CATARACT FACTS
A cataract is an abnormally clouded natural lens of the eye, which impairs vision. The condition is usually brought on by ageing. Surgery is needed to replace the clouded natural lens with an artificial one.

Cataract surgery just got better. Now, you wouldn't think there would be much improvement to be made on a procedure which is among the safest and most routine in any hospital.

In fact, just one in 5,000 patients gets any kind of infection from the standard operation, used for the last 10 years, to replace a clouded eye lens.

The surgeon makes a tiny 2.7mm incision in the cornea, through which an ultrasound probe is inserted to break and suck up the cataract (the clouded lens). A new lens is then fitted through the incision.

But a new machine, by eyecare giant Bausch & Lomb, makes the cut even smaller - 1.8mm - through which the same surgery can be performed.

A smaller cut heals faster, so patients can be driving or lifting heavy things after a day or two, instead of after seven to 10 days.

The cut is also too small to cause the cornea to curve abnormally and result in astigmatism, which is a known complication of cataract surgery, said Associate Professor Heng Wee Jin, who heads Tan Tock Seng Hospital's (TTSH) cornea and refractive surgery unit.

The standard procedure leaves 'all patients' with some degree of astigmatism, less-than-perfect vision caused by an abnormally shaped eyeball.

Add to this that the price remains about the same for patients and there seems to be few downsides to the new procedure.

A smaller incision will probably also lower the risk of developing infections and other complications, said Dr Terence Devine, chief of ophthalmology at Guthrie Centre in Pennsylvania, who was the first surgeon to use the machine last October.

Less fluid leaks out of the smaller cut, so pressure within the eye remains stable, making it easier for surgeons to operate, he said.

Less bacteria can invade the eye and cause infections.

None of the 60 patients he has treated has developed astigmatism, infections or other complications.

Prof Heng and Associate Professor Chee Soon Phaik from the Singapore National Eye Centre (SNEC) both expect the new machine to become the standard eventually.

The average cost remains about the same - $823 at TTSH and $935 at SNEC for subsidised patients.

The two centres have used the machine on a total of 30 patients in the last month.

One of them, Madam Lu Choon Pah, 67, had her right cataract removed on June 28, and her left on July 5.

She said in Mandarin: 'In the past year, my eyesight became so bad that everything was blurred. But right after the operation, I could see clearly.

'The next day, I could do things normally. The discomfort went away after three days.'

E-mail: huichieh@sph.com.sg