Cataract

What is a Cataract?

A cataract is partial or complete opacity or discoloration of the crystalline lens in the eye. It reduces the amount of light reaching the retina. These changes cause a loss of visual clarity. The aging process is responsible for most cataracts.

What are the common symptoms of a cataract?

1) Blurred vision
2) Glare
3) Increasing or decreasing shortsightedness, or a rapid change in spectacle prescription
4) Double vision in the affected eye
5) In severe advanced cataracts that are left untreated, the eye may turn red and painful

What is the main cause of a Cataract?

Most cataracts are caused by age related changes in the crystalline lens of the eye. As the lens is contained within a capsule and it continually grows throughout life, there is increasing compression of the lens cells and some cells lose their transparency and become cloudy. This makes images look blurred or fuzzy when light passes through a cloudy lens.

What are other causes of Cataracts?

1) Diseases such as diabetes
2) Traumatic injury
3) Long time usage of medications such as cortisone
4) Inflammation of the eye such as iritis
5) Excessive exposure to sunlight and its ultraviolet rays
6) Congenital

What are the types of cataracts?

1) Congenital and Juvenile. Sometimes, infants and young children develop cataracts or they are present from birth often due to an intrauterine infection.

2) Cataract Senilis. This cataract progressively forms due to the natural process of aging.

3) Traumatic. There are two main types of trauma that may cause cataracts, blunt trauma and penetrating trauma. In blunt trauma, the force of injury is quite substantial and there may be damage to other parts of the eye. In penetrating trauma, either a small high velocity projectile penetrates the eye ball or a very sharp object penetrates the eyeball. The inflammation from both of these injuries can cause cataracts.

4) Systemic Complications. Infections, inflammations, or diseases such as diabetes or glaucoma, or retinal detachments can cause changes in the lens metabolism and cause cataracts.

5) Subluxated/Dislocated. A subluxated cataract is a cataract that is wobbly and this is usually due to a defiency or damage to the supporting structures of the lens that normally hold it in place. A dislocated cataract is a cataract that has displaced completely from its normal position and it may be displaced either into the anterior or posterior chamber of the eye.

Phacoemulsification

A special kind of probe is used. The business end of the probe features a hollow titanium needle that vibrates about 40,000 times per second, breaking the cataract up and virtually liquefying it with ultrasonic vibrations. The phacoemulsifier also functions as a vacuum cleaner, sucking the liquefied cataract from the eye. After the removal of all soft lens material, the empty lens capsule is ready for the insertion of the artificial intraocular lens. The artificial lens is a foldable type that can be folded like a pancake and passed through the small entry wound. Most of the time, foldable intraocular lenses are used, even though they are more expensive than foldable lenses. This is because there is no need to place sutures at the end of the operation and the small surgical wound is very strong and heals quickly. The phacoemulsification technique takes only 20-30 minutes per eye. It uses local anesthetic eye drops for the operation and the patient remains awake during the procedure.

Extracapsular Cataract Extraction

This technique manually expresses the lens nucleus out of the eye through a large wound in the front of the eye. The remaining soft lens material is sucked out with a suction probe and the empty lens capsule is left intact in order to support the placement of an artificial lens implant within the lens capsule. The wound is usually closed with 5-8 very fine absorbable sutures to prevent leakage and wound rupture. The disadvantage of extracapsular cataract surgery is the longer healing period due to the large wound and the unpredictable wound astigmatism due to the many sutures placed. However, in skillful hands, extracapsular cataract surgery can give similar results to phacoemulsification surgery. In fact, for very hard, dense cataracts, extracapsular cataract surgery may be the surgery of choice.

Expectations and Recovery

A large portion of the cataract operation patients will continually and gradually experience improved vision soon after the operation.

Sometimes there is thickening of the posterior layer of the lens capsular bag and the vision is slightly poor. This is called Posterior Capsule Opacification (PCO). Treatment of PCO is relatively simple. The eye surgeon performs a simple treatment called a YAG laser to create an opening in the thickened posterior capsule. This treatment is an outpatient procedure. It is painless and very quick. Vision improves immediately.

The best visual acuity can be attained with or without glasses after the eye has been completely healed, approximately 2-3 months after the operation.

The decision for cataract surgery must be a joint venture between the patient and the surgeon. If the patient cannot perform his normal daily activities, surgery is indicated. The question of visual comfort lies solely with the patient. The surgeon will consider the patient’s life expectancy, mental well- being, and overall health before considering surgery. The patient must be healthy enough to tolerate the surgery and subsequent medications.

Please consult directly with our team of expert doctors at our clinic to determine if a cataract operation is right for you. The doctor will do an assessment of your fitness to undergo the operation. He will consider your visual and vocational needs. He will evaluate your patient history including previous eye disease or injury as well as current medications. The surgeon will also evaluate the health of your eye. He will determine if the anesthetic, and pre-operative and post-operative medications and drugs can be tolerated by you. He will do an assessment of the eye to determine the power of the artificial lens that will be implanted during the surgery. Together, a decision can be made whether to proceed with the operation.

I Care Lasik Center uses the Sovereign instrument from AMO. It uses the technology called “White Star” to achieve the optimal results.

With the combination of solid service, high and modern technology, and a commitment to achieving the highest patient satisfaction, I Care provides an advanced solution for better vision and a brighter life.

Precautions To Be Taken After Catarat Surgery.

These precautions are designed to prevent infection, stress, prolapse, wound rupture, and accidental trauma to the operated eye.

Do not rub your eyes

Do not bend too far forward

Do not carry heavy loads

Do not read more than usual

Do not strain when evacuating the bowels

Do not lie on your side too soon after the operation

Do not brush your teeth too harshly
The operated eye should not have contact with water or soap for at least 2 weeks
Sex can be engaged about 4 weeks after surgery
No smoking is allowed 4 weeks before and after the operation
No bowing down for 1 week after surgery

Postoperative Care After Cataract Surgery

Change the bandage and plaster everyday

Use the eye medication and drops in the exact manner taught to you by the medical staff

At night, while sleeping, it is safest to wear the protective eye shield for the first 2 weeks.

Alternately, you may decide to wear sunglasses during the day to protect the operated eye instead of the eye shield.

The operated eye should not have contact with soap or water for at least 2 weeks

You may gently clean the area around the operated eye with a clean cloth soaked in warm water.

You may also use a mild soap such as Johnson’s baby shampoo together with the warm water to clean the eyelids of the operated eye if there is a lot of crusting or discharge.

Avoid getting the soap into the eye.

Return to the Eye Clinic for regular progress checks. Minimal:

1 week after the operation

2 weeks after the operation

4 weeks after the operation

8 weeks after the operation

2 months after the operation the spectacles can be prescribed