Cataract Surgery

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cataract surgery and procedure in Singapore

What is a cataract?

Most cataracts are due to age-related protein build up in the natural lens in the eye. This causes decreased light reaching the retina and reduces vision.

Cataracts can also be caused by trauma. With significant damage to the naturally clear lens, it starts to turn cloudy and affects vision.

Long term steroid use can also cause cataracts. This is the “posterior subcapsular” type of cataract with classic symptoms of blurred vision and glare symptoms.

Previous eye surgeries done can also predispose to formation of cataract e.g. after retinal detachment surgery, cataract formation accelerates and many may require cataract surgery within 2 years.

Why is cataract surgery important?

Cataract surgery is a safe and effective means of restoring vision loss due to cataracts. The standard of care is phacoemulsification in which ultrasound energy is used to liquify the cataract and allows its removal. The surgery itself takes about 10-15 minutes and there is no need to stay in the hospital. Delaying cataract surgery could result in other eye issues other than just blurred vision. The stiffening of the lens with cataract can cause the “strings” of the lens bag to be damaged, resulting in the lens being out of alignment and can even fall to the back of the eye. In some cases, instead of falling to the back of the eye, the lens can get dislocated to the front of the eye and damage the cornea and if this damage to the cornea is severe, a cornea transplant may be needed.

With untreated cataracts, it can also cause glaucoma in several ways. The eye pressure can suddenly go up because the cataract becomes so bulky that it blocks the normal flow of “water” in the eye and the lens proteins can also leak out of the bag and choke up the drainage system in the eye. This high pressure in the eye further compromises vision by damaging the main nerve in the eye, the optic nerve. In addition to the above complications, performing cataract surgery on dense mature cataracts is also more difficult with increased chances of complications happening during the surgery. This could mean a more prolonged recovery after surgery and poorer visual outcomes.

Who is at the risk of cataract?

  • Patients who are older
    With advancing age, protein builds up in the naturally clear lens in the eye. This results in the lens turning cloudy and reduces light reaching the retina, causing decreased vision.
  • Patients on long term medications e.g. steroids
    Long term steroid use is known to cause several conditions in the eye including glaucoma and cataract. These steroid induced types of cataracts cause an opacification in the posterior portion of the lens. This classically results in increased glare symptoms experienced by patients.
  • Patients with co-existing medical problems
    Existing conditions like diabetes can increase the risk of cataract. In poorly controlled diabetes, it not only causes cataract but also glaucoma. Patients who smoke and have increased amounts of sun exposure can also increase the risk of cataract. Patients who have severe allergies e.g. eczema, asthma are also more prone to having cataracts.
  • Patients who have had previous trauma to the eye
    Blunt or penetrating trauma to the eye can disrupt the lens fibres and induce a cataract. In the acute setting, this is accompanied by other signs and symptoms of trauma including redness, pain and discomfort, inflammation, corneal swelling and even infection.
  • Patients with a family history of cataract
    Not all patients with cataract are old or have existing comorbidities. Some patients with a strong family history of cataract can get them even when they are young. It is not uncommon for someone in their 20s or 30s getting surgery for cataract due to this.

How would i know if i have cataracts?

Symptoms of cataracts include:

  • Blurring of vision
  • Glare and halos around bright lights
  • Decreased night vision
  • Decreased contrast and colour perception
  • Worsening myopia (frequent changes in glasses power)
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cataract eye surgery

What is the difference between standard cataract surgery (phacoemulsification) and bladeless cataract surgery (femto-second laser assisted cataract surgery - FLACS)?

In standard cataract surgery (phacoemulsification), sharp surgical blades are used to create small wounds (<3mm) to allow surgical access for the ultrasound probe used to break up and remove the cataract. With bladeless cataract surgery (femto-second laser assisted cataract surgery – FLACS), a femto-second laser is used in place of the blades to not only create the corneal wounds, it is also to create an opening in the lens capsule and break up the cataract. The subsequent removal of the cataract still relies on the ultrasound probe.

What are the benefits of cataract surgery?

Benefits of cataract surgery include:

  • Restoring vision
  • Quick recovery with minimal downtime
  • Minimal pain and discomfort during the recovery period
  • Minimal disruption to work schedule
  • Ability to correct any refractive error at the same sitting
  • Ability to address presbyopia (lao hua yen) at the same sitting
Want to find out more? Browse our FAQs
cataract eye surgery cost Singapore
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Why Dr Val Phua at Eagle Eye Centre?

  • Dr Val Phua is a Singapore Medical Council (SMC) accredited eye specialist, a consultant ophthalmologist and cataract and refractive surgery specialist with Eagle Eye Centre
  • He has received numerous recommendations and referrals from satisfied patients
  • He provides personalised care throughout the treatment journey
  • He is supported by more than 90 staff at Eagle Eye Centre to ensure a seamless experience to achieve your vision goals

Price list – Cataract Surgery

(Phacoemulsification)

Cataract surgery is an affordable means to treat a leading cause of blindness and to restore vision. Costs of cataract surgery can range from $4000-$8000 depending on several factors.

Before surgery

A thorough consultation and assessment has to be done to look for any other existing eye conditions which may require treatment. These include specialised tests to assess the health of your cornea and retina. Planning for the implanted lens requires accurate measurements of the eye including the eyeball length, amount of space in the eye and the steepness of your cornea. These require specialised investigations and provide the necessary information to make calculations for the power of the intraocular lens to be used. Further investigations such as an electrocardiogram (ECG) and urine tests are also needed before the surgery to ensure that you are healthy and well enough to go through with the surgery.

During surgery

Surgery takes place in an operating theatre and there are several locations for this. Wherever it takes place, there is a need to book a slot, prepare the needed equipment, medication and even the assisting staff. Most surgeries are carried out under topical anesthesia with intravenous sedation and further costs are involved when booking the slot with an anesthetist to ensure this goes smoothly. The choice of IOL can further add to the cost of surgery. Monofocal IOLs help you to see clearly at distance or at near and cost about $450. Toric IOLs allow for correction of astigmatism as well and cost about $850. Multifocal IOLs allow vision at distance, intermediate and near and cost about $2000. The choice of IOL depends on lifestyle needs, a detailed eye examination on suitability and weighing the pros and cons of each.

After surgery

Eye drops are needed to prevent infection and to reduce inflammation. They are typically continued for about a month while the eye heals. Follow up consultations are needed during this period. Patients are usually seen 1 day after surgery, 1 week after surgery and 1 month after surgery. More visits may be needed depending on how the eye recovers.

Cataract surgery is medisave claimable and you can expect to offset about $2450 from the surgical costs. Furthermore, should you have insurance coverage, depending on your individual policy the remaining may be fully covered as well. My team of professional staff will gladly assist you in navigating through this should you need help with this.

Procedure Price
From $4000 – $8000

*Medisave claims per eye is about $2450

*While most insurance policies provide coverage for cataract surgery, the amount claimable will depend on the coverage of the policy.

*Exact pricing can be advised during the consultation

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    FAQs – Cataract Surgery

    What is a cataract?

    Cataracts are a clouding of the naturally transparent lens of the eye. It occurs due to a build up of proteins in the natural lens. This reduces the amount of light going into the eye and causes decreased vision.

    How would i know if i have cataracts?

    Symptoms of cataracts include:

    • Blurring of vision
    • Glare and halos around bright lights
    • Decreased night vision
    • Decreased contrast and colour perception
    • Worsening myopia (frequent changes in glasses power)

    What are the benefits of FLACS (femto-second laser assisted cataract surgery)?

    Benefits of FLACS include:

    • 100% Bladeless surgery
    • Precision in wound creation
    • Precision in capsulorrhexis creation
    • Minimize ultrasound energy needed to remove the cataract
    • Less damage to the corneal endothelial cells during surgery

    Who is a good candidate for cataract surgery?

    A thorough assessment should be done before proceeding with cataract surgery to ensure there are no other eye pathology that would account for the symptoms of blurred vision. In general, a suitable candidate for cataract surgery includes patients who:

    • Visually significant cataract
    • No other eye pathology that needs to be addressed first
    • Keen to be free of glasses or contact lenses

    What are the risks of cataract surgery? Is cataract surgery safe?

    Cataract surgery is considered one of the safest surgical procedures around. As with any surgery, there are potential risks which should be understood.
    Risks of cataract surgery include:

    • Bleeding, infection, inflammation
    • Zonulysis, Posterior capsular rupture (PCR <1%), dropped nucleus
    • Retinal detachment, corneal decompensation

    Is cataract surgery painful?

    Cataract surgery itself is painless due to the numbing eye drops given before surgery begins. After cataract surgery, there may be some discomfort immediately after the procedure, this largely resolves by the following day.

    What will I see during the procedure?

    During cataract surgery, the anesthetist may give you a mild sedation to make you feel drowsy. You may fall into a light sleep during the surgery itself.

    What precautions do I need to take after cataract Surgery?

    After cataract surgery, avoid getting any water into the eye, avoid swimming in the first month and avoid vigorous exercise in the first 1-2 weeks. it is also important to avoid eye rubbing and to keep the prescribed eye drops going as planned. Goggles are given and should be used at night to prevent eye rubbing during sleeping hours.

    Can cataract surgery treat presbyopia (lao hua yen)?

    Cataract surgery can treat presbyopia in several ways. This can be in the form of monovision where one eye is corrected for distance vision and the other eye corrected for near vision using monofocal intraocular lenses.  Patients may simulate this with a trial of contact lenses before undergoing cataract surgery.
    Another option would be to use multifocal intraocular lenses which has by virtue of the lens design, the ability to aid vision for distance, intermediate and near vision.

    What is an “after cataract”?

    After some time (months to years), some patients may develop blurred vision after cataract surgery. This is due to a growing of some of the lens cells which lines the back of the lens bag and blocks light. This is not a cataract and repeat cataract surgery is not needed. This condition also known as a posterior capsular opacification (PCO) can be easily treated with a YAG laser in a clinic setting.

    What is the difference between monofocal and multifocal lenses?

    After cataract surgery, an intraocular lens is implanted into the eye to correct any refractive errors. There are different options to choose from.
    Monofocal lenses focuses vision at a fixed distance. This can be targeted for distance vision (beyond 100cm), intermediate vision (80cm, computer work) or near vision (40cm, near work). When looking at objects at the specific distance, the object is in focus but objects at other distances are out of focus.
    Multifocal lenses allows for focused vision at distance, intermediate and near vision.
    Extended depth of vision (EDOF) lenses are designed to increase the range of focus compared with monofocal lenses, allowing for distance and intermediate focused vision.

    What are the advantages of multifocal intraocular lenses?

    The main advantage of multifocal intraocular lenses is the ability to focus and see clearly at all distances. The lens is not only able to address refractive errors like hyperopia (long-signtedness), myopia (short-sightedness) and astigmatism, it is also able to address the concerns of presbyopia (lao hua yen). This may eliminate the need for glasses for distance or near work.

    Am i suitable for multifocal intraocular lenses?

    A thorough history, eye examination and specialised tests are done to assess suitability for multifocal intraocular lenses.
    Some factors which make for a poor candidate for multifocal lenses include:

    • High expectations of perfect vision for distance, intermediate and near vision
    • Night driving
    • Prolonged reading and near work
    • Other eye pathologies: e.g. Irregular corneas, glaucoma, weak zonules, macular degeneration, retinal detachment

    What are the advantages of an extended depth of focus (EDoF) intraocular lens?

    EDoF lenses provide sharp and clear vision over a range of vision (distance and intermediate vision). It avoids the risks of multifocal intraocular lenses such as glare, halos, decreased contrast sensitivity, decreased night vision.

    Which is the best intraocular lens?

    There is no single best intraocular lens for everybody. A thorough assessment should be made to determine which type of intraocular lens and their respective optics would best help you achieve your vision goals.

    What is the difference between standard cataract surgery (phacoemulsification) and bladeless cataract surgery (femto-second laser assisted cataract surgery – FLACS)?

    In standard cataract surgery (phacoemulsification), sharp surgical blades are used to create small wounds (<3mm) to allow surgical access for the ultrasound probe used to break up and remove the cataract. With bladeless cataract surgery (femto-second laser assisted cataract surgery – FLACS), a femto-second laser is used in place of the blades to not only create the corneal wounds, it is also to create an opening in the lens capsule and break up the cataract. The subsequent removal of the cataract still relies on the ultrasound probe.

    What are the benefits of cataract surgery?

    Benefits of cataract surgery include:

    • Restoring vision
    • Quick recovery with minimal downtime
    • Minimal pain and discomfort during the recovery period
    • Minimal disruption to work schedule
    • Ability to correct any refractive error at the same sitting
    • Ability to address presbyopia (lao hua yen) at the same sitting

    What can you expect with cataract surgery?

    Cataract surgery is quick day surgery that does not require hospitalization, taking about 10-15 minutes for each eye. After the cataract is removed, an artificial lens (Intraocular lens) is placed in the lens bag to correct the refractive error present. Recovery is generally comfortable with minimal discomfort. Antibiotic and steroid eye drops are given after cataract surgery for about a month to prevent infection and minimise inflammation. Many patients are able to return back to normal activities in 1-2 weeks.

    When can i go back to work? How much leave do i need to take?

    Recovery from cataract surgery is quick with minimal downtime with many returning to work in 2-3 weeks. It is important not to rub your eyes during this early recovery period. A hospitalisation medical certificate is issued cover any absence from work after cataract surgery.

    When can i go back to exercising?

    During each follow up consultation after cataract surgery, the recovery process is assessed and advise given on when returning to exercising is suitable. Most patients are able to return to running, jogging and gyming within 1-2 weeks. Swimming should be avoided during the early recovery period.

    What are the chances of vision recovery after cataract surgery?

    Significant improvement of vision is expected immediately after cataract surgery compared to the previous unaided vision without glasses or contact lenses. There may be some blurriness which will settle down over a few days. About 98% will no longer need glasses or contact lenses to meet legal requirements for driving if there are no other eye pathology that compromises vision.

    How big is the wound in cataract surgery? Are there stitches involved?

    In modern day cataract surgery, phacoemulsification can be performed via a wound that is less than 3mm in size. This wound is self sealing and does not require any stitches. This is vastly different from the older methods of cataract surgery which required a large wound more than 10mm and multiple stitches.

    Can cataract surgery treat astigmatism?

    With cataract surgery, the implanted lens (Intraocular lens) is able to treat hyperopia (long-sightedness), myopia (short-sightedness) and astigmatism.

    How long will cataract surgery last?

    Cataract surgery is expected to last a lifetime. Once cataract surgery is done, the cataract does not grow back. In intraocular lens that is placed in the eye is made of a very inert and stable material with negligible changes over time.

    Is cataract surgery done for both eyes at the same time?

    Cataract surgery is usually done one eye at a time with the second eye undergoing cataract surgery a few days to weeks later. Some patients choose to have both eyes done at the same sitting to minimise downtime and having to repeat the recovery process. This can be arranged if it is your preference.

    Can these intraocular lenses treat astigmatism?

    Not all intraocular lenses are designed with the ability to astigmatism. Those designed to correct astigmatism are called toric lenses. These can be monofocal or multifocal by design.

    What is considered a “Premium intraocular lens”?

    Premium intraocular lenses have certain characteristics including:

    • Apheric: The non-uniform curved design of these lenses enables them to correct spherical aberrations of the eye and hence increase image quality
    • Toric: The lenses are able to correct astigmatism when aligned correctly in the right orientation
    • Multifocal: These lenses allow for clear vision at all distances (Far, intermediate and near)
    • Extended Depth of Focus (EDoF): These lenses provides a larger range of clear vision compared with monofocal lenses

    What are the risks of multifocal intraocular lenses?

    Risks of multifocal intraocular lenses include:

    • Glare and halos
    • Decreased contrast sensitivity
    • Decreased night vision
    • Need for brighter light when reading

    What are the advantages of a monofocal intraocular lens?

    Monofocal lenses provide sharp and clear vision at a fixed distance. It avoids the risks of multifocal intraocular lenses such as glare, halos, decreased contrast sensitivity, decreased night vision.

    What are the disadvantages of a monofocal intraocular lens?

    Monofocal lenses are not able to provide a range of focused vision. If both the eyes are targeted for clear distance vision, glasses would be needed to have focused vision for intermediate and near work.

    What are the disadvantages of an extended depth of focus (EDoF) intraocular lens?

    EDoF lenses do not provide as good a vision for near tasks compared with multifocal lenses. Patients may still need reading glasses for prolonged near work.

    What happens during an assessment for suitability for cataract surgery?

    During an assessment, a detailed history will be taken from you and specialised test to gather data on suitability will be done. This includes checking your visual acuity, refraction, corneal topography, eye anterior segment examination, dilated fundus examination and other specialised tests directed by examination findings. Based on the assessment results, Dr Val Phua will then have a detailed discussion on the various options for cataract surgery and recommend a suitable treatment plan including the choice of intraocular lens to meet your vision goals.