Cataract

Cataract: A clouding or loss of transparency of the lens in the eye as a result of tissue breakdown and protein clumping. There are many causes of cataracts, including aging, cortisone medication, trauma, diabetes, and other diseases.

Catatact is the most common cause of blindness in the world. Causing a gradual deterioration in vision, patients will become unable to drive, find it increasingly difficult to read, suffer the effects of glare, especially on sunny days and will eventually lose their sight altogether.

You need to have your operation done by a Cataract Specialist.

Although a significant proportion of ophthalmologists in the UK undertake cataract surgery, a smaller number have a sub-specialty interest in cataract surgery and Mr Girgis is one of those who perform the technically difficult cases.

If your vision is deteriorating because of this condition, you can be treated quickly (with an operation under local or general anaesthetic) .

I trained at Moorfields Eye Hospital, in London, and worked there for a year as a consultant before moving to Bristol.

Most of my work involves cataracts I am a cataract specialist, but I also see patients with other acute ophthalmic problems and general ophthalmology.

Surgery to remove cataract usually takes about 20 minutes and the patient is free to leave hospital just an hour after the operation. www.nuffieldhealth.com - www.spirehealthcare.com

Removing cataracts is a routine operation in Britain and is available on the NHS, but if you need both eyes treated, it may not be possible to have the operations scheduled close together, which can be a problem also you don’t have the choice of choosing the surgeon with the NHS.

However, it’s always possible to have both eyes done within a short period of time, which is a crucial point for patients who have high refractive errors, who usually develop an imbalance after having only one cataract operation done.

The vast majority of patients treated by me report an “excellent” standard of care. I always ask patients who have had their cataract operation done under my care at Spire and Chesterfield to fill in a questionnaire, which shows that more than 95 percent say it is an excellent service, with very good communication, that the hospital is clean and the team is very friendly.

I have evidence of good feedback from each patient of mine over the past two to three years.

I think having your cataract operation under my care at Spire and Chesterfield is a five star service, and I work there with a very good team.

Complications of cataract surgery

The two complications of cataract surgery which have received most attention in previous large scale audits are posterior capsule rupture and endophthalmitis.

It is important during cataract surgery to maintain an intact lens capsular bag and zonular fibres as this provides the best means of supporting the intraocular lens. It also prevents vitreous gel from migrating forwards into the anterior chamber during or following surgery. posterior capsule rupture (PCR), particularly if accompanied by vitreous prolapse or displacement of the lens nucleus into the vitreous cavity significantly increases the likelihood of a poorer than expected visual outcome. However, the risk of a poor visual outcome can be mitigated by prompt recognition and careful management of a capsule rupture during surgery.

An audit of more than 55000 cataract operations showed an overall PCR rate of 1.92%, but also demonstrated that the probability of PCR can be increased greatly by a range of preoperative risk factors related to the type of cataract, other co-existing ocular conditions, or the patient’s physical condition. A particularly unfavourable combination of risk factors may result in a risk of PCR of over 50% even for highly experienced surgeons. (Royal College of Ophthalmologists website)

Mr Girgis has less than 1% PCR despite of the complex cases he does.

Infective endophthalmitis is one of the most serious potential complications of cataract surgery because it can result in a very poor visual outcome or even loss of the eye. It fortunately occurs rarely (around 1 in 1000 cases).

Other complications that occasionally occur include problems with the retina such as swelling of the retina (macular oedema), retinal detachment or bleeding, some of which require further surgery to correct.