There is a clear, crystalline lens inside our eyes similar to a camera. When we look at something, light rays travel into our eye through the pupil and are focused through the lens on the retina. The lens must be clear in order to focus light properly onto the retina. Cataract is the clouding of the eye's natural lens.
As a result of aging, our crysalline lens looses its clarity. Visual acuity decreases, colors becomes less vivid and the vision becomes blurry - like looking through a foggy or dirty window.
Stronger light and changing eyeglasses can help to improve vision at the beginning. A balanced-healthy diet, uv-protective sun-glasseses are also advised in early stages of cataract.
Most frequent type of cataract is the age-related one. The disease is generally seen after 55-60 years of age. 70% of people aged 75 or more have significant visual impairment due to cataracts. Except for the age; diabetes, smoking, trauma, uveitis (eye inflammation), long term steroid use, long-term exposure to ultraviolet light and positive family history may also play a role in the formation of cataracts at an earlier age.
When a cataract progresses, it may cause visual problems that interfere with daily activities including reading, driving or working. At this stage, eye glasses will not be helpful anymore and surgery for the removal of the cataract should be planned.
Laser assisted cataract surgery (LACS)
Cataract surgery technniques have been improved since the discovery of prosthetic intra-ocular lenses. Cataract surgery is in it’s golden ages with the surgical use of premium intra-ocular lenses and the femtosecond laser technology.
Twenty years ago cataracts were removed through a large corneal incision after needle injection of some local anesthetics around the eye and a standard monofocal intra-ocular lens was implanted. The large corneal incision was closed with stitches, frequently resulting in high – irreguler astigmatism. Postoperative healing and rehabilitation period was long and an acceptable visual acuity was obtained only after removal of the stitches and correction of the astigmatism with eyeglasses for far and near vision. This technique is only used for highly complicated cataract cases today.
The second era started with the invention of phacoemulsification technique and still used frequently today. Phacoemulsification (fragmentation and aspiration of the cataractous lens with ultrasonic power) surgery was performed through microscopic incisions performed with special blades and a foldable intraocular lens was implanted. The phacoemulsification surgery became very popular because it was performed under topical anesthesia (numbing drops) and visual rehabilitation was sooner compared to the old technique. However, even in experienced hands; phacoemulsification surgery was not risk free.
The introduction of femtosecond lasers to cataract surgery is a recent revolution. These lasers assist the surgeon in performing precise corneal incisions and correction of astigmatism via corneal incisions. They also perform the capsule openning and cataract fragmantation steps in a more controlled and safe manner.
For a problem-free cataract surgery
Succesfull cataract surgery is closely related to the surgical experience of your doctor, technology of the intraocular lens and the quality of surgical equipment. Cataract subtype and surgical techniques used can be different among the patients. That is why your doctor should evaluate you in detail before the surgery. Post operative timely examinations also decrease the possibility of further complications. Surgical equipment must be disposable and the sterilization conditions must be followed very carefully for reducing the infection risk.
Risks of the surgery
Complications that occur during or after the cataract surgery can reduce the success of the operatipon. As with any other surgery, cataract surgery poses risks; such as infection, bleeding and corneal edema.
Premium Intraocular Lenses
In standard cataract surgery, a monofocal standard lens is inserted into the eye after the removal of the cloudy cataract.
Monofocal intraocular lens is a fixed-strength lens which is set for one level of vision - usually thr distance vision. Distance visual acuity improves with the increased quality of monofocal lenses. HD lens technology provides more detailed visual acuity. These lenses also protects our retina from UV-light and are highly compatible with intraocular tissues; which decrease the risc of secondary cataract and intraocular lens exchange. Standard monofocal intraocular lenses correct only distance vision however premium intraocular lenses may provide excellent vision for both near and distance thus a spectacle-free life. Astigmatism can also be corrected with premium intraocular lens.
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