New cataract surgery cuts blindness risk

This story was first published in The Straits Times on May 9, 2013

THE National University Hospital (NUH) is now offering what it says is a safer way to remove cataracts.

The procedure, which can greatly cut the risk of blindness, would be a boon for Singapore's ageing population, since the disease affects 80 per cent of those above 60 years old.

Most patients are able to opt for the surgery, which helps to preserve the layer of cells lining the inside of the cornea, a transparent surface of the eye that lets in light, through the use of a laser.

These cells cannot regenerate, making their preservation critical.

The more cells that are saved, the lower the chance of blindness, and of needing a cornea transplant in the future.

More than 30,000 cataract operations are carried out a year in Singapore.

The new method is especially useful for older patients because the number of endothelial cells lining the cornea gets fewer with age, said Dr Lennard Thean, who heads NUH's cataract services.

The development allows patients with a low endothelial cell count to have cataract surgery safely, he added.

Of the 40 patients who underwent the new "femtosecond laser assisted cataract surgery method with patented lens cubing technology", half experienced negligible cell loss.

In contrast, those who had the traditional cataract surgery typically lose about 10 to 40 per cent of endothelial cells.

Cataract is a disease in which the lens of the eye gets clouded, obscuring vision.

The normal procedure involves the sole use of ultrasound to dissolve the cataract.

The doctor then sucks the pieces out of the patient's eye with a pump. However, ultrasound damages the inner lining of cells.

The new method, which was developed in the United States, uses a laser to first break up the cloudy lens into tiny cubes. That allows for a more limited use of ultrasound to dislodge the particles.

"The less energy used, the less cells will be lost," explained Dr Thean.

The cost of the laser-assisted surgery for each eye is $2,300 for subsidised patients, and up to $6,800 for private patients. The usual operation costs $1,000 and up to $5,000 respectively.

NUH will be offering fellowships to train external ophthalmologists in the procedure. For a start, about 20 doctors will be trained every year.

Retiree Chua Yong Ann, 74, underwent the latest procedure last month.

He first started experiencing blurry vision six years ago.

"I encountered this embarrassing problem of mistaking strangers for people I knew - until I didn't dare to say hello first," he said.

But the conventional cataract surgery was an issue for him, given his borderline endothelial cell count.

So he opted for the laser-assisted day surgery, which takes 35 minutes to complete for each eye, about 15 minutes longer than the previous method.

Said Mr Chua: "It's almost as if I didn't go for any operation at all. Today, I see things in high-definition. I can't get used to it, really."