CATARACT SURGERY
What is cataract?
Cataract is clouding of a natural lens that leads to poor vision. The vision becomes blurry and colors become pale (yellowish-brown tones prevail). Night vision problems (night driving) appear when visual acuity becomeseven worse, and sometimes people see circles around source of light. According to the latest research conducted by the World Health Organisation, over 50% of the non treated cases lead to blindness.
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When does cataract occur?
Cataract occurs most frequently in the third age, after 65, as a result of degenerative changes in the lens. It can also occur earlier because of some other illness, when it is called secondary cataract (trauma, exposure to irradiation, metabolic disease, diabetes, corticosteroid use, etc.). If cataract is present in the infant – it is called congenital cataract.
Cataracts – What is the best time for surgery?
Cataract surgery is recommended when a patient has a functional problem. This is most common when visual acuity decreases to 70 percent and lower. It is important to note that it is not recommended to wait for the cataract to “ripe” as it used to be, because it is easier to perform the surgery at an early stage. Later, when the cataract gets mature, much more ultrasonic energy is needed to remove the cloudy part of the lens and the procedure is more difficult and risky.
Cataract – how to diagnose it?
The cataract is usually detected when the patient notice that vision weakens and that loss cannot be corrected by wearing eyewear. Refractive error is rapidly changing and people often change a few glasses a year. Driving a car becomes more difficult, especially at night, when glare and circles appear around the light source.
Does blurry vision means that I have a cataract?
Blurry vision can be caused by a variety of diagnoses, such as: diopter change, astigmatism, glaucoma, eye changes, etc. However, in the case of people older than 65, blurred vision is most often caused by changes in the lens or cataract.
Ophthalmic Examination / What is Included?
The examination is very important and needs to be thorough, performed by a specialist ophthalmologist.
The examination includes:
• Determining the refractive power,
• Eye pressure measurement,
• Slit lamp examination,
• Tear film evaluation,
• Dilating the pupils
As a part of the exam, biometry is performed – the calculation of the optical power of the intraocular lens that will be inserted in the eye during the operation.
Biometrics may be performed ultrasonically or with a special laser device, which is more precise and is very important if the patient decides to have multifocal intraocular lens implanted (clear vision at all distances).
Modern clinics usually also have an endothelial microscope which determines the number and shape of the corneal endothelial cells, which is important because it assesses the risk of surgery. Ocular ultrasound is also required to exclude certain ocular eye diseases (retinal ablation).
Is the eye pressure related to cataract?
Eye pressure is not the cause of the cataract, although cataracts may sometimes cause eye pressure increase and glaucoma. There are two reasons.
The first is that the lens volume increases, which moves the lens forward and partially closes the eye drainage system (trabeculum). This causes an increase in the pressure of the eye, because the aqueous (liquid that fills the eye) can not get out of the eye (phacomorphic glaucoma).
Another reason for increasing eye pressure due to cataracts may be the increased release of protein from the cloudy lens which obstructs the trabeculum with protein clots (phacolytic glaucoma).
Cataract – natural healing?
Unfortunately, until today there is no therapy that has been proven in treatment of cataract. It is important to reduce exposure to UV radiation and to avoid over exposure to sunlight during hot summer days. It is also recommended to regulate the diet and eat as much heat-untreated vegetables (peppers, carrots, green salad). The only effective way of treatment is surgery.
WHAT DOES THE CATARACT SURGERY LOOK LIKE?
Preparing for the cataract surgery
The eye drops that dilate the pupils are applied when patient arrives to the Clinic. Eye pressure and blood pressure are measured and the patient is examined on the slit-lamp. After about an hour (depending on how fast pupils dilate), the patient is ready to go to the operating room. In the operating room, the patient is comfortably placed on the operating table, which is soft and movable in multiple directions to ergonomically adapt to each patient.
Nurses disinfect the skin around the eyes, put a sterile patch over the patient, and place an eyelid holder that helps the patient not to blink. The eye is anaesthetised with eyedrops and there is no need for general anaesthesia. No injections are given and the procedure is completely painless.
Cataract surgery – the procedure
The surgery itself lasts about 10 minutes. The patient looks at the light source and is constantly awake and communicating with the surgeon. Since surgery is painless and fast, most patients are surprised that everything has passed so quickly and easily, and that all the fears that people usually have before the procedure were unnecessary. The procedure is performed through a small incision only 2 mm wide, without the need for sutures or any injection. At the end of the procedure, the lens is implanted in the eye, which also enters the eye through the small incision and unfolds in the eye. At the end of the surgery, sterile eyepatch is put on the eye and the patient leaves the operating room with a help of medical staff.
After the cataract surgery
About half an hour after surgery, the patient goes home, warned to avoid greater physical exertion and unfavorable microclimatic conditions (wind, dust, smoke). Check-up examination is scheduled next morning.
Three hours after surgery
Sterile eyepatch may be removed from the eye. Except for the first check-up examination the next day, it is recommended to have a check-up one-month after the surgery (when glasses are prescribed if needed). Regular control follow-up of the patient are scheduled 6 months and a year after the surgery.
Cataract surgery complications
Every surgical procedure may have potential complications such as eye infections, damage to the eye tissues during surgery, etc. With modern technology and ultrasonic devices that release minimal amounts of ultrasonic energy,
complications are extremely rare. The reason for this is stable eye pressure during the entire procedure. Before, when the surgeries were not performed ultrasonically (classical method or ECCE), complications were much more frequent and the results of the procedure were worse. Nowadays, cataract surgery has become a routine surgery.
Cataract surgery complications
Once the cataract surgery has been performed, the cataract cannot emerge again. The surgery effect is lasting and lifelong.
CATARACT SURGERY AT THE KNEZOVIC EYE INSTITUTE
The Knezovic Eye Institute is equipped with the most modern technology for cataract surgery. The ultrasonic device Infiniti is characterised as an extremely precise and functions in multiple modes in order to individually adapt to each patient. Energy dissipation is minimal, leading to rapid recovery after surgery without any adverse effects on the surrounding eye tissue. Apart from technology, the advantage of our Clinic is a great experience in calculating different intraocular lenses (especially multifocal) as well as in the actual performance of the surgery attributed to Dr. Knezovic´s experience gained through several thousand successful surgeries. It is important to emphasise the kind and humane approach of all of the Knezovic Eye Institute employees, which further influences the outcome of the whole process as people are calm and well informed about each step of the operation. There is no fear or unknowns, nor hidden costs of the intervention.
During surgery or examination, the Clinic staff is available for outpatient care, and all control check-up examinations and postoperative therapy are free for a year after the surgery itself.