Cataract surgery in the Waikato: what your optometrist checks before and after

Before cataract surgery, your optometrist confirms that the cataract explains your vision, checks the surface of the eye and the macula, and takes measurements that help the surgeon plan. After surgery, your optometrist checks healing, looks for the less common problems that need the surgeon, and updates your glasses once the eye has settled.

A cataract is a clouding of the lens inside the eye. In surgery the cloudy lens is removed and a clear replacement lens is put in its place [1].

What surgery usually achieves

A United Kingdom national audit followed 180,114 cataract operations. In eyes with no other eye disease, 94.6% reached 6/12 vision (0.30 logMAR) or better afterwards. In eyes that also had another eye condition, the figure was 79.9% [2]. In one randomised trial of 306 women, first-eye cataract surgery reduced the rate of falls but not the number of women who fell. In the same review, second-eye surgery did not reduce the rate of falls [3]. A trial of second-eye surgery found better visual function and confidence, while the effect on falls was uncertain [4].

What we check before you are referred

The macula. A cataract can hide changes at the centre of the retina. A systematic review of nine studies found that an OCT scan picked up macular disease in 13.7% of eyes that had looked normal on examination alone [5]. Knowing this beforehand helps set realistic expectations.

The surface of the eye. Lens power is calculated from measurements of the cornea, and a dry or unstable tear film makes those measurements less repeatable. In one study of 116 people booked for cataract surgery, eyes with dry eye disease gave different astigmatism readings when measured twice within 20 minutes, and the calculated lens power changed after four weeks of tear treatment [6]. A trial in 80 patients found that lubricating drops used just before measurement changed the readings, more so in dry eyes [7]. If your eyes are dry, we may treat that first and measure again.

Eye measurements. The optometrists at Rose Optometry use a Heidelberg ANTERION, a swept-source OCT instrument, for pre-operative measurements and corneal imaging. In a study of 101 eyes its measurements were repeatable for most parameters [8]. In 152 eyes measured on the ANTERION and on another widely used swept-source biometer, the calculated lens power and the accuracy of the result one month after surgery were similar [9]. Very dense cataracts can block optical measurement. In one study of 51 such eyes the ANTERION obtained an eye length reading in 94% [10]. The surgeon makes the final lens calculation.

Your choice of lens. A Cochrane review of 20 trials compared multifocal with standard single-focus lens implants. Distance vision was similar. People with multifocal lenses were less likely to need glasses, and they reported more haloes and glare [1]. We talk through how you use your eyes so you can discuss this with your surgeon. Our surgical partner explains the operation itself on its page about cataract surgery at Eye Surgeons NZ.

What we check after surgery

Follow-up shared between surgeons and optometrists has been studied overseas. A scoping review of ten studies from the United States, England, Scotland, Ireland and the Netherlands concluded that it was feasible and safe, and noted that results may not carry over to every health system [11]. In a Cambridgeshire scheme, 1,492 people were followed up by community optometrists. Recovery was uneventful in 93.8% and 2.95% were sent back to the hospital [12]. In an Irish service, 38 of 369 people returned to the hospital, 21 of them with a complication such as inflammation or macular swelling [13]. A clear route back to the surgeon is part of safe shared care [13].

At your visits our optometry team looks for:

• Macular swelling. In a database study of 81,984 eyes, swelling at the macula was recorded within 90 days in 1.17% of eyes with no risk factors. The risk was higher in people with diabetes, and higher again with diabetic retinopathy [14]. It typically appears around six weeks after surgery, and OCT is the main test for it [15].
• Inflammation and eye pressure. Both were among the problems recorded in the shared-care studies [12][13].
• Your new prescription. Many guidelines advise waiting four to six weeks before new glasses. In a study of 257 eyes, 93.4% showed little change in prescription between one week and six weeks [16].
• Clouding behind the implant. The capsule that holds the new lens can turn cloudy months or years later. In 20,763 eyes, between 5.8% and 19.3% had laser treatment for this within five years, depending on the lens model [17]. The laser procedure is the standard treatment [18].

Serious complications such as infection inside the eye or retinal detachment need urgent treatment [13]. Tell us or your surgeon the same day if your vision or comfort changes suddenly.

Planning your care

If you live in Hamilton or the wider Waikato, the optometrists at Rose Optometry at 37 Lake Road, Frankton can assess your cataract, take pre-operative measurements, and share your results with your surgeon.

Choosing a surgeon: in Hamilton, cataract surgery is offered by Dr James McKelvie and his colleagues at Eye Surgeons NZ, and by the surgeons at Hamilton Eye Clinic, Eye Institute and Laser Eye Centre, and Mr Chris Murphy. You are free to choose any of them, or another surgeon, and we will send your results to whoever you choose.

This article is general information and does not replace an eye examination.

Care at Rose Optometry is provided by our optometrist team: Jagrut Lallu, Jacqueline Rowe, Emilie Lawson, Jason Shen, Jessica Wood, Stella Wong and Anjali Hira.

References

1. de Silva, 2016, Cochrane Database Syst Rev. DOI PubMed 27943250
2. Day, 2015, Eye (Lond). DOI PubMed 25679413
3. Gillespie, 2012, Cochrane Database Syst Rev. DOI PubMed 22972103
4. Foss, 2006, Age Ageing. DOI PubMed 16364936
5. Ahmed, 2022, Eye (Lond). DOI PubMed 36517576
6. Lacmanović Lončar, 2026, Medicina (Kaunas). DOI PubMed 41597465
7. Röggla, 2020, Am J Ophthalmol. DOI PubMed 32828877
8. Cheng, 2022, Graefes Arch Clin Exp Ophthalmol. DOI PubMed 35171331
9. Agard, 2024, J Fr Ophtalmol. DOI PubMed 38663226
10. Tañá-Rivero, 2023, Eye Vis (Lond). DOI PubMed 37653460
11. Loke, 2025, Ophthalmic Epidemiol. DOI PubMed 41316717
12. Voyatzis, 2014, Br J Ophthalmol. DOI PubMed 24515987
13. O'Regan, 2021, Ir J Med Sci. DOI PubMed 33495971
14. Chu, 2016, Ophthalmology. DOI PubMed 26681390
15. Fouad, 2025, Curr Opin Ophthalmol. DOI PubMed 39446879
16. Nanda, 2024, World J Exp Med. DOI PubMed 38948423
17. Ursell, 2019, Eye (Lond). DOI PubMed 31616057
18. Brézin, 2023, BMC Ophthalmol. DOI PubMed 37845645

This article is general information, not personal medical advice. Most sources were checked against the full published papers in October 2026.