Dr Brett Rogers - Specialist Cataract Surgeon | Ophthalmologist

The natural lens normally focuses light inside the eye allowing sharp vision.

Over time, the lens becomes gradually hazy. A hazy lens is referred to as a ‘cataract’.

Light through a hazy lens is ‘scattered’ and the quality of the vision deteriorates, often as though one’s spectacles were becoming dirty.

Because vision loss is gradual, those affected often forget how good their vision once was, or think they are “just getting older”, not realising how bad their vision has become or that normal vision can easily be restored with cataract surgery.

Whilst in the early stages, sunglasses can reduce glare, the only way to treat significant cataract to regain normal vision, is with cataract surgery.

Standard Eye Charts typically have high contrast black letters on a white background and can be a very poor way of assessing the quality of vision in the presence of cataract. Vision tested on an eye chart might still seem quite good and a person with quite marked cataract can often still read quite small print on an eye chart, yet still be disabled by poor quality vision, with poor contrast, glare with bright lights. Quality of life gradually suffers and affected people can become a danger on the road and be at increased risk of car crashes, falls and hip fractures .

Symptomatic patients are sometimes told that their cataract is “not yet bad enough to treat”, especially if they can still make out smallish print on an eye chart; however cataract is ‘bad enough to treat’ when symptoms begin to interfere with everyday activities such as driving, reading and whenever cataract affects quality of life.

Most cataract surgery is performed on those over the age of 50. About 10 per cent are in their fifties, 20 per cent in their sixties, 35 per cent in their seventies and 35 per cent are over the age of 80.

Almost everybody over the age of 60 is affected by cataract to some degree. Cataract slowly worsens and virtually everyone over the age of 80 would see very much better following cataract surgery.

Specialist Cataract Surgeon Dr Brett Rogers can safely remove the cloudy cataract using microsurgery and can replace the cataract with a clear, foldable, intraocular lens (IOL) to restore normal vision.

Most of Dr Rogers’ cataract surgery is performed under local anaesthesia.

Surgery takes 20-30 minutes and the total time in hospital is only 2-3 hours.

Modern techniques and state-of-the-art equipment mean recovery is quick and you can be back to normal activities within days.

Cataract surgery can also eliminate short-sightedness (myopia) and long-sightedness (hypermetropia) and Dr Rogers often corrects another very common spectacle problem called astigmatism (caused by an oval curvature of the surface of the eye) by using a ‘premium toric’ lens not normally used in public hospitals. This lens can give even better distance vision without spectacles than ordinary IOLs.

Public hospitals use a questionnaire and its ‘points’, to determine whether or not you can receive publicly funded cataract surgery. It is often wrongly assumed that a low ‘score’, means that the cataract is ‘not bad enough' to treat; however the public hospital ‘threshold score’ is determined by available funding and those missing out often have Dr Rogers perform their cataract surgery at Southern Cross Hospital where ‘scoring’ and rationing does not apply and where surgery can be done within a week or two if required.

These three spectacle ("refractive") conditions all cause distance blur, however all three can be eliminated with refractive cataract surgery where Dr Rogers aims to reduce or eliminate dependence on spectacles for clear vision following cataract surgery.

Patients undergoing cataract surgery with Dr Rogers can have all of these refractive conditions corrected during the operation, regardless of how much myopia, hypermetropia or astigmatism is present before surgery and even if this has been present since childhood. This means you can expect to be able see well enough to drive a car without spectacles. There are also options to enable you to also see clearly for near vision without spectacles, following cataract surgery.

Some suitable patients with significant refractive (spectacle) problems choose to have a 'clear lens exchange', which is essentially a cataract operation done at an earlier stage, mainly to correct significant spectacle problems.

Toric intraocular lenses

These are a 'premium intraocular lens' option, which in experienced hands can be used in more than 50% of eyes undergoing cataract surgery.

Toric intraocular lenses look similar to ‘regular’ IOLs, however are designed with a curved (‘toric’) surface. They must be precisely aligned inside the eye at a specific angle, depending on the shape and the 'total' power of the eye's astigmatism.

Correction of astigmatism can allow much better quality vision and less dependence on glasses.

Dr Rogers has had more experience than most, having used toric intraocular lenses for 15 years.

He is the only cataract surgeon in Southland/Otago using “Swept Source OCT” Laser Biometry which measures both the  inside and the outside surfaces of the cornea to obtain the  ‘total power’ of the cornea for more precise IOL measurements and better visual outcomes.

This is particularly important when deciding on the patient's suitability for a toric IOL, when calculating which Toric IOL power to use and the precise alignment of this toric IOL.

https://www.youtube.com/watch?v=8D-GI331l18

Not uncommonly, at some time following routine cataract surgery, the normally-transparent thin membrane called the 'posterior capsule', which lies behind the intraocular lens, can thicken and become hazy.

This can cause symptoms that are similar to cataract symptoms, however the treatment of 'posterior  capsule haze' is much easier and involves simply clearing the membrane using "YAG"  LASER.

 YAG LASER CAPSULOTOMY CAN BE PERFORMED BOTH IN INVERCARGILL AND IN QUEENSTOWN

The procedure takes only a few minutes and gives an almost immediate return of vision to the state it was in following the original cataract surgery, even if that surgery was many years ago.

(The YAG Laser is also used to perform several other types of eye procedures.)

Both Cataract and Glaucoma are common with increasing age and many people over 60 have both.

Are those with glaucoma at higher risk of developing cataracts?

Those with glaucoma are  not usually at higher risk of developing cataracts.

Both eye conditions are more common with age, which is why many who have one disease may develop the other.

How will cataract surgery affect the glaucoma?

Cataract surgery can cause a change in eye pressure. In general, it is not possible to predict whether the eye pressure will rise, fall or stay the same after cataract surgery; however, most people have slightly lower eye pressure following cataract surgery. This is often not permanent and the pressure may increase again later.

Increases in eye pressure immediately after the surgery are called ‘pressure spikes’ and sometimes occur in patients 1-2 days after cataract surgery. Usually these are short-lived and can be easily treated with medications.

Dr Rogers may give you tablets or eye drops to use following surgery to prevent these pressure rises.

Is there a need to change glaucoma medication after cataract surgery?

After cataract surgery Dr Rogers might reassess the need for glaucoma drops.
In some instances, glaucoma drops can be decreased.

This is a "YAG Laser" procedure that Dr Rogers performs at his private rooms on patients who are at risk of developing a relatively uncommon type of glaucoma known as 'narrow-angle' or 'angle-closure' glaucoma.