EyeWise Vision Clinic

Cataract Surgery, Complex Lens Disorders & Iris Repair

Dr Khng is experienced in complex cataract surgical techniques, having completed overseas clinical fellowships in the US in complex lens surgery and iris repair.
A cataract is the term given to any clouding of the normally clear human natural crystalline lens. This can occur as a result of normal aging, or may be accelerated by some medical illnesses such as diabetes. Other types of damage to the lens from trauma, eye inflammation (iritis and uveitis), or certain drugs taken for other illnesses (corticosteroids) may also cause cataracts to form. The appearances of different types of cataracts are shown in these photos.

Cataract surgery is normally a quick and safe operation, usually taking about 15 minutes by an experienced surgeon. During this process, the old cloudy yellowed lens is removed through a tiny incision, and it is replaced by a new flexible man-made lens implant which is then inserted though the same tiny incision. The optical power of the new lens is usually chosen so that the patient will have good distance vision without glasses. These lens implants also make it possible for near vision to also be perfect. Other optical problems present before surgery may also be corrected at the time of cataract surgery, such as astigmatism (cylinder), myopia, hyperopia and presbyopia (Aging sight).

Although generally is safe, cataract surgery has a complication rate of 0.5-5%, depending on the difficulty of the eye and surgeon experience. Fortunately, Dr Khng has trained under several surgeons around the world in difficult and complicated cataract surgery. He frequently is referred cases for surgical repair when some surgeons encounter cataract surgery complications, or for the more complex cataract cases (pics).

Part of his time was spent as a visiting consultant in a major eye hospital in Singapore, where he sees only complicated cataract cases, and cases requiring cataract complications repair. Fortunately, many of these complicated cases can be satisfactorily repaired with no or minimal visual compromise. The repair of these cases requires major experience and exposure to specialized surgical techniques and implant devices, which include standard and modified capsular tension rings, special capsular and iris hooks, specialized sutures, as well as special lens implants that can be secured by stitching them to the wall of the eye in badly injured eyes.

Frequently Asked Questions

What Is Cataract?
A cataract is what we call any opacification in the human lens. The normal human lens is clear, but with age and certain conditions like diabetes and trauma, the lens becomes cloudy, leading to cataract formation.

How do I know if I have a cataract? What are some of the symptoms?
Many people may discover they have a cataract when they make new glasses and still cannot see well, especially if they are over the age of 50y. Cataracts usually cause a gradual, progressive, painless, blurring of vision in one or both eyes. Some patients also complain of increasing glare in bright light or difficulty seeing while driving at night. Certain types of cataracts also cause progressive myopia (increased short-sightedness) with frequent changes of spectacle power.

When should I consider going for cataract surgery?
When you are no longer happy with your vision for your work or leisure activities.

Should I wait for my cataract to be ‘ripe’ or ‘mature’?
This was the thinking for old-style cataract surgery. Because modern cataract surgery has progressed, this thinking is now incorrect. In fact, surgery is much easier when the cataract is not too ‘ripe’ or ‘mature’.

Is cataract surgery painful?
No surgery is completely risk-free. One major complication that we try very hard to prevent is post-operative infection. There is less than a 1 in 1000 risk of this happening. Even if this happens, it can usually be treated.

Are there any risks in cataract surgery?
No surgery is completely risk-free. One major complication that we try very hard to prevent is post-operative infection. There is less than a 1 in 1000 risk of this happening. Even if this happens, it can usually be treated.

Who should I choose to do my cataract surgery?
Ideally, your surgery should be done by a cataract subspecialist, who is a surgeon trained to a higher level in advanced cataract surgery. Although every eye surgeon can do cataract surgery, the level of skill and training may vary. A cataract subspecialist experienced in dealing with difficult cataract surgery and complex lens repair would be preferable, as he would be familiar with dealing with cataract complications. Although cataract complications are not very common, you would want a surgeon with more experience in this area, when it is your turn to have your cataract removed.

Will my cataract come back again?
No, your cataract will never come back again. What sometimes happens in under 10% of patients a few years after surgery is thickening and haziness (called an “after-cataract”) of the lens envelope(capsule) that supports the lens implant. This leads to blurred vision similar to cataract, but is easily, painlessly and safely treated at a YAG laser to restore clear vision again.