By Cheah Ui-Hoon

TOO old to go for Lasik? If you're in your 50s and above, the other way to gain spectacle-less vision these days is to go for cataract surgery. Well, ok, so it presumes that you get cataracts, but inevitably, your chances of getting them increases with age, eye surgeons tell us. Be glad that new techniques of cataract surgery have allowed for the operation to double as refractive surgery. Cataract surgery spells a new lease of sight for your eyes these days.

"Having cataract surgery would not only restore but would actually enhance your vision more than before because it's now a chance to get rid of myopia and astigmatism as well," says Dr Ronald Yeoh, medical director of Eye & Retina Surgeons.

Our lenses act like camera lens, by focusing light on the retina which allows us to have vision. But as we age, they gradually lose their transparency. "Most people start developing cataracts in their 50s. With each decade, the likelihood of getting cataracts increases," he points out.

Factors which heighten cataract risk include poorly controlled diabetes, high myopia and trauma - the three most common causes of cataract formation. Some common signs are blurred vision (even with glasses) and impaired night vision, or even a rapid change of degrees, from say 200 to 800 within just a few months. "There can be four to five different types of cataracts depending on what stage the patient is at," says Dr Yeoh.

NEW LEASE OF SIGHT: New techniques of cataract surgery have allowed for special corrective lens to be implanted at the same time.

The new approach to cataract treatment has nullified the old advice to "wait till your cataracts ripen" before you treat them, points out Dr Christopher Khng, medical director of Eyewise Vision Clinic.

More than a decade ago that might be true, because surgeons would cut a 10 to 11mm incision on top of the eye and "pluck out" the hardened, opaque lens. But these days, with the use of ultrasound equipment, surgeons need to get to your cataracts at the early stages, when they're still soft, so that they can be broken up with the ultrasound and sucked out - all through a 2mm incision. With the modern ultrasound phaco-emulsification technique, there are no stitches either, explains Dr Khng.

Previously, astigmatism also couldn't be corrected, but these days it's possible. If astigmatism is higher than 250 degrees, the surgeons can combine the use of toric lenses with astigmatic keratotomy and correct the cornea during cataract surgery itself. "About 15 per cent of the patients who have cataract surgery tend to have astigmatism as well," says Dr Khng.

There are three types of implantable lens available now. The standard lens is the least costly option; toric lenses are for those with low astigmatism, while multifocal lenses are the most costly as those correct presbyopia.

Dr Yeoh points out that for those with myopia and low astigmatism, toric lenses will do. But for those who read a lot and use the computer heavily, and who are determined to have good vision, they might need multifocal lenses. An exciting development is the advent of a new accommodative lens implant which moves within the eye, allowing for distant and near vision with better quality of vision, he adds. Dr Yeoh successfully implanted the first of these new lenses in Singapore and Asia last week.

"Some people would choose multifocal lenses even though it costs about $1,500 compared with the $300-$400 for standard lenses, because of the range of vision and flexibility they offer. But your choice should suit your lifestyle," says Dr Yeoh. "Because it's not easy for patients to detect cataracts, it's important for those above 50 to go for thorough eye check-ups with opthalmologists once a year," he adds.

The take-home message is that cataract surgery is almost 100 per cent safe, and now vision can also be restored, all in a 15-minute procedure.

uihoon@sph.com.sg

This article was first published in The Business Times on September 13, 2008.