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Phaco-emulsification – cataract surgery
Table of Content
Cataract (cataract) is a lens torbiding leading to distortion of vision. The disease is painless, whose incidence increases with age. There are many causes of this disease, including.
- Advanced age so- called senile cataract (the most common cause),
- In the course of certain diseases like :
- Diabetes
- Glaucoma
- Retinitis pigmentosa,
- Ggalactosemia,
- steroids (cortisol use)
And even after blunt or penetrating injuries of the eyeball.
The most common symptoms of cataract:
- hazy vision until complete blindness,
- deterioration of vision in low light conditions such as night,
- the need to use stronger light for reading,
- image splitting in one eye (polyopia), such as seeing many moons at night,
- dull colour vision,
- the need for frequent changes of glasses,
- splitting of light,
- misjudging the distance,
- deterioration of visual acuity.
The healthy eye has almost a transparent device that focuses light rays – called the lens. The transparency of the organ determines the correct, clear vision. The lens works much like in a camera. In humans, it is convex on both sides, which allows sharpening of sight on the object. The lens is composed of protein called crystallin, allowing light permeability. This protein is formed in fetal life and does not regenerate in time However, over the years, the protein gradually begins to become impervious to light. When most proteins undergo such modification, it will prevent proper vision – this is called cataract.
How can we prevent from cataract?
At present, it is neither possible to prevent from cataract nor treat it with medication.
How to cure cataract?
Cataract can be treated only by surgery. Phaco-emulsification of lens is carried out Every year, millions of people undergo this treatment with excellent results. Currently, it is the safest method, which allows the patient to a rapid return to normal functioning.
What is lens phacoemulsification surgery?
- Anesthesia: drops applied locally, the patient is fully aware and maintains contact with the doctor during the whole procedure
- The operation is performed by a qualified ophthalmologist only
- Duration of surgery : about 20 minutes, and within an hour after surgery, the patient is dismissed home
Phaco-emulsification procedure step by step
- A small incision at the edge of the cornea (2.2-2.8 mm) is made, which allows to avoid stitches so that the patient does not feel any discomfort associated with stitches.
- Turbid lens is softened by ultrasound, so that it can be easily removed. In very rare cases, when the lens is too hard to be removed in this way, an indirect method is applied . Then, a larger opening is made to remove the turbid lens, which entails the use of sutures.
- Then, an artificial lens is implanted IOL (Intra Ocular Lens). Before surgery, the type is selected by an ophthalmologist (see table on the next page describes each type of IOL). During the entire surgery the surgeon uses a special microscope, which guarantees the highest precision of movements.
IOL lens
Recommendations after surgery
- strictly follow all recommendations of your doctor.
- Immediately after the surgery, do not rub your eyes, and avoid their excessive wetting
- The day after surgery, the patient can do basic activities such as reading and watching TV. Do not drive a motor vehicle during the first day after surgery.
- In two to seven days, you can return to work.
- Doctors usually recommend avoiding strenuous activity for at least two weeks after surgery.
After surgery, should you use glasses or contact lenses?
Modern medicine offers not only the surgical removal of the turbid lens, but appropriate selection of artificial lenses.It allows you to correct effectively the vision defect (such as astigmatism, myopia and hyperopia). The use of multifocal lenses allows for distance vision, near vision and intermediate distances. As a result , the patient is freed from the need of wearing glasses or contact lenses.
Are there any possible complications?
No operation is completely without risk. No doctor is not able to guarantee complete success in every case . However, serious complications occur extremely rarely at cataract surgery.
Despite the biggest concern of our physicians at our center, the patient might experience the following complications that can cause deterioration of visual acuity:
- Severe bleeding occurs in 1-2 per 1000 patients during or shortly after surgery.
- Infections can occur despite compliance with the principles of antisepsis by medical personnel.
- Retinal detachment occurs in 1 % of patients with unstable posterior cyst ; Risk increases to 3-4 %, if the cyst is cut or removed during the operation. However, the retina can be re- applied during the next surgery .
- Increase in intraocular pressure , the appearance of inflammatory foci in front of the pupil or turbid cornea often appear in the first days after the operation. All these ailments can usually be removed with medication. However, if the cornea had already been damaged or turbid prior to surgery , most likely this will never change . Then you might have a cornea transplantation .
- Swelling of the central part of the retina leads to a decrease in visual acuity . Most often disappears after a few weeks ,otherwise, it undergoes pharmacological treatment .
- Changes the curvature of the cornea appear frequently , however, they can be completely corrected with glasses. In some cases, some pieces of the cornea are cut or laser treatment is applied in order to eliminate this problem.
After inplantation of artificial lens, there might be the following complications :
- Poor power breaking of the implanted lens is very rare. Most lenses differ by no more than two dioptres from ideal. However, despite careful calculations of the type of implanted lens, sometimes it is not quite possible . In such cases, another operation is performed and the lens is replaced .
- Dislocation of the artificial lens occurs extremely rarely. In these cases, a second surgery is necessary, the removal of artificial lenses sometimes is permanent.
