Cataract Surgery in Singapore
A personal approach to cataract surgery and choosing the right lens for your eyes.-Dr Cheryl Lee
Cataract surgery is not simply about removing a cataract. It is about how you would like to see afterwards.
Hello , I am Dr Cheryl Lee
I have been an ophthalmologist for more than 35 years, and cataract surgery has changed enormously during that time.
Today, removing the cloudy cataract is only part of the conversation.
We also have the opportunity to choose an intraocular lens — or IOL — that suits your eyes, your lifestyle and the way you would like to see after surgery.
Some patients want excellent distance vision and are perfectly happy to put on reading glasses.
Others would love to read their phone, work on a computer, play golf, drive or travel with less dependence on glasses.
There isn't one “best” cataract lens for everybody.
There is a lens that may be better suited to you.
My job is to help you understand the difference.
Looking forward to discussing more with you.
Dr Cheryl Lee
Ophthalmologist & Cataract Surgeon, Singapore
What Is a Cataract?
Inside your eye is a natural lens.
When we are young, this lens is clear and flexible. As we get older, it gradually becomes less transparent. When the lens becomes cloudy enough to affect vision, we call this a cataract.
Cataracts are extremely common and, for most people, are simply part of ageing.
They usually develop gradually, which is why you may not immediately realise how much your vision has changed.
You may notice:
Blurred or hazy vision
Colours appearing less bright
Increasing glare from headlights
Halos around lights at night
Difficulty driving at night
Needing brighter light to read
Frequent changes in your glasses prescription
Difficulty recognising faces from a distance
Vision that simply doesn't feel as crisp as it used to
Sometimes patients tell me:
“I can still see — but everything just looks a little dull.”
That can be a cataract too.
When Should I Have Cataract Surgery?
This is one of the questions I am asked most often.
A cataract does not necessarily need surgery simply because it is there.
What matters is whether it is beginning to interfere with your life.
Perhaps driving at night has become uncomfortable.
Perhaps you are struggling with small print.
Perhaps golf balls are becoming harder to follow, or you need much more light to read.
Or perhaps your vision is technically still quite good on an eye chart, but it no longer feels good to you.
I don't believe cataract surgery should be decided by a number on an eye chart alone.
We operate when the cataract and your vision are affecting the things that matter to you.
Before Cataract Surgery, I Look at More Than Your Cataract
One of the most important parts of cataract surgery happens before we ever enter the operating theatre.
A cataract may be responsible for your blurred vision — but it may not be the only reason.
Before recommending surgery, I want to understand the health of the whole eye.
Depending on your eyes, this may include assessing:
Your cornea
Your retina and macula
Your optic nerve
Your eye pressure
Astigmatism
Dry eye
Previous eye surgery
Your glasses prescription
The measurements required to calculate your new lens
This is particularly important when considering lenses designed to reduce dependence on glasses.
The more sophisticated the lens, the more carefully we need to understand the eye in which we are placing it.
Why I Check for Dry Eyes Before Cataract Surgery
A beautiful cataract result starts with a healthy surface of the eye.
Dry eye is something I look for very carefully before cataract surgery — even in patients who don't think they have dry eyes.
Why?
Because the tear film is the first optical surface that light passes through when it enters your eye. If that surface is dry, unstable or inflamed, it can affect two things that matter enormously before cataract surgery: the accuracy of your cataract measurements and the quality of your vision afterwards.
Dry eye can affect your cataract lens measurements
Before cataract surgery, we take very precise measurements of your eye to calculate the power of the intraocular lens — or IOL — that will replace your cataract.
If the surface of the eye is dry and the tear film is unstable, some of these measurements, particularly those involving the curvature of the cornea, can be less consistent.
And when we are trying to achieve an accurate refractive result after cataract surgery, small measurements matter.
This becomes even more important when we are considering toric, multifocal or extended-depth-of-focus lenses, where accurate measurements and careful patient selection are particularly important.
I would rather treat the surface of the eye first, repeat the measurements if necessary, and operate with measurements I trust.
Why can dry eye feel worse after cataract surgery?
This is something patients are sometimes surprised by.
You may already have dry eye before cataract surgery without really noticing it. After surgery, however, those symptoms can become much more obvious.
The eye has undergone surgery, postoperative eye drops are required, and the ocular surface and tear film can temporarily become more disturbed.
You may notice:
Fluctuating or intermittently blurred vision
Grittiness, burning or irritation
Tired or uncomfortable eyes
Increased sensitivity
Vision that seems clear one moment and blurred the next
Sometimes the cataract surgery itself has gone beautifully and the lens implant is exactly where it should be — but the patient is frustrated because the surface of the eye is dry.
This is one reason vision may not initially feel as crisp or comfortable as expected after cataract surgery.
I prefer to find dry eye before surgery — not afterwards
I don't want to discover significant dry eye only after we have implanted your cataract lens.
If I find dry eye, meibomian gland dysfunction, eyelid inflammation or an unstable tear film during your cataract assessment, I may recommend treating it before we finalise your cataract measurements.
For some patients, treatment is relatively simple. Others may benefit from more specialised dry-eye treatment before the surface is sufficiently stable.
Once the ocular surface is healthier, we can repeat the necessary measurements and proceed with greater confidence.
Treat the dry eye first.
Measure accurately.
Then choose the cataract lens.
For me, that is simply part of planning cataract surgery properly.
[LEARN ABOUT OUR DRY EYE CLINIC →]
Choosing Your Cataract Lens
Once I am happy with the health of the eye and the accuracy of your measurements, we can have a very different conversation:
How would you like to see after cataract surgery?
During cataract surgery, your cloudy natural lens is removed and replaced with a clear artificial lens called an intraocular lens, or IOL.
That lens stays inside your eye.
Choosing it deserves some thought.
I don't begin by asking:
“Which is the most expensive lens?”
I begin by asking:
“How do you want to see?”
When you decide to go ahead
Step 1: Your consultation and eye check
You will first see me at The EyeClinic. I will examine your retina and optic nerve and look carefully for dry eye.
A cataract may be responsible for your blurred vision, but it may not be the only reason. I want to understand the health of the whole eye before recommending surgery.
If I find dry eye, I may recommend treating it first, before we take further measurements.
Step 2: Measurements and choosing your lens
If everything looks good, you can go on to further tests that calculate the power of your intraocular lens (IOL).
We then choose your lens together. I don't begin by asking which lens is the most expensive. I begin by asking: how would you like to see?
Step 3: Booking your surgery
Once you have decided, we will book a date for your surgery. If you are travelling from overseas, I will work around your schedule.
Costs and insurance
Financial counselling is done in the clinic. For eligible patients, cataract surgery may be claimed through insurance and MediSave, depending on your eligibility and policy terms. We will explain this at your consultation.
Step 4: The day of surgery
You will come to Mount Elizabeth Hospital or Paragon one to two hours before your surgery.
The procedure can be done under sedation or under local anaesthetic, and we will decide together which suits you. The aim is that you are comfortable throughout.
For the full details of after care please the cataract surgery journey here.
What are your choice of Lenses?
Monofocal Cataract Lenses
A monofocal lens is designed to provide a clear focal point, usually for distance.
For many patients, this is an excellent choice.
You may see well for activities such as walking, watching television and driving, while continuing to use glasses for reading and other close work.
For someone who doesn't mind wearing reading glasses, simplicity can be a very good thing.
Toric Lenses for Astigmatism
If you have significant astigmatism, we may consider a toric intraocular lens.
Astigmatism means the eye focuses light differently in different directions.
A toric lens can correct some or all of this astigmatism at the same time as the cataract is treated.
Whether you need one depends on your individual measurements.
Multifocal Cataract Lenses
Multifocal lenses are designed to provide vision at more than one distance and can reduce dependence on glasses.
For the right patient, this can be wonderful.
But they are not automatically the best choice for everyone.
Your retina, cornea, optic nerve and other aspects of your eye need to be suitable, and we also need to discuss visual phenomena such as halos or glare around lights.
This is why I prefer to choose the lens after examining the patient, rather than deciding from a brochure.
EDOF — Extended Depth of Focus Lenses
Extended Depth of Focus, or EDOF, lenses are another option.
They are designed to extend the range of useful vision, particularly through distance and intermediate vision.
Intermediate vision has become increasingly important.
It is the distance at which many of us use:
Computers
Car dashboards
Kitchen counters
Supermarket shelves
Tablets and other digital devices
Some patients may still require reading glasses for very small print.
Again, whether an EDOF lens is suitable depends on your eyes and what you hope to achieve.
Which Cataract Lens Would I Choose for You?
I am asked this all the time.
And I cannot answer it until I know you.
I want to know what you do during your day.
Do you drive frequently at night?
Do you spend hours at a computer?
Do you read books?
Play golf?
Cook?
Travel?
Use your phone constantly?
Would you happily wear reading glasses occasionally if it meant a different quality of vision?
Or is reducing your dependence on glasses one of your biggest priorities?
These questions matter.
Cataract surgery is performed on an eye.
But the lens is chosen for a person.
That is why I prefer to make this decision together.
Lens options to replace your cataract
How do monofocal lenses and multifocal lenses compare?
Cataract Surgery After LASIK or Previous Laser Eye Surgery
If you have previously undergone LASIK, PRK or another form of laser vision correction, please tell us.
Cataract surgery is still possible, but calculating the power of the intraocular lens can be more complex because the cornea has previously been reshaped.
This is one reason your previous eye history matters when planning cataract surgery.
If you have old prescriptions or records from your laser surgery, bring them with you if they are available.
Cataract Surgery for Patients With High Myopia
Patients with high myopia deserve particular attention.
High myopia is associated with changes in the structure of the eye and a higher lifetime risk of certain retinal conditions.
Before cataract surgery, I therefore pay particular attention to the retina and the overall health of the eye.
If something else is limiting your vision, I want to know about it before we operate.
My Approach to Cataract Surgery
After more than 35 years in ophthalmology, I still believe the most important part of cataract surgery is not technology alone.
Technology is extremely useful.
Measurements matter.
Lens calculations matter.
Surgical technique matters.
But so does listening.
I want to understand what you expect from your vision before I recommend what goes inside your eye.
The consultation should therefore be a conversation — not simply a list of lens options.
Your eyes. Your lifestyle. Your choice.
My role is to help you make that choice with as much information as possible.
Dr Cheryl Lee
Frequently Asked Questions About Cataract Surgery
Can cataracts come back after surgery?
No. Once the natural lens containing the cataract has been removed, that cataract cannot grow back.
Some patients later develop clouding of the thin capsule behind the artificial lens. This is called posterior capsule opacification and can usually be treated with a laser procedure if necessary.
Do both eyes need cataract surgery?
Not necessarily.
We assess each eye individually. Often cataracts develop in both eyes, but one may affect vision more than the other.
Is cataract surgery painful?
Anaesthetic is used to make the procedure comfortable. Most of my patients choose to be sedated so they are completely unaware of light and do not move during surgery, but the aim is that you should not experience pain.
How long does cataract surgery take?
The actual procedure takes me about 11 minutes , although you should allow additional time for preparation and observation at the surgical centre.
Can cataract surgery correct astigmatism?
Yes, toric intraocular lens may be used to reduce astigmatism.
Can cataract surgery reduce my need for glasses?
Yes, depending on your eyes and the lens selected.
Different intraocular lenses offer different ranges of vision. This is something we discuss carefully during your cataract assessment.
Considering Cataract Surgery in Singapore?
If your vision is becoming cloudy, colours seem less vivid, driving at night is becoming uncomfortable or you simply feel that you are not seeing as well as you used to, come and have your eyes checked.
You don't have to decide on surgery before you come.
First, let us find out why your vision has changed.
If it is a cataract, I will explain whether I think it is time to consider surgery and, if so, the lens options that may suit your eyes and your life.
Dr Cheryl Lee
Ophthalmologist & Cataract Surgeon
The Eye Clinic by Dr Cheryl Lee, Singapore
What is a Cataract?
How is a Cataract treated?
“If you would like to see what actually happens inside the eye during cataract surgery, this short animation explains it beautifully.”