How much does a cataract surgery cost in Singapore? [An unbiased view from an Optometrist]

Based from the data on Ministry of Health, cataract surgery in public hospitals can cost around SGD$1,306 for Singaporeans for one eye. This cost includes cataract surgery, lens implant and other miscellaneous fees.

If you want to have a faster treatment and cut the waiting line, you can consider visiting to private hospitals in Singapore. However, the cost of cataract surgery can range anywhere from SDG$4,490 to SGD$ 10,385 for ONE eye. This price range is subjected to the experience of the eye surgeon, how complex is the eye condition , how the eye examinations conducted, medication and the type of intraocular lens implant.

As you can see, the cost of cataract surgery is extremely high. Fortunately, Singapore citizens can claim Medisave and insurance for cataract surgery. Medisave allows a maximum claim of SGD$2,450 for each eye.You can claim from your own medisave  or account of your next-of-kin, be it your spouse or child.

Most insurance policies in Singapore provide coverage for cataract surgery, but the claimable amount will depend on your insurance coverage policy. Click here if you need claim specialist to help you with.

There are also some special government subsidies such as Community Health Assist Scheme (CHAS) and Pioneer Generation Package, make sure you inform the hospital upfront so you will be able to receive further subsidies at a public hospital.

Different Types of Surgery , Different Cost

There are two types of cataract surgery:

• Traditional Manual Micro-incision phacoemulsification surgery: Requires using ultrasound energy to liquify the cataract and then it is then removed through a tiny incision of 2-3mm. Does not require any stitching allowing for faster recovery.

• Laser-assisted cataract surgery: Involves the use of a femtosecond laser to create the incision and fragment the cataract, allows for accurate lens positioning and is ideal for complex surgeries.

Traditional Manual Phaco-emulsification Cataract Surgery

This method using ultrasound and an incisional cut on the cornea has been around for 60 years, and over this time, the size of the corneal incision has come down from around 5.5 mm to half the original size today. All incisions are made manually with knives and sharp instruments inside the eye.

This is followed by ultrasonic energy to cut the whole cataract into small pieces and remove the pieces one by one.

This method is already more than 50 years old and although the incision size is now a lot smaller than before, certain aspects of manual phaco-emulsification are performed with limited precision and still has greater room for human errors to occur, resulting in intraoperative complications.

Bladeless Femtosecond Laser cataract surgery

Advances in technology now allow for 100% bladeless cataract surgery where a Femtosecond Laser (CATALYS) replaces the human hand to make the cuts into the eye without any sharp knives or blades, all in less than 60 seconds.

It performs many of the important and most challenging steps in cataract surgery which enables the surgeon to remove the cataract more gently by using much less energy and surgical time inside the eye, thus enabling faster post-op visual recovery for patients.

The biggest advantage of Bladeless Femtosecond (FS) Laser Cataract Surgery is that it allows perfect centration of the intraocular lens implant (IOL) to the centre of the visual axis. 3D optical coherence tomography scans and laser precision create perfectly sized and circular capsule openings for IOLs.

FS laser capsulotomies attain reproducible, uniformly circular and precise diameter compared to manual capsulotomies, improving refractive outcomes of multifocal / EDOF (extended depth of focus ) IOLs and maximising patients’ chances of achieving total spectacle independence.

Usually, the cost will be higher for Bladeless Femtosecond Laser cataract surgery VS Traditional Manual Phaco-emulsification. It is estimated the cost difference starts from 35% onwards.

Which type of lens should i choose?

With modern surgery, you have a wide choice for which intra-ocular lens ( IOL ) you would like implanted. Your options though come under two main lens choices, depending on if you would like to minimise the need for reading glasses after surgery:

• Premium Aspheric mono-focal IOLs
  
• Premium multi-focal IOLs
  

IOLs that correct short-sight and long-sight are standard mono-focal implants, and there are toric IOLs that correct astigmatism as well.

If you don’t mind wearing glasses after cataract surgery, a monofocal lens implant can be used and both eyes can be set for distance vision. Aspheric IOLs are also known as premium high definition IOLs and can offer excellent aberration-free distance vision. However, you will need reading glasses post-operatively. Reading glasses can be prescribed for you approximately one month after surgery.

If you like the idea of being less dependent on reading glasses after cataract surgery, one way to correct presbyopia and reduce your need for reading glasses is to have your cataract surgeon adjust the power of one eye of your mono-focal IOLs to give you a monovision correction.

This is where your dominant eye would be set for providing distance vision and your non-dominant eye would be set for providing near vision, both without the need for glasses to be worn.

There is a period of adjustment for a patient to get used to the feeling where one eye sees far and the other eye sees near; this period varies between individuals, but is usually anywhere between a few days to a few months.

Another option is to choose one of a variety of advanced Multifocal presbyopia-correcting IOLs to improve your reading vision without sacrificing your distance vision.

Presbyopia-correcting IOLs include bifocal and trifocal IOLs; both types are designed to provide a greater range of vision ( including close-up, intermediate, and distance) after cataract surgery than conventional mono-focal IOLs.

In order to be considered a good candidate for these premium multifocal IOLs, the health of your eye has to be in very good condition and you should not be suffering from eye diseases such as severe dry eyes, corneal scars, glaucoma, macular degeneration and autoimmune disease etc.

Multifocal IOLs can be associated with post-operative glare and halo issues, especially in dim light conditions. These visual disturbances usually spontaneously resolve after a few months as the patient gets used to the lens implant. Multifocal presbyopia-correcting IOLs are only available in certain clinics in Singapore.

What are the risk?

Cataract surgery in Singapore is a very safe procedure, with more than 99% success rate. Having said that, any kind of surgery carries some risk even if very low. The risk of blindness is quoted at 0.0001% (approximately 1 in 10,000).

The main complications that may arise during cataract surgery are:

1. Infection – First of all, this complication is very rare (1 in 1000). Even with the best precautions including copious antibiotic coverage before, during and after surgery, there is still a small risk of eye infection. The infection could come about from unclean surroundings, microbial contamination or a lowered immune system. Your eye doctor will be able to advise you on how to boost your eye health and general well-being after surgery.
   
2. Bleeding – Again, this complication is very rare. During any surgery there is always a risk of excessive bleeding in or at the back of the eye. This occurs especially in those who have uncontrolled high blood pressure or are on pre-existing blood thinning medication. It is important to inform your doctor about the medicines you are taking so that they can be stopped prior.
   
3. Posterior Capsular Rupture – This describes a tear or break in the bag which holds the lens during the cataract removal. Without getting too technical, this complication makes the whole surgical procedure longer, surgery cost higher and visual recovery slower. Depending on the severity of the tear, some surgeons will be able to manage independently during surgery, while other surgeons may need to call in a retinal specialist for their expertise in this area. Although this complication occurs rather uncommonly, it is ideal to have a surgeon who is competent enough to handle it if and when it occurs.
   
4. Retinal tears or detachment – Due to turbulence created within the eyeball during surgery, rarely a retina tear or detachment can occur. If detected early, it can be fixed by a retinal specialist without any permanent damage to the vision. It is important to have an eye doctor who pays attention to your retina during cataract surgery as well.
   
5. Injury to the surrounding tissue such as the eyelid, cornea and iris can occur during cataract surgery. This is uncommon especially in the hands of a skillful surgeon.
   
6. Anaesthetic Risk – There is always a small risk of any kind of anaesthesia to your brain, heart and lungs. It is important to have the surgery done with the support of a good anaesthetist who will be there to take care of your brain, heart and lungs while your eye surgeon is operating on your eyes.
   

During the recovery period, it is usual for the eye to experience inflammation which may result in transient eye redness, eye swelling, changes in eye pressure or transient retinal swelling. These temporary effects can be treated easily with eyedrops or medication if detected early by your surgeon. Hence, it is important to continue regular follow-up checks after surgery.

In the long run, it is usual for the intraocular lens to accumulate tissue cells or opacification with time (1 to 5 years later). This is can managed with a simple office laser procedure which ‘polishes’ the lens to its original clear condition again.

Private or Government Hospital?

Does shorter waiting time, more attention receive from the health care professional sounds good to you? Then you may want to consider choosing a private hospital to receive the best treatment for your cataract surgery. After all, health is wealth and getting the optimal recovery is the most important objective after doing a cataract surgery.

However, one thing to note is that you will not be able to use your special government subsidies benefit to offset your bills. Some insurance plan may cover some or all of it. You may contact this link to know more information.

Other Treatment Options For Cataracts In Singapore

Here are some of the following methods to help to slow down the cataract growth :

• Wearing sunglasses, cap, or umbrellas when outdoors
• Choosing UV Protection Lenses
• Maintain overall good health conditions

Conclusion

To sum it up, an average cataract surgery will cost from $1306 to $10,385 per eye. It is highly recommended that you utilise your insurance coverage to reduce your out of your money expenses to pay for your cataract surgery. If you need help on regards on your insurance policies, feel free to contact us to find out more.

Also, some of the factors that can affect the cost of cataract surgery can be due to which type of surgery method and what kind of intra ocular lens you are using. Private hospital definitely will add in more cost on the surgery, and you may want to ask yourself this question. Do you want to receive the best treatment and most care and attention when you are at your weakest point?

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