Cataract Operations

What is Cataract? How does it occur?

An unnoticeable, transparent - natural lens is placed just behind the coloured part of the eye. This lens is very transparent so that we see the pupil in the colour of black. This lens reflects the lights which is received by the eye on a layer of nerves, and it must be definitely transparent so that the light can reach nerves. Anyhow, if this lens loses its transparency and gets blurred, this is called Cataract. This opacity can occur in any part of the lens or all around it.

Is Cataract an Age - Related Problem? Do Young People also get Cataract?

Cataract can be observed at any age, including the babies. It’s very rare at middle-ages. It becomes more frequent when the age is older. 50% of the people between 50-59 ages and almost every person over 59 has this “opacity”. But this opacity doesn’t always affect the near sight significantly.

What causes Cataract?

The first reason of cataract in adults are the changes on the lens related to aging and by the kids, it is mostly because of the metabolic diseases, family marriages, problems & using medication during the pregnancy, microbic situations. Other than these, traumas on the eye, blood sugar, uveitis, kidney diseases, glaucoma, radiation, hypertension and using long time cortisone might cause cataract.

Symptoms of Cataract

• Blurred vision without pain
• Glares on sight and low light sensitivity
• Frequent change of numbers
• Frequent need of cleaning the glasses
• Difficulties while driving
• Low night vision
• Need for strong light while reading
• Double vision with one eye
• Paleness

Can Cataract be Cured with Medicine?

There is no treatment for cataract other than surgical intervention. There are some medication methods being tested, however they are not yet proved and only solution to cataract is a surgical intervention.

When do we need a Cataract Surgery?

It is recommended to have surgical intervention if the patient experiences one of the following:

• Has difficulties in Daily life with the vision.
• If any inflammation in the eye caused cataract and prevents the treatment and follow up.
• If the ocular pressure is increased due to cataract.
• Low vision and cross eye risks if the child is born with cataract.
• Cataract Surgery Methods

For long time, cataract surgeries are performed with PHACO method. It is a painless procedure also without needles and stitches. The eye is benumbed with eye drops and a small incision of 2,2 – 2,4 mm is performed. All the process is performed through this incision. Firstly, a round piece of the membrane which wraps the lens is peeled out. Afterwards, the lens with cataract is thorn into small pieces with the PHACO devices by the help of ultrasonic waves. A new, suitable, artificial intra-ocular lens is planted, and antibiotics are injected. Finally, the incision is closed without stiches.

The newest method nowadays is “Femtosecond Laser Cataract Surgery”

Using the Laser in cataract operations, the procedure is now safer, more comfortable, more trustworthy and less risky than classical phaco method. With laser method, the eye is benumbed and then by the help of computer-controlled laser for 30 – 45 seconds; the incision is made, the front capsule is opened, and the lens is thorn into pieces. The patient doesn’t feel anything at all. Later on, the patient is moved under the surgical microscope and the piece of the lens is removed with the PHACO device. The artificial lens is implanted; the antibiotic is injected, and the operation gets terminated.

What are the specifications of the intra ocular lenses?

There are many kinds of intra-ocular lenses such as the multifocal ones which provides the patient both far sight and close sight, there are also lenses with special colours and tinted ones against the harmful sun lights. The choice of the lens should be made together with the specialist.

What are the superiorities of Femtosecond Laser Cataract Surgery against Classical Phaco Method?

Without scalpels

Computer Automated (Minimum Error Margin)

Less time spent inside the eye, tissues are protected

Splintering of the lens is so fast that the surrounding area is protected

With the Femtosecond method, making the incision and splintering the lens is completed in seconds; without giving any damage to the eye. However, with the classical Phaco method, these processes have complication risks and very related to the talent of the surgeon.

One of the most important advantage is that the thin layer which the lens is extracted from is cut very decent by the help of the laser so that the intra-ocular lens fits inside perfectly.

All the incisions in the classical phaco method are made by the hands of the surgeon so that they all might not be in the same size or the same shape. This might cause the instability of the artificial lens and might affect the eyesight of the patient very negatively.

Femtosecond Lasers are developed especially for the patient who want to get rid of their glasses with the multifocal, trifocal and toric intra-ocular lenses by providing them maximum efficiency. The patients who choose one of those specific lenses should especially consider the Femtosecond Laser Method.

Post-operative care

Eye is covered with a bandage after the operation which will stay on your eyes until your doctor will tell you. You mustn’t make pressure on the eye and mustn’t rub it. Driving is also not recommended right after the operation. The prescribed medicines (pomades, drops, tablets or syrups) should be used according to the physician’s instructions. The hygiene is very important after the surgery so the hands should be washed before applying the medications. The tips of the pomades or drops should be avoided from the eyelashes, eyelids, skin, hand, tissues in order to prevent any bacteria & microbic related discomforts. Post-operative controls are done in the first day, first week and first month. Between these controls, the eye is protected against microbes with the drops and the healing process is accelerated. The instructions of the physician should be applied carefully after the operation.

Can cataract relapse after the operation?

Cataract doesn’t relapse one more time after the operation. The thin layer in which the lens is implanted might get blurred after a while. This is called “secondary cataract” colloquially. However, this is actually not a cataract and can be treated via laser easily. There are also rare occasions observed in children or where the thin layer gets thicker, it can be also fixed with surgery.

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