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cataract surgery is 'the most successful procedure in all of medicine'
4 minute read
with cataracts commonly developing with age, the demand for surgery is rising exponentially as our population ages. getty
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“it’s extremely safe, extremely predictable. i think it’s the most successful procedure in all of medicine,” says dr. richard weinstein about cataract removal, one of his most-requested surgeries. “and the outcomes are often fantastic,”
weinstein, chair of the eye physicians and surgeons of ontario and co-founder of the ocular health centre in kitchener, ont., has practiced as an ophthalmologist and surgeon for over 20 years. he’s performed more than 15,000 cataract surgeries where vision loss can be reversed and eyesight restored.
“to take people and give them back their sight is just an amazing experience to go through,” he says. “even today, somebody i had done the surgery on, when i went to shake his hand, he grabbed my hand and he kissed it. i almost didn’t know what to say.”
with cataracts commonly developing with age, the demand for surgery is rising exponentially as our population ages. the need has made headlines recently with youtube star mrbeast, jimmy donaldson, footing the bill for cataract removal for 1,000 people living with blindness or near-blindness around the world who couldn’t afford the surgery. it is one of the most commonly performed surgeries in canada where costs are covered under health insurance plans.
in fact, experienced eye surgeons make quick work of this life-changing procedure, says weinstein.
“the technology has really advanced to the point where routine cases, which are the majority, can be done in 10 to 15 minutes,” he says. “some people have great vision the next day. sometimes it may take two to three weeks for vision to get better.”
people are in hospital or an operating clinic, awake for the surgery and then in recovery typically for two to three hours. then, they use eye drops to prevent infection and promote healing for three to four weeks at home. the restored vision is permanent.
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the wait for cataract surgery is at least one year
with these surgeries shut down during the pandemic, the wait is now about a year to 18 months. for ontario, weinstein credits the ford government’s recent changes to allow certain private or non-hospital surgical centres to now offer ohip-covered cases in the exact same way they would be covered at the hospital. regulations, however, differ across the country.
“this is being done to increase access, perform more cases and hopefully reduce the backlog,” he says, with a note of hope for people in ontario waiting to regain their sight with the procedure. “i think that it will actually have a significant impact on how quickly we can get through the backlog.”
while traditional cataract surgery required a much larger incision and sutures for closing, now, the procedure called phacoemulsification needs only a small, self-sealing incision, reducing the risk of complications. phacoemulsification uses ultrasound power to break the cataract up into little pieces and vacuum it out of the eye. an artificial intraocular lens is then folded up and inserted inside the shell of the old cataract.
“we don’t remove the entire natural lens,” says weinstein. “we leave sort of a saran wrap coating behind, and the new implant essentially unfolds inside that shell.”
he predicts that the intraocular lens technology will continue to advance to the point of giving people a complete range of vision (for both close-up and distance sight clarity) after surgery without the need for any glasses.
other progressive trends include oral medication instead of iv sedation, along with topical freezing and then injections of anesthetic into the eye during the procedure.
what are cataracts?
a cataract is the natural lens inside your eye that helps focus light. as you get older, that lens becomes cloudy or changes colour, making it difficult to see. while you can be born with congenital cataracts, cataract degeneration from genetic conditions can take place at a younger age or certain medications such as long-term use of anti-inflammatory steroid medications, used to treat rheumatoid arthritis, lupus or vasculitis (inflammation of the blood vessels), can cause cataracts to develop, according to the mayo clinic.
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but for the vast majority of the population, it’s an age-related change where the lenses in your eyes become thicker, less flexible and less transparent. as the cataract develops over time, the clouding becomes denser and increasingly interferes with your vision. an estimated 5.59 million canadians have an eye disease that could cause loss of sight, reports the cnib, with cataracts cited as the leading cause of blindness, “
what are the risk factors for cataracts?
increasing age increases the likelihood of cataracts — weinstein says the majority of patients are 65 and older. you may also be more prone to developing cataracts after an eye injury, eye inflammation or previous eye surgery. and for people with diabetes, high blood sugar levels over time can cause structural changes in the eye lenses that can speed cataract development.
preventing cataracts
regular eye examinations can help with detection at the earliest stages, and managing other health problems is recommended, especially if you have diabetes or take steroid medications. while some supplements and certain foods may help generally with eye health, weinstein says there’s no science to make any direct links to diet and lifestyle habits.
“it truly is an honour to be able to restore someone’s vision, and we are lucky in this country to have so many gifted surgeons who are able to perform the procedure,” he says.
for more information on cataract removal surgery and advocacy for services, visit fighting blindness canada.
karen hawthorne is a toronto-based writer.
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