Dr Simon ChenCataract & Retina SurgeonCataract care for eyes with retinal disease, previous surgery or more complex needs, and the exchange of an intraocular lens (IOL) that is no longer serving the eye.
Dr Chen regularly receives complex cataract referrals, including eyes with retinal disease, trauma or complications from previous surgery, and eyes in which the lens implant has moved or needs to be exchanged.
How coexisting retinal disease, a membrane or previous vitrectomy affects lens choice, timing and expectations.
→Assessment of lens position and the support available for a lens when the usual pathway is more complicated.
Understanding what has already happened, including laser vision correction or trauma, before planning the next step.
Because Dr Chen operates on both the cataract and the retina, a complex eye is planned as one problem rather than handed between specialists; where appropriate, a retinal procedure and cataract surgery are considered together.
An intraocular lens (IOL) is the artificial lens placed in the eye during cataract surgery or refractive lens exchange. Occasionally it needs to be repositioned or replaced.
The reasons vary: a lens power or design that has not suited the eye, a lens that has moved because the capsule or its supporting fibres have weakened, damage or clouding of the lens material, or the aftermath of earlier surgery. IOL exchange is a more involved operation than first-time cataract surgery, particularly when the capsule can no longer hold a lens and the new one has to be fixed to the wall of the eye by a technique such as Yamane or sutured fixation.
Dr Chen performs IOL exchange and secondary lens fixation, and sets out the options for each eye in plain language, including when leaving a lens in place is the wiser course.
Contains surgical footage. A video does not determine individual treatment suitability.
Techniques are named for orientation only; which approach suits an eye is decided at the consultation. General information, not a guarantee of outcome.
The assessment looks at both the front and the back of the eye, because both shape the plan.
The position of the existing lens and the support left in the capsule are examined through a dilated pupil, sometimes with imaging of the front of the eye. The cornea is measured and its health checked, since exchange surgery asks more of it. An OCT scan (optical coherence tomography) of the macula and a full retinal examination establish what the retina can be expected to deliver, and whether a retinal procedure should be combined with the lens surgery.
Dr Chen explains what he found, the options that are realistic for that eye, and what to expect from each, including the recovery and the limits on predictability.
Bring these, and anything else on your mind. Write the answers down, or bring someone who can.
Sometimes, yes. The capsule and the eye change with time, so the assessment looks carefully at what support remains. Whether exchange is sensible, and what the new lens should be, is decided eye by eye.
The implant, or the capsule holding it, has moved from its usual position, often because the fibres that support the capsule have weakened. Vision becomes unstable or blurred. Options range from leaving a mildly displaced lens alone to repositioning or replacing it.
Common reasons include previous eye surgery or injury, a very dense cataract, a weak capsule, a small pupil, high short-sightedness or coexisting retinal disease. Each changes the planning, the technique or the expectations.
Yes. Because Dr Chen operates on both the lens and the retina, the retina is assessed as part of the plan, and any retinal problem can be treated at the same operation or in sequence.
Appointments and enquiries through Vision Eye Institute, Chatswood.
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