EYE DISEASE & TREATMENT / CATARACT

CATARACT

What is a cataract?

The natural lens of the eye (the crystalline lens), is approximately 10mm in size, located immediately behind the iris and is normally transparent. Light passes through it to reach the retina which is on the posterior part of the eye to imprint the images.
With age, this lens loses its original texture and blurs. The gradual blurring of the crystalloid lens is called cataract.

When does it occur?

The cataract is directly related to age and its frequency increases as the age increases. In the ages over 75, the rate borders on s almost 75% of the general population, but this fact does not mean the exclusion of it appearing among children and infants, or even rarely at birth (congenital cataract). Albeit it can be caused through other causes (injuries, drugs, diseases or radiation).

What are the symptoms?

• Gradual reduction of vision (blurred) whether it is distant or near
• Frequent changes in prescription glasses
• Bulb and photophobia mainly in the early stages
• Reduced colour perception
• Reduced contrast sensitivity
• Reduced night vision
• Halo and asteroid formations around light sources

Required Treatment

The cataract is treated only through surgery.
There is no conservative treatment with eye drops.

The most widespread method is phacoemulsification using lasers. This is a highly safe method, completely painless and bloodless for the patient.

Initially two microscopic side incisions are made to reach the anterior capsule i.e. a circular continuous opening on the capsular surface. Then a special ultrasound tool is inserted, which crushes and sucks the crushed lens. Following the extracapsular extraction an intraocular lens (IOL), is usually placed into the eye in the same position of the natural crystalline lens (usually acrylic).

Nowadays, the intraocular technology has made tremendous progress with the possibility of placing intraocularly monofocal, toric and multifocal intraoculars lenses. Therefore, cataract surgery is now a refractive surgery with excellent post-operative results in both hyperopia or myopia of patients.

Surgeon Magdalini Riga, due to her extended experience in cataract surgery with phacoemulsification, performs the above operation using local anesthesia (eye drops) and a 2.4mm short incision technique.
This method guarantees the safe and successful outcome of this surgery without the use of sutures. It is a short duration surgery, requiring a mere 15 minutes, and the patient returns directly to his home. The postoperative results are excellent, the recovery of the patient is rapid and quickly returns to his daily activities.

What is Secondary Cataracts?

A percentage of patients treated for a cataract may show months or years after the surgery, the so-called secondary cataract, pseudo-cataract or in medical terminology posterior capsular opacification (PCO).

In fact, this is not a cataract as we know it to date, but a blur or cloudiness of the posterior capsule, that is, the membrane that we leave after cataract removal, in order to support and hold the artificial lens in place. The result being the progressive decrease in vision, similar to that of the cataract.

The treatment is simple and short. With the use of a special laser, a Yag laser capsulotomy is performed and the membrane breaks, resulting in the vision returning to normal.

QUESTIONS

1. Are there preventive measures to delay the onset of cataracts?

It is not known what causes senile cataract. However, we may be able to delay its appearance by:
• Quitting smoking
• Physical exercise and weight maintenance at desirable levels
• Nutrition rich in vegetables, fruits and foods with antioxidant action
• Paying attention to health problems that accelerate its progression (e.g. diabetes)
• Use of appropriate sun glasses to protect ultraviolet radiation

2. When should a cataract be operated on?

The time of surgery depends on the patient’s needs and the impact of the reduced vision on his daily activities. The optimal time for surgery is co-decided after consultation with an ophthalmologist. In addition, early intervention is required in patients with diabetes to properly monitor vision for diabetic retinopathy.

3. Do complications follow cataract surgery?

Complications rarely occur and are fully treatable.
Their frequency increases as the cataract matures.

4. What happens if the cataract is not treated in time?

It can cause serious complications that could eventually lead to blindness.

5. What do I need to know on the day of surgery?

It is recommended that the patient be escorted by a relative.
The patient’s medication should be normally taken except for any anticoagulant therapy, which should be duly adjusted according to a cardiologist’s instructions.

Breakfast should be light.

Surgery lasts about 15 minutes, but the retention time in the clinic is 2-3 hours due to the pre-operative preparation of the patient.

6. Is surgery painful?

Cataract surgery is painless and only uses a local aesthetic collyrium.

7. What should I know about post operatory procedures?

The patient can immediately leave after surgery for his home without covering the operated eye. The use of sunglasses is indicated after leaving the clinic.

The doctor’s instructions should be followed. Antibiotics and anti-inflammatory eye drops should be taken for about 3-4 weeks.

A mild painkiller may be taken if the patient experiences light pain in the first 24 hours.

Patient should contact the ophthalmologist if the pain is severe or if they have a sharp drop in vision or there is a sudden redness of the eye.

It is forbidden to rub the operated eye or lift weights for one week.

If glasses are needed for distant or close vision, they are prescribed about a month following surgery.