Cataract surgery - lens implant treatment

WHAT IS THE CATARACT?

Cataract is the clouding of the lens, the transparent lens inside the eye that focuses light to the retina to obtain a clear picture. Cataract usually develops in elderly patients, but can also occur in younger patients, in case of trauma, general conditions (e.g. diabetes), or in the case of long treatment with certain drugs (e.g. cortisone derivates).

WHAT ARE THE FIRST SYMPTOMS?

Cataract is manifested by a progressive decline in visual acuity, especially for distance, a change in colour and contrast perception, a feeling of dimming (blindness) in bright lights. Sometimes cataract manifests by decrease in distance dioptres in farsighted patients. They gladly find they start to see at near distance without glasses, but this apparent “recovery” of vision is just the first step of the cataract development.

Senile cataract usually occurs in both eyes, but evolves asymmetrically.

Patients over 40 years old should go to eye check-up once a year.

CONGENITAL CATARACT

It appears in babies. Cataracts can occur if the mother had an infection during pregnancy (e.g. rubella). This form of cataract requires rapid intervention in the first months of life, in order to preserve the visual function of the affected eye.

Any change in colour, or eye aspects in infants should forewarn parents and it requires having an eye examination.

WHEN TO DO CATARACT SURGERY?

The surgery can take place when cataract is diagnosed and when the patient feels the vision quality is no longer satisfactory. It is not good for the cataract to evolve or become hard, because a hard cataract is difficult to operate and the post-surgery recovery lasts longer.

WHAT TO DO ON THE DAY OF THE SURGERY?

Depending on the anaesthetist’s recommendations, the patient should eat something light or should not eat at all before surgery. Children should not eat and drink for at least 6 hours before surgery. The patient should continue the medication for systemic associated conditions (e.g. diabetes, high blood pressure, or asthma). Patients should not wear make-up on the day of surgery.

HOW LONG DOES THE SURGERY LAST?

The duration of cataract surgery is generally from 10 to 12 minutes, but it can vary depending on the case complexity. The patient can go home shortly after surgery and is expected to return for check-up according to the doctor’s instructions. The Patient should not go home alone.

WHAT DOES THE SURGERY INVOLVE?

Before surgery, the patient will be examined by the anaesthetist who, jointly with the ophthalmologist surgeon, shall choose the most suitable type of anaesthesia. The anaesthesia is most often local, by injection near the eye, or topical, by using eye drops. The general anaesthesia is rarely indicated (e.g. in children).

The most commonly used surgical technique, called phacoemulsification, consists of a small incision in the anterior part of the eye, lens fragmentation and aspiration using an ultrasound probe. The implant is then inserted in place of the natural lens, behind the pupil. The incision does not usually require suture.

RECOVERY PERIOD

The Patient’s vision will usually be improved the very next day. The Patient’s visual recovery is complete in 30 days. The glasses can be prescribed after a few weeks. The recovery period is longer if the cataract hardness is high or if the surgery is more laborious. The recovery of visual acuity also depends on the existence of other eye conditions associated.

CATARACT SURGERY WITH IMPLANTATION OF MULTIFOCAL IOL

After cataract surgery with implantation of a standard lens, the patient needs either distance glasses or reading glasses. If the patient does not wear such glasses, the vision will not be as good as in a healthy patient. If a multifocal lens implant is used, wearing these glasses is no longer required.

ARE THERE ANY RISKS AFTER SURGERY?

There is always a risk after surgery as after any type of surgery. Infection is the most serious complication after surgery.

WHAT PRECAUTIONS SHOULD BE TAKEN AFTER UNDERGOING SURGERY?

It is very important that the patient keeps a very strict local hygiene.
The patient must be very cautious in the first 72 hours postoperatively;
The patient should not rub the operated eye or exert pressure on the eyeball;
Patient should not sleep on the operated eye;
It is normal that the eye is more sensitive during the postoperative period;
The patient must wear goggles during a certain amount of time after surgery;
Postoperatively, the patient can walk, read or watch TV;
New glasses will be prescribed 3 to 4 weeks after the surgery;
The patient should not drive until receiving such permission from the ophthalmologist;
The patient must use all the medication prescribed by the ophthalmologist and should not skip any check-up indicated by the latter;