Professor Claoué is a Consultant Ophthalmic Surgeon in East London and at Harley Street specialising in cataract corneal and refractive disorders of the eye. He has been an innovator in cataract surgery for 20 years and has many journal and book chapter publications.
Treating Cataracts with Intraocular Lenses (IOLs)
What are Cataracts?
Cataract describes the clouding of the natural lens in the eye to an extent that it causes symptoms. Typically an age-related phenomenon, cataract can be present at birth or may occur in early to mid-adulthood due to a variety of factors such as trauma, heredity, diabetes and smoking. The symptoms are typically described as “misty” vision, with disabling glare a frequent complaint. Sometimes there are multiple images (“monocular polyopia”). Eventually, it becomes difficult to see well enough for daily activities such as driving, cooking and so forth.
What happens if Cataracts remain untreated?
Without treatment, cataract typically gets worse. The only treatment which has been shown to be effective is surgery. Clearly, since the cataract is the natural lens in the eye that has become cloudy, removal of the cataract will result in a focussing problem. For the past 50 years, this has been dealt with by putting a plastic lens inside the eye; an intraocular lens or IOL.
Intraocular Lenses (IOLs)
IOLs typically can give most patients good vision without glasses at distance, but there will be need to wear reading glasses for all near-vision tasks. To avoid this, multifocal IOLs were introduced in the early 1990s and have evolved progressively since. They are able to allow most people to do most activities without any need for spectacles. A further technology is the recent introduction of “toric” IOLs to treat astigmatism and “toric multifocal IOLs” for patients with astigmatism who don’t want to wear glasses. We also have what are called “supplemental IOLs” which allow people who have already had cataract surgery with an IOL to become spectacle-independent. IOLs are truly a wonderful and versatile tool.
Painless IOL Surgery
IOL Surgery is typically done under local anaesthetic (usually needle-free) as a day case. There is no pain. Patients typically see an improvement in their vision the same or the next day, although it may take as long as 6 months to get the full effect. Eye drops have to be taken post-operatively for a few weeks, but most normal daily activities are possible within a couple of days.