CLINICAL SERVICES - CATARACT & COMPREHENSIVE OPHTHALMOLOGY

OUR CLINICAL SERVICES : WHAT WE DO

Cataract extraction and intraocular lens implantation is the most common operation performed in Singapore National Eye Centre (SNEC). More than 10,000 cataract procedures are performed in SNEC each year, by a team of 52 full time ophthalmology specialists. 

 

In a report on Cataract Surgery by the Ministry of Health of Singapore in 2006, 11,532 of the 16,310 cases of cataract surgery performed at 3 participating centres in 2004 were done at SNEC. Click here for Ministry of Health's statistics on the number of cataract surgeries performed by SNEC and other hospitals.

Cataract surgeries performed at SNEC have a consistently high overall visual success rate of 98 - 99%. This means 97-98% of all our cataract surgeries attain a Snellen visual acuity of 6/12 (internationally accepted visual requirement for driving) or better. Our visual success rate compare favourably with those from international eye centres such as those in the US (93%) and the UK (92%). Cataract surgeries at SNEC performed by the phacoemulsification technique has a high success rate of 99%.

The Straits Times, 29 April 2009     Click here to read full article

Another important yardstick of success in cataract surgery is the rate of endophthalmitis, a sight-threatening microbial infection of the content of the eye. At SNEC, we take great pains to reduce and eliminate the risks of endophthalmitis. As a result, our cataract operations enjoy a very low rate of post-operative endophthalmitis. Of our 99,655 cases of cataract operations in a 10 year period (1999-2008), the average endophthalmitis incidence rate was 0.037%, well below the international advisory of 0.1%. In year 2008, SNEC has an endophthalmitis rate of ZERO%.

At SNEC, cataract surgery is performed as a day/ambulatory procedure.  We have a dedicated dayward managed by a team of friendly and experienced nurses to make your few hours here comfortable.

 

Our dayward xxxxx	Our surgeon with a phacoemulsification machine

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The vast majority of cataract surgeries at SNEC use phacoemulsification technology. These cases are performed under operating microscopes using sophisticated machines and instruments, under local or topical anaesthesia. In phacoemulsification, wound sizes are tiny, from less than 3mm right down to 1.8mm, and no stitches are required. 

SNEC has introduced Femtosecond Laser-Assisted Cataract Surgery to Singapore.  Click here to know more about the difference with conventional cataract surgery and the benefits to patients.

Modern intraocular lenses are then implanted to replace the power of the natural lens. At SNEC, we use acrylic intraocular lenses exclusively, as they are associated with a lower rate of endophthalmitis. Some of these can even be boutique intraocular lenses which are customiseable to individual requirements, for improving and enhancing one’s unaided, spectacle-free vision.  

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The SNEC Cataract Service offers vision enhancement in cataract surgery with intraocular lenses. In addition, our centre is the regional referral centre for complicated and highly challenging cataract cases. Our surgeons also perform cataract surgeries requiring complex and advanced intraocular lens calculations. 
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VISION ENHANCEMENT IN CATARACT SURGERY

 

In recent years, cataract operations are no longer just about removing cataracts. There is a worldwide trend of convergence of cataract and refractive surgery technologies, resulting in cataract surgeries becoming convenient, some may say golden, opportunities to improve and enhance one's unaided, spectacle-free vision.

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Our surgeons understand the desire of some our patients for such a premium service. We offer intraocular lenses for restoring one’s vision through cataract surgery. Some of these are boutique, premium intraocular lenses which can also enhance one’s vision. These lenses need to be customised to the individual, and may not be suitable for all. Concurrent eye pathologies may also limit the achievable visual success.

Our surgeons are able to guide and advise you on what lens should be most suitable for your eyes, as well as your needs and desires in visual performance.

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Alcon Restor multifocal lens	Alcon monofocal lens	Alcon toric lens for astigmatism	ZMA multifocal lens by AMO	Hoya monofocal intraocular lens

        
                     AT Lisa toric multifocal lens by Zeiss      

Crystalens accommodative lens by Bausch & Lomb	AKreos MICS monofocal lens by Bausch & Lomb	Akreos Adapt monofocal lens by Bausch & Lomb

ADVANCED CATARACT SURGERIES FOR COMPLICATED CASES

SNEC serves as a referral centre for complicated cataract operations. Our specialists have the expertise to manage cases of highly complicated cataract surgery, that require very advanced intraocular manipulation, such as in the following scenarios:

• uveitic cataracts
• traumatic cataracts
• congenital or paediatric cataracts
• secondary lens implantation
• subluxated cataracts or implants
• intraocular lens exchange
• aniridia
• iridodialysis
• piggyback intraocular lenses

A subluxated intraocular implant	Uveitic cataract
Subluxated white cataract	Paediatric cataract

Intraocular Lens Calculations

To maximise the success rate of cataract operations, accuracy of intraocular lens power calculations is vital. At SNEC, our specialised biometry service and adjunct investigations ensure that results of cataract operations at our centre are as exact as possible. 

We perform power measurements of intraocular lenses with instruments in all of our routine cataract surgeries with either standard or premium vision-enhancing intraocular lenses, as well as complicated ones such as those following previous corneal and refractive surgeries, in extremely small or large eyes, in eyes with previous vitrectomies, silicone oil fill and in aphakic eyes.

 

The vast majority of our cataract cases utilise the IOL Master non-contact biometry, which is the gold standard for axial length measurement. It uses infrared technology, is non-contact and highly accurate in measuring the axial length of the eye. In its recent version, it provides measurement of the corneal power as well. We sometimes offer Applanation or Immersion A-scan ultrasound Biometry, in cases of very dense cataracts.

IOLMaster non-contract infrared biometer by Carl Zeiss Meditec

Other adjunctive investigations such as corneal topography with the Orbscan corneal topographer and contrast sensitivity tests may sometimes be necessary in cases of advanced intraocular lens power calculations and selection. B-scan ultrasonography is also occasionally used in very dense or white cataracts to provide a gross assessment of the vitreo-retina profile.

Orbscan corneal topographer by Bausch & Lomb	OcuScan Ophthalmic Ultrasound System for A-scan by Alcon Laboratories

Please visit the following relevant links:

Outcome Results on Cataract Procedure
Cataract & Comprehensive Ophthalmology Clinical Staff
I Want an Eye examination / an Appointment
Care After Cataract Surgery
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Read more on related Eye Conditions and Treatments:

Cataracts