Mr Petrushkin is one of the leading cataract surgeons in the United Kingdom. He operates on all types of cataract and specializes in complex cataracts in patients with uveitis.
Each cataract is unique. During your consultation, Mr Petrushkin will explore what you hope to gain following surgery and tailor the lens implant to your needs.
Cataract
A cataract is clouding or opacity of the lens inside the eye. It is useful to learn about how the eye works in order to understand what a cataract is.
Inside the eye, behind the coloured part (the iris) with a black hole in the middle (the pupil), is the lens. In a normal eye, this lens is clear. It helps focus light rays on to the back of the eye (the retina), which sends messages to the brain allowing us to see. When a cataract develops, the lens becomes cloudy and prevents the light rays from passing through.
Lens choice
No lens implant is as versatile as the lens you were born with. However, modern monofocal intraocular lens implants allow excellent clarity of vision, but do not offer the flexibility of seeing near and distance in the way a young person can.
The majority of individuals undergoing cataract surgery choose to prioritise good vision for distance (arms length to horizon vision). Some patients, particularly those who enjoy close work, may prefer to be left short-sighted so they can see objects 30cm-50cm away without glasses. Others may choose to have one eye set for distance and the other for near. This is called monovision.
Certain patients may benefit from multifocal or enhanced depth of focus (EDOF) lens implants. These lenses offer flexibility of vision closer to that of the natural lens before a cataract forms. Mr Petrushkin will discuss the pros and cons of each type of lens with you to explore which is best suited to your needs.
Astigmatism is often present in patients with cataract. The front surface of a normal eye is round like a football. But if you have astigmatism the eye is shaped more like an oval rugby ball, making your vision blurred. A person with astigmatism will usually also be short- or long-sighted. People can be born with astigmatism or it can develop later in life. Patients with significant astigmatism can have a toric lens implant, which will correct much of the astigmatism arising from the cornea.
Posterior capsule
opacification
Posterior capsule opacification (PCO) is a relatively common occurrence after cataract surgery but is easily treatable. Sometimes you can develop a thickening of the back (posterior) of the lens capsule which holds your artificial lens in place. Thickening of the capsule means that light is less able to travel through to the retina (the light sensitive layer at the back of your eye). Sight can become cloudy or blurred or you may have problems with bright lights and glare. Current studies show us that this can occur between 10-20 % of patients at any time after surgery
Cataract surgery
in patients with
uveitis
Uveitis can cause cataract, but so can the steroid-based medications used to treat uveitis. Patients with uveitis have specific complexities and should always be operated on by a cataract surgeon who specializes in uveitis.
It is likely that there will need to be a staged approach to surgery involving:
Pre-treatment - this may be steroid eyedrops, intravitreal injections or oral medication to be taken in the weeks preceding surgery
The surgery itself - this may be longer that normal cataract surgery and often will require additional steps to remove scar tissue and the placement of medication in or around the eye
Post operative follow up - depending on your type of uveitis, you may require additional follow up and further medical or surgical treatment to ensure best results.