Cataract Surgery
Cataract
Cataract means the greying of the lens, causing vision impairment. Most cataracts are related to age, they mainly occur in an old age. By the age of 80, half of people will have had a cataract, or they will have already undergone eye surgery. Cataract may occur on one or both sides, however, it cannot go from one eye to the other.
Cataract surgery is one of the most frequently performed surgical procedures, however, it is one of the safest and most effective interventions worldwide. At our Ophthalmology Centre cataract surgery is performed with the use of the most modern technique, called phacoemulsification technique, in local anaesthesia (with the use of eye drops). This intervention usually takes less than 10 minutes and is almost painless. Patients have to rest 1 or 2 hours after the surgery, and if no complications occur, patients may go home following this.
Types Of Cataract
Although most cataracts are related to age, there are several forms of it.
• Cataract: Cataract means the greying of the lens, involving vision impairment.
• Secondary cataract: Cataract may form after ophthalmological surgeries performed for other reasons or it may occur as a result of certain diseases, e.g. diabetes as well. Sometimes it is caused by the administration of medicines containing steroid.
• Traumatic cataract: Cataract may be produced related to an injury of the eye, sometimes even after years of the injury.
• Hereditary, childhood or juvenile cataract: It may occur that a baby is born with an existing cataract or cataract forms in childhood, often in both eyes. Sometimes these blurs are so small that they do not influence vision. However, if they do, their removal may be important.
Treatment Of Cataract
Treatment methods
Surgery is the only effective treatment to a cataract that has formed. During the intervention, the blurred lens is removed and replaced with a plastic lens. Cataract surgery becomes necessary when patient’s vision is not sufficient for performing everyday activities (e.g. reading, driving, watching TV). The date of surgery is agreed on by the patient and doctor together. In most cases delaying the cataract surgery does not mean any disadvantages, and it does not make the surgery more difficult either, moreover, in most cases delay does not involve any damages (naturally your vision becomes poorer and poorer as “cataract is becoming mature”).
However, cataract may need to be removed even if it does not cause any complaints to the patient, or if no significant improvement can be expected of the surgery. This is the case for example when cataract hinders the detailed examination of the eye-ground or the efficient treatment of other eye diseases (such as age-related macular degeneration or eye-ground complications due to diabetes). The surgery has to be performed in that case as well when “cataract becomes over-mature” and it may cause internal eye inflammation or increased eye pressure.
Vision correction by means of lens surgery
Most of the surgeries performed today happen within the frame of an outpatient surgery, with the use of phacoemulsification technique in local anaesthesia (with eye drops). During the surgery two small (1-3 mm long) cuts are made in the cornea, through which the greyed-lens can be broken into tiny pieces with the use of ultrasound, it can be removed by suction, then it can be replaced with an artificial lens.
Without an artificial lens, vision would be appropriate only with the use of high-dioptre glasses. In most cases the implanted artificial lens is monofocal, i.e. it provides good vision for a definite distance, whereas for other distances you need glasses (e.g. you have good far vision but you need glasses for reading). Today there are multifocal or adjustable and cylindrical lenses as well. At the end of the surgery, wounds usually do not need to be closed with sutures.
About Artificial Lenses
In the pre-operative ophthalmological examination you can decide on what artificial lens type should be implanted during the surgery.
Monofocal artificial lens: in most cases this lens type is implanted in cataract surgeries. This lens provides good vision without glasses for a definite distance (usually for far vision) and you may need glasses for other tasks (e.g. reading glasses).
Toric artificial lens: you may need this lens type if you had astigmatism and wore cylindrical glasses before the surgery. The normal monofocal artificial lens cannot correct cylinder dioptre so in these cases you may need toric artificial lenses in order not to wear glasses.
Multifocal artificial lens: this artificial lens type can allow you to have good vision for all distances without glasses after the surgery.
The Process Of Surgery
Before the surgery
You need to undergo some ophthalmological examinations preoperatively. These include ultrasound examination and the assessment of cornea convexity. These data are needed for assessing the dioptre of the artificial lens implant.
On the day of surgery
In our Clinic we dilate the pupil on the concerned side with the use of eye drops. This is followed by washing and disinfecting the areas around the eye, then giving anaesthetic eye drops. This intervention usually takes less than 10 minutes and almost without any pain. At the end of the surgery your eye is covered by a plastic bandage cover. You have to rest for 1 or 2 hours. If no complications occur, you can go home following this.
Life After The Surgery
Immediately after the surgery
You may have a slight feeling of discomfort, and you may be tearing as well. You may have light sensitivity. Most of these complaints will disappear in 1 or 2 days. When you are in your home, avoid frequent bending and do not lift heavy objects. However, you may do your usual activities. Your treating doctor will agree on the control examinations with you.
Is cataract surgery efficient?
Cataract surgery is the second most frequent surgical procedure in Hungary (birth is in the first place). However, this is one of the safest and most successful interventions. Over 90% of the patients have better vision after the surgery than earlier.
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