Cataracts

Early Biometry is Best Practice

Are you or a loved one experiencing blurry vision, optical distortion, colour distortion, glare or faint ghosting due to cataracts? The first step toward restoring clear vision is planning. At Expressive Eyes we offer early cataract biometry—a precise, advanced measurement process that enables you to chose the best possible outcomes for cataract surgery. By taking this step early, you can protect your vision and enjoy a smoother surgical experience.

Why Early Biometry Matters

  • Precision Matters: Cataract surgery involves replacing your cloudy natural lens with an artificial intraocular lens (IOL). The success of this procedure depends on accurate measurements of your eye’s unique structure, including axial length, corneal curvature, and anterior chamber depth.
  • Better Outcomes: Early biometry allows us to detect any anatomical variations or abnormalities, ensuring the correct IOL power is chosen for your eye. This reduces the risk of postoperative complications like blurred vision, glare, or the need for additional corrective procedures.
  • Personalized Care: Every eye is different. Early biometry helps us guide you on the surgical outcome to meet your specific needs, whether you’re considering standard monofocal lenses or advanced options like toric or multifocal lenses. Simulation with contact lenses should give you a good idea of what outcomes would work for your lifestyle.

Benefits of Early Cataract Biometry

  • Accurate IOL Power Calculation: Ensures the best possible visual outcome after surgery.
  • Early Detection of Eye Abnormalities: Identifies issues like short or long axial length, irregular corneas, or prior refractive surgery that could affect surgical planning.
  • Reduced Risk of Refractive Surprises: Minimizes the chance of unexpected refractive error or additional procedures after surgery.
  • Improved Patient Satisfaction: Achieve the clear vision you deserve with confidence. 

What We Do

  • Comprehensive Eye Exam: We start with a thorough evaluation of your eye health and vision.
  • Advanced Equipment: We measure your eye’s dimensions with precision.
  • Personalized Outcome Plan: Based on the results, we could recommend the best IOL option for your unique needs, depending on your eye surgeon’s preferred IOL brands.
  • Ongoing Support: We’re with you every step of the way, from pre-surgery planning to post-surgery care.

Why Expressive Eyes

  • Biometry: We use biometry equipment for accurate measurements.
  • Expert Team: Our optometrist is in touch with a number of surgeons ranked by expertise and locality/convenience to each patient’s needs; however your preferred eye surgeon will also be informed about our findings.
  • Personalized Approach: We take the time to understand your vision goals and tailor our recommendations to meet your needs.
  • Care: Your vision is the priority.
  • Dry Eye and/or blepharitis can present complications in cataract surgery hence we address any issues that would prove a risk to your successful cataract surgery outcome.

Do It

Take the First Step Toward Clearer Vision! Don’t wait for cataracts to worsen. Schedule your early cataract biometry assessment today and take control of your eye health. Contact us now to book an appointment or learn more about how we can help you achieve the best possible outcomes from your cataract surgery.

Cataract Surgery Planning

Cataracts

A cataract forms as the eye’s lens proteins denature and degrade over time. This process could be accelerated by diabetes and hypertension, exposure to toxins, radiation, and ultraviolet light and eye trauma (including post retinal detachment surgery and treatment) and extended use of corticosteroids – nasal sprays included. The build-up of clumps of protein or yellow-brown pigment in the lens obscures transmission of light to the retina at the back of the eye. This could result in blurred vision, double vision, poor night vision or colour distortion. The most common is age-related cataracts. If left untreated for a prolonged period, it may lead to increased risk of glaucoma and sight loss due to severe cataract.

As the cataract progresses slowly or rapidly, the increasing density of the clumps of protein can reach a stage were it becomes more difficult to remove which increases the surgical risk.

Cataract Surgery

Cataract surgery is a procedure that usually takes 30 to 45 minutes. It is often carried out as day surgery under local anaesthetic. During the operation, the surgeon will make a tiny incision in the eye to remove the cloudy lens and replace it with a clear plastic Intraocular Lens (IOL). There are different types of IOLs available, ranging from single vision spherical, single vision toric, multifocal … You have a choice of mono-vision ( one eye for far and one eye for near), focussed for long distance, slightly short sighted, corrected for near and far with a multifocal lenses, or a combination. Once a lens has been implanted, it can be replaced but at extremely high surgical risk, so it is important that the right optimal choice is made at the first instance. We are able to simulate some of these outcomes with contact lenses prior to surgery, enabling you to make an informed choice.

Complications of cataract surgery

Cataract surgery is a very common and generally safe outpatient procedure. However, like any surgical procedure, there is some risk of complications, but this tends to be rare as long as the surgeon is presented without any surprises. Prior eye injuries, surgery and retina issues increase risk.  Some of the complications include infection, inflammation, incomplete removal of cataract, unsuitable IOL, IOL not locating properly, puncturing of the capsular bag, retina loosening and the list continues. Most of these are manageable with further treatments and of course under the appropriate specialised hands.

Other important aspects include knowing the state of the retina and vitreous prior to surgery. Patients with Glaucoma and Diabetes undergoing cataract surgery require specialist care because structurally these eyes present differently from the norm.

Cataract Biometry

Cataract biometry is a sophisticated and essential process for ensuring optimal visual outcomes after cataract surgery. Advances in technology and algorithmic formulae have significantly improved the accuracy of IOL power calculations, but careful attention to detail and patient-specific factors remains critical.

Performing biometry at the start of cataract evaluation is highly advantageous and is considered a standard practice in modern ophthalmology. Here are the key reasons why:

Accurate Intraocular Lens (IOL) Power Calculation

Biometry measures the eye’s axial length, corneal curvature and anterior chamber depth which are critical for calculating the correct power of the intraocular lens (IOL) to be implanted during cataract surgery.
Early biometry ensures that the measurements are taken before significant changes in the lens density or other ocular structures occur which can affect accuracy.

Detection of Pre-existing Conditions

Biometry can help identify pre-existing conditions such as high myopia, hyperopia or astigmatism which may influence the choice of IOL (e.g. toric or multifocal lenses).
It can also detect abnormalities like staphylomas or unusually short/long axial lengths, which may require special surgical planning.

Improved Surgical Planning

Early biometry allows us to plan and simulate the visual expectations with contact lenses well in advance, including selecting the appropriate IOL type (eg. monofocal, toric, multifocal, modern optics) and discussing these options.
It also helps in predicting postoperative refractive outcomes which are crucial for visual satisfaction.

Reduced Risk of Measurement Errors

Performing biometry early minimizes the risk of errors that can arise from advanced cataract stages such as dense cataracts causing poor signal quality during optical biometry.
Early measurements are often more reliable and reproducible.

Patient Counseling and Expectation Management

Early biometry provides an opportunity to discuss realistic visual outcomes with the patient based on their measurements.
It helps in setting appropriate expectations regarding postoperative vision, especially if premium IOLs are being considered.

Monitoring Progression

In cases where cataract surgery is not immediately required, early biometry provides a baseline for monitoring changes in the eye over time, which can be useful for optimal timing before the surgery.

Conclusion

Performing biometry at the start of cataract evaluation is a best practice that enhances surgical planning, improves accuracy, and ensures better patient outcomes. It is a critical step in the preoperative assessment of cataract patients.

We are in the fortunate position whereby we have a biometer on our premises and are equipped to perform early biometry without the need for dilation and anesthestic.

Additional Information

American Academy of Ophthalmology (AAO):“Cataract in the Adult Eye Preferred Practice Pattern.” AAO guidelines emphasize the importance of accurate biometry for optimizing IOL calculations and surgical outcomes. Available at: [https://www.aao.org](https://www.aao.org)

Hoffer, K. J. (1993)he Hoffer Q formula: A comparison of theoretic and regression formulas.” Journal of Cataract & Refractive Surgery. This study highlights the importance of accurate biometry in IOL power calculations.

Olsen, T. (2012): Prediction of the effective postoperative (intraocular lens) anterior chamber depth.” Journal of Cataract & Refractive Surgery. This paper discusses the role of biometry in predicting postoperative outcomes.

Royal College of Ophthalmologists (RCOphth): “Cataract Surgery Guidelines.” These guidelines stress the importance of early biometry for achieving optimal surgical results. Available at: [https://www.rcophth.ac.uk](https://www.rcophth.ac.uk)

Wang, L., & Koch, D. D. (2018): “Intraocular lens power calculations in eyes with previous corneal refractive surgery.” Current Opinion in Ophthalmology. This review highlights the challenges and importance of early biometry in eyes with prior refractive surgery.