CATARACT
SURGERY
The development of cataract is a slow process, it can take years before it has any, let alone serious effect on vision.
However, it is important to know that what is already lost cannot be reversed and the process cannot be stopped, it continually keeps getting worse. Nowadays, thanks to the advanced technologies of medicine, this disease can be easily cured with a short and pain-free procedure, so when everyday life is affected by your vision, your glasses no longer help, there is no point in waiting. You can save yourself a couple of years’ hassle by undergoing cataract surgery and enjoy your life once again.
In countries with the best healthcare, there is the opportunity to have the surgery even at the very first onset of symptoms.
Presbyopia
The aging on the crystalline lens starts inevitably as we age and progresses continuously and unstoppably, as it happens with every tissue in our body. As light gets into our eyes, which is essential for vision, UV radiation generates free radicals in the eye (oxidative stress) that damages the proteins of the crystalline lens. As they damage their structure changes and as a result the lens first loses its flexibility leading to presbyopia, meaning we cannot read the newspaper without reading glasses anymore. Later the crystalline lens loses its transparency as well, that is when cataract develops. The first sign of this process occurs at around the age of 40-45, is that we cannot focus on items close by anymore, for example we will have a problem reading something. At this point we will need a prescription for our first glasses. If you are lucky, cataract does not develop in the next 20-30 years, you will only have to replace your glasses every couple of years and have a multifocal. However, during this period you also have the option to have a lens replacement surgery and have multifocal intraocular artificial lenses implanted (IOL) and you will only need to have glasses for fine work. Read more about this procedure here…… The great advantage of this procedure is that because it is methodologically equivalent to a cataract surgery, the development of cataract is also prevented.
The development of cataract
According to WHO, “Cataract is a clouding of the lens in the eye that normally affects vision.”. Its main sign is the decrease in visual functions. As said before, it is due to the damage of its content and structure that leads to a loss of opacity. The lens becomes greyish or brownish, and will not let through light of certain wavelengths. This way, glasses will no longer help, and not only visual acuity but also color vision will also be affected. Sometimes it is much worse on one eye but the person does not notice it because he/she got used to the gradually decreasing vision and the other eye sees fairly well and compensates for the loss. Nonetheless, it can be a bit dangerous in certain situations, for example when driving a car.
Which factors contribute to a cataract?
- Family accumulation (genetic disposal)
- Metabolic diseases (Diabetes)
- Medicines (Steroids), Alcohol, Smoking
- Diet
- Hormonal changes (Menopause, Pregnancy)
- UV radiation
- Eye injury, Blunt trauma
Signs and symptoms of cataract
Cataract is essentially the aging of the eye lens, a process that occurs with age and develops as a result of harmful effects, with its main symptom being a decrease in visual functions.
The main signs and symptoms are all related to aspects of visual function.
- Gradually decreasing blurred, foggy vision
- Decreased color vision
- Prescription diopter changes
- Contrast sensitivity decrease
- Sensitivity to sunlight and nighttime lights
- Halos around light sources
- Decrease in 3D vision that can affect orientation in the environment
- Monocular double vision
The treatment of cataract
The treatment of cataracts involves the extraction of the opaque crystalline lens and the implantation of an artificial lens into the eyes. Even though modern medicine (both western and eastern) offers various options to treat diseases and eye conditions, for cataracts, the only solution is surgery. But, the good news is that it offers a lifelong solution, and when there are no other eye conditions that can affect your vision, you can see as clearly as in your 20s. The operation is a routine procedure with state-of-the-art techniques and in the hand of an experienced surgeon. It only takes 20-30 minutes, it is pain free, it is safe and you can go home soon after it, there is no need to spend days in a hospital. Among many of its advantages, it is important to know that previous refractive errors can also be corrected by choosing the right type of lens and you can say goodbye to the spectacles you have been wearing all your life. You also do not have to wait until your vision is severely impaired, you can have the surgery anytime at the first signs of presbyopia, after the age of 45.
Preparing for the cataract surgery
You will need to attend a detailed consultation with your surgeon before the surgery where the eye care specialist examines your eyes, establishes the type of cataract, your suitability for the surgery, and the type and the diopter of the artificial lens to be implanted. You will also discuss the procedure, what to expect and how to prepare for the surgery. This altogether takes 60-90 minutes. For precise diagnosis, the visual acuity, back of the eyes (fundus), instrumental examination and pupil dilation is needed. We do not recommend driving a car afterwards, on that day. For precise measurements, we recommend that you do not wear contact lenses for 1-4 weeks beforehand (1 week for soft, 4week for hard contact lenses). Please bring your previous medical reports, a list of your regular medications and your glasses with you.
You will need an ECG and a lab test before, we can help to obtain them when needed.
The day of the cataract surgery
In the morning before the surgery, take your medications, have breakfast and drink fluids. Avoid the use of makeup and cosmetics around the eyes and do not wear contact lenses. Bring sunglasses and have somebody to accompany you. You will have the opportunity to talk to your doctor, and ask questions one more time before the operation. We will ask you to read and sign the consent form. There is a 1-2 hour long waiting period during which, as a preparation for the surgery you will receive pupil dilating and anesthetic eye drops. There is no need for general anesthesia, or the injection of lidocaine, the drops make sure that it is a completely pain free procedure. During the operation, they make a very little, 2.2 mm long incision, through which they go in with a device, fragment and remove the cataract (phacoemulsification technique) lens and implant the clear artificial lens into its place that provides you a clear vision for the rest of your life. Also, there is no need for stitches, this type of wound closes by itself.
The eye surgeons have decades of experience in performing the procedure and work with the latest technologies in state-of-the-art environments, therefore it is nowadays regarded as a routine procedure, which in most cases lasts no longer half an hour.
The recovery after cataract surgery
There is a 1-2 hours long rest after the surgery during which we will ask you to sit comfortably and relax. If you fill well and fit, you can leave the clinic after this and rest at home or at your chosen accommodation. Your eyes will be covered with a see-through protection lid for 24 hours and you will have to use eye drops regularly for a couple of weeks. In general, you will experience your improved vision a couple of hours after the surgery and it will continuously enhance during the first week when, in most of the cases your final visual acuity settles. After this, the patients report a significantly improved quality of life. Of course, it is important to keep in mind the total recovery takes about a month and vision can further recover during this time.
Types of premium intraocular lenses
Cataract surgery not only restores but also enhances vision to a great extent. After the surgery, the blurring grayish sensation disappears, and with the vision correcting lenses it is also possible to live a completely spectacle free life, with the exception of close-up work or reading small print.
The most suitable lens that will be implanted will be decided based on the profession and lifestyle of the individual, it has to be tailored to the individual’s needs. The monofocal intraocular lenses provide perfect vision for one given distance, for which spectacles will not be needed. When you choose trifocals you will see clearly into the distance, and also closer up, in most cases completely spectacle free.
