Phacoemulsification minimizes the risk of complications after lens replacement. Therefore, this operation is in great demand among ophthalmologists and patients. Phacoemulsification uses self-sealing incisions.
A reduction in the number of complications is caused by folding lenses or viscoelastics, which well protect the internal structures of the eye. With this procedure, it became possible to carry out the operation at any time. There is no need to wait for more favorable conditions.
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Lens replacement surgery: choosing an implant
Surgery to replace a damaged lens involves the use of an implant called an “intraocular lens.” Its competent selection determines the success of the operation as a whole, affects the patient’s quality of life after it, and the functioning of his visual apparatus. The choice is made on an individual basis, based on the patient’s indications and financial capabilities. In this case, the doctor takes into account the parameters presented in the table below:
| Characteristic | Kinds | Peculiarities |
| Rigidity | Soft | They are more expensive, but they minimize trauma to the eye tissue during surgery, since they can be rolled up before installation, which will require a smaller incision. |
| Hard | They use hard material for manufacturing, are cheaper, but are not functional enough. | |
| Number of foci (foci are points that form image clarity: the more there are, the less need to use glasses or lenses) | Monofocal | Used for cataracts, they have only one point at which image clarity is achieved. Outside of it, objects remain blurred. Provide clarity at a distance, require the use of glasses for close-up work. |
| Bifocal | They have two focal points, which ensures clear images of objects at two fixed distances: near and far. Images of objects located between them may be blurry, so correction by optical means is necessary. | |
| Multifocal | They have three or more focuses due to the division of the implant into functional areas responsible for the quality of vision at different distances. They provide good visual effects and do not require additional correction by optical means - that is, in fact, they completely replace the natural lens. | |
| Accommodative ability (adaptation to focusing when contemplating objects that are located at different distances) | Non-accommodating | They are cheaper and are not able to change their curvature, as happens with a real lens, and therefore require the use of optical correction devices after surgery. |
| Accommodating | They are capable of changing curvature in the same way as a real eye lens does, they are more functional and convenient, but they are more expensive. Allows you to stop using glasses after surgery. |
Complications of cataract surgery
After removing the clouded lens, the human eye is deprived of a particularly important optical component - the lens. At the same time, the refractive properties of the cornea, vitreous body and intraocular humor of the anterior chamber become insufficient for good vision. The operated eye requires additional correction with glasses, contact lenses or an artificial lens.
The optimal way to treat cataracts is implantation of an artificial lens. True, it is not always possible to apply it. The condition of the patient's eye tissues or his blood vessels, as well as some existing diseases (recurrent inflammation of the eyes, inflammation of the joints) do not allow implantation of an artificial lens, since they will reduce the results of the operation to zero.
With advanced cataracts (mature and overripe), the swollen lens begins to occupy the bulk of the anterior chamber of the eye, which disrupts the outflow of the fluid produced there. As a result, a dangerous complication may occur - secondary glaucoma. If you delay surgery in this situation, your vision may be lost forever. Cataract treatment cannot be postponed.
Selection by manufacturer
| Manufacturer country | Brand names | Types of implants | Peculiarities |
| Russia | bifocal | Provided free of charge if surgery is carried out under a compulsory health insurance policy | |
| Germany |
|
| They have an aspherical edge and offer a high degree of color rendering. Recommended by many domestic specialists for cataracts complicated by astigmatism. |
| USA |
| Multifocal accommodating | Capable of providing high quality vision in varying degrees of illumination. The back surface of the lens is shaped to focus light rays to one point on the retina, resulting in high image quality. |
| Great Britain | Rayner | Multifocal accommodating | They have an optimal shape and are made using multizonal aspheric optics technology, which allows you to avoid correction with glasses or lenses after surgery. |
Surgical intervention
For many years, the only effective way to remove cataracts was surgery. It should be understood that if the cataract has become mature, as ophthalmologists call it, then, as a rule, there is no need to wait for it to resolve by itself. Also, there is no point in waiting for innovative drugs to appear on the optics market, as this will only worsen the condition. In such a situation, there is only one way, and he goes to the hospital. During the operation, the affected lens, which has lost its functions, is replaced by surgeons with an artificial one - a kind of transparent lens that performs its inherent functions. There is no need to be afraid of the operating room. According to official data, in 90% of cases, operations are successful and do not entail any complications.
To date, there is no consensus among professionals as to exactly when it would be more productive to perform cataract surgery. Some of them believe that it needs to be allowed to “mature”, and in the early stages there is no point in risking the health of the patient’s visual organs and not subjecting him to lens replacement. Others are confident that there is no point in wasting precious time and surgery should be performed as early as possible. This will not only reduce possible risks, but also carry out the operation with maximum efficiency and painlessness.
Cataract surgery will not take much time. As a rule, the patient goes to the hospital the day before or on the day of the scheduled intervention. He is carefully examined by an ophthalmologist, who will subsequently perform the operation, and examines the tests taken and the patient’s medical history. The doctor will definitely explain to the patient that there is no reason to worry, and during the procedure he will only be required to look ahead of himself without blinking. You should stop eating for a few hours, but you can drink water in any quantity. In general, the duration of the operation, as a rule, does not exceed half an hour. In extreme cases, it can be performed for an hour, but this depends on the individual characteristics of the patient, for example, high blood pressure or the presence of chronic diseases.
How is an artificial lens implanted in CELT?
Surgical intervention requires a mandatory preparatory stage. It consists of conducting comprehensive diagnostic studies and consultations with specialists in other fields (if necessary).
In order to minimize the risk of infection, the patient is prescribed antibacterial drops three to five days before surgery.
At the CELT clinic, the operation is performed under local anesthesia (anesthetic eye drops). Its stages include the following:
- fixation of eyelids using expanders;
- incision of the eyeball (2‒2.5 mm) and insertion of a special needle;
- the use of ultrasound to whip up the cloudy contents of the eye lens and remove crushed particles of the lens by aspiration;
- placing the implant in the vacant space, straightening it and filling it with liquid;
- applying a sterile dressing.
If the patient has no violations, he is sent home. It is important to understand that after surgery, vision and spatial orientation may be impaired, so it is advisable to come to the operation with an accompanying person.
Treatment methods
For the treatment of cataracts in modern ophthalmology, medical and surgical treatment methods have been developed.
At the initial stage of the disease, experts recommend using special eye drops. The most popular of them are: Quinax, Vita-Iodurol, Oftan-Katachrom, Taufon.
Medications slow down the progression of opacities, but existing opacities are not able to resolve. It is strictly not recommended to prescribe medications on your own; this should only be done by an ophthalmologist.
The main method of getting rid of cataracts is surgery. The name of this operation is phacoemulsification of cataract with intraocular lens implantation. This is what is performed in 99% of cataract cases. However, the most favorable outcome of surgical treatment can be expected only in patients with immature cataracts.
The phacoemulsification operation has been used in our country for more than 20 years. It is performed under local anesthesia, without hospitalization. The flow of the operation is as follows:
- An ultrasound tip is inserted into the eye through a small corneal incision and the cloudy lens is destroyed.
- A flexible artificial lens is placed into the lens capsule.
The operation usually lasts no more than 20 minutes. Vision is restored by the end of the first day to the preoperative level. The entire recovery period is no more than 4 weeks, during which time the patient must use eye drops with a disinfectant and anti-inflammatory effect. After a month, you can return to your normal rhythm of life.
If a patient is diagnosed with mature or overmature cataracts, complicated by weakness of the ligaments that support the lens, intra- or extracapsular cataract extraction may be prescribed. During the operation, the lens is completely removed and a rigid lens is implanted in its place. The lens is sutured to the iris or attached to the lens capsule. In this case, the surgeon will have to apply a continuous suture, which can be removed only after 4-6 months. For the first few months after surgery, the patient has low vision due to postoperative reverse astigmatism. After removal of the suture, vision is restored to the level that preceded the formation of cataracts. The rehabilitation period is quite long and can be complicated by dehiscence of the postoperative wound.
Lens replacement surgery: postoperative period
The duration of the recovery period varies from person to person. As a rule, patients notice improvement in vision within a few hours; the maximum effect is achieved after approximately 30 days. In order to minimize the risk of complications, it is necessary to follow certain rules:
- Rinse the operated eye daily with sterile water;
- wear a bandage for 7 - 14 days;
- put antiseptic drops into the eyes;
- during the first days, avoid alcohol consumption and physical activity;
- do not lift anything weighing more than three kilograms;
- sleep on the side opposite the operated one;
- sleep on your back if the operation was performed on both eyes;
- minimize visits to baths and saunas in the future.
What are eye drops for?
Drops must be used after cataract surgery to prevent infection of the operated organ, as well as to accelerate the healing and restoration of eye tissue. Typically, the drop instillation scheme is arranged in descending order, i.e. In the first postoperative week, 4 times daily instillation is necessary, in the second - 3 times, in the third - 2 times, and so on until the fifth week. In the fifth week, all medications, as a rule, are completely discontinued if the course of the postoperative period is not complicated by eye infections.
Proper instillation of drops does not cause difficulties, but requires some consistency. That is, you need to do the following:
- Prepare a bottle with the drug and a sterile napkin.
- Unscrew the protective cap and turn the bottle with the drug upside down.
- Lie on your back or tilt your head back.
- It is easy to pull back the lower eyelid with your fingers.
- By pressing on the bottle, extract 1-2 drops of the drug and send them behind the lower eyelid.
- Close eyes.
- Using your index finger on top of a sterile napkin, lightly press the inner corner of the eye for 1-2 minutes.
If several different drops are prescribed at once, be sure to maintain an interval of at least 3-5 minutes between instillations. When instilling drops, it is necessary to avoid contact of the dispenser spout with the surface of the eyelids and eyes in order to maintain the sterility of the solution.
Lens replacement surgery: possible complications
The development of complications is possible due to refusal to follow the doctor’s recommendations after surgery or due to medical errors. The most common of them:
- retinal detachment;
- corneal edema (goes away on its own);
- development of secondary cataracts (laser correction required);
- increased intraocular pressure (requires the use of special eye drops and timely treatment, as it can lead to the development of glaucoma);
- infection (occurs extremely rarely and requires treatment with antibiotics).
How to minimize the risk of complications
To reduce postoperative complications, it is recommended to adhere to the following rules:
- staying at rest in a dark room so that negative environmental factors do not affect the eyeballs;
- use of sunglasses outdoors so that bright sun rays do not negatively affect the retina of the eyes in the postoperative period;
- postoperative antibiotic therapy, which eliminates the risk of developing infectious and inflammatory diseases;
- eating food rich in vitamins, nutrients, microelements necessary for normal metabolism and regeneration of damaged surfaces;
- lack of exercise in the first month after surgery, then exercises are prescribed on the recommendation of a doctor;
- the use of moisturizing drops that eliminate the risk of drying out the cornea.
Cataract removal is an operation that damages a small amount of tissue. Despite this, the patient may develop many complications, especially if he does not adhere to the doctor's recommendations. If a complication appears, you need to immediately contact a specialist so as not to lose vision function.
Reviews of doctors providing the service - Eye lens replacement surgery
When illness strikes, it is very important to find a highly qualified, caring doctor.
Tatyana Igorevna is exactly such a doctor! Behind each of her recommendations is enormous knowledge and experience, as well as respect for the patient’s personality. This is what gives hope for the best! THANK YOU. Read full review Svetlana
06.09.2019
Vladimir Yuryevich Makhmutov is a doctor of rare talent. Out of this world! Talent, kindness, courtesy, attentiveness. Skillful fingers. Many thanks and low bow. Shchedrova E. Read full review
Shchedrova Ekaterina
25.03.2019
Extracapsular extraction
It is no coincidence that we began our characterization of cataract removal methods with this method. The fact is that this cataract removal operation is the very first type of surgical intervention, which began to be used in Ancient Egypt. This technique became most widely used in the 60s of the last century. It is the simplest way to remove the lens, which does not require the use of expensive equipment. This operation is prescribed in situations where the patient has a rather weak ligamentous apparatus or has been diagnosed with corneal dystrophy. Surgeons give their preference to performing this particular procedure for secondary cataracts caused by lens decay, as well as for partial rupture of ligaments or excessively narrow pupils.
The meaning of this procedure is to cut the membrane of the eyeball with the obligatory removal of the entire lens. Today, such categoricalness is the main disadvantage of the operation. As you might have guessed, such a process entails mandatory sutures, which has a very negative effect on visual functions. Many patients may subsequently complain to their doctor about symptoms of astigmatism, as well as decreased visual acuity when trying to see objects at close range. The rehabilitation process is also quite lengthy and on average can take from 4 months to six months.
Despite significant disadvantages, removing cataracts in this way has certain advantages. For example, extracapsular extraction is possible even in the most advanced cases, for example, with a hard lens or the presence of concomitant ophthalmological diseases. Among other things, after this procedure, surgeons are able to preserve the posterior capsule, which significantly reduces the risk of vitreous prolapse into the anterior chamber. Due to the fact that the operation can be performed without the use of expensive instruments, its cost is significantly reduced. This is an undoubted advantage for many people.
More about cataracts
Cataracts in older people are one of the most common eye pathologies. The eye lens is a natural lens that refracts and transmits light rays through it. The lens is located in the eyeball (in the space between the iris and the vitreous body).
Naturally, in youth, most people have an elastic and transparent lens, which allows it to constantly change its shape and be aimed at any object or object. This helps a person to clearly see all objects that are located close or far away from him.
With age, the elasticity of the lens decreases, it begins to thicken, and then loses transparency. All this leads to the fact that the eye loses the ability to transmit light. Against the background of this process, vision decreases, the world around a person becomes fuzzy and blurry. The longer this pathology progresses, the wider the area of turbidity will become. Lack of timely treatment leads to complete loss of vision.
