets rid of the haze. Have you ever seen someone endlessly wiping their glasses when their glasses are actually spotless? One of the main indicators of cataracts is that the patient’s lens looks hazy under a microscope. When people look through a cataract, they think this haze is on their glasses, when it is actually due to the cataract behind the pupil.

Five- Your ophthalmologist will be seated next to you the entire time. One or two hours before the surgery you will be in a pre-operative preparation room where you will get drops in your eye to dilate the pupil. You will then be taken to the theatre in a wheelchair. Your face will be cleaned with an antiseptic solution. Your ophthalmologist will be seated next to you, the eye not being operated on will be covered with a drape. You won’t have to worry about keeping your eye open, Dr will keep it open with a small speculum. You will have access to oxygen to prevent feeling claustrophobic.

Six- Cataracts cannot ‘grow back’ after surgery. But, the eye, like all other organs, has a metabolism of its own. Fluid constantly circulates through the eye. What can happen is that protein deposits can start to cling to the lens, giving you the impression that a cataract is developing again. In this case, it appears as if you are looking through that same mist as before the surgery. This certainly does not always happen. Rather – We can not predict when this will happen – it might take years.

Seven- These post-surgery protein deposits can be dealt with non-surgically. It can be treated with a painless, non-surgical procedure, which is not in the theatre. You sit in a similar chair as during your examination, with your chin in a chinrest. Your ophthalmologist will then dilate your pupil and shoot the protein deposits off with a YAG laser. You feel as if he is doing nothing and all you can hear is a “tick tick” sound. Your pupil will remain dilated for the rest of the day, so your vision will still be blurry. The next day when your pupil is back to its normal size, your vision will also be back to normal.

Eight- You can have LASIK after Cataract surgery. Bear in mind that you need to have a regular corneal shape and enough corneal tissue to correct the remaining refractive error. But this has nothing to do with the cataract surgery and is a factor that all ophthalmologists will consider when determining whether or not a patient is a candidate for LASIK.

Nine- Cataract surgery is performed on the lens of the eye. This is surgery which involves going behind the pupil and operating on the lens. The lens should be naturally crystalline, but with age the lens can lose transparency, causing the aforementioned haze.

Ten- Cataract surgery can also be used for other eye conditions. Refractive Lens Exchange involves changing the lens due to optical error and not because it is misty. This is the same procedure as cataract surgery. This is not done on ages less than 45 unless you have cataract as well.

If you have any questions about Cataract Surgery contact Dr Aleksic at his rooms in our Office Tower on the 7th floor.

Understanding cardiovascular disease

Understanding cardiovascular disease

By Dr Jane Benjamin

 

Cardiovascular disease refers to heart disease (angina & heart attacks), stroke & disease affecting your vessels.

 

CVD is the leading cause of preventable deaths. 80% of heart disease and stroke could be prevented by simple lifestyle measures. Risk factors for CVD are often silent, meaning we are unaware of them until it is too late.

 

Risk factors:

There are certain risk factors that you can’t changes, these include:

  • Age: risk increases with age
  • Sex: Men are at greater risk than women
  • Genetics: Your risk increases if you have a first-degree relative affected at a young age or a family history of high cholesterol
  • Ethnicity: risk differs among ethnic groups
  • Socioeconomic status: Death from cardiovascular disease is 3 times higher in the poorest areas

 

Other risk factors:

  • Smoking
  • Cholesterol
  • Lack of Exercise
  • Diet (low in fruit and veg, high in saturated fat, high in salt and sugars)
    • High blood pressure
    • Increased alcohol intake
    • Increased psychosocial stress
    • Being overweight

 

Other illnesses can increase cardiovascular risk, and treatment of these conditions may reduce the risk. These conditions include:

  • Diabetes (and pre-diabetes/metabolic syndrome).
  • Chronic kidney disease
  • Atrial fibrillation
  • Rheumatoid arthritis and other autoimmune diseases.
  • High cholesterol
  • High blood pressure

 

How to reduce your risk of CVD?

  1. See your doctor for a proper risk assessment:
  • to check for other illnesses that increase risk including diabetes and high blood pressure
  • to check your cholesterol, thyroid function and sugar levels
  • to check blood pressure, waist circumference and BMI (body mass index)
  1. Eat well to protect your heart
  • At least 5 portions of fruit and veg daily
  • Reduce salt intake
  • Eat oily fish
  • Reduce total fat, saturated fat and sugar intake
  • Avoid excessive intake of caffeine containing drinks
  1. Stop smoking
  2. Stay active:
  • 30 min of exercise 5 days a week is advised, this can be in 10 min bursts throughout the day
  1. Keep an eye on your alcohol intake:
  • Men should not have more than 3-4 units per day/ 21 units per week
  • Females should not have more than 2-3 units per day/14units per week
  • Don’t binge drink and have 2-3 alcohol free days a week
  1. Keep an eye on your weight:
  • If you are overweight BMI>25 your doctor will offer you advice and support to help you achieve a healthy weight

 

What if you are at increased risk of cardiovascular disease?

Your risk is modifiable, that means with dietary and lifestyle changes your risk can be reduced. If you are at high risk, together with the lifestyle changes listed above, you may benefit from lipid lowering agents such as statins, and or aspirin or a similar drug.

 

For more information please contact your doctor or visit the Heart and Stroke Foundation of South Africa website www.heartfoundation.co.za/‎