A cataract is a clouding of the eye's crystalline lens. The crystalline lens lies behind the iris and the pupil. It is mostly made of water and protein. Protein chains are arranged in such a way to maintain the lens transparent during the first decades of life allowing light to refract light to be focused on the retina.
However, with aging, proteins may undergo structural changes and gradually the lens may lose its translucence. During the cataract developmental stages due to aging, the crystalline lens may increase its refractive power causing myopia (shortsightedness) and, its progressive yellowing and dullness gradually reduce the quality of our sight. Therefore, the cataract is only a natural aging process of the lens but can also be due to pathological causes such as injury, ophthalmic conditions, use of cortisone etc. In certain cases, a child may be born with cataract (congenital cataract).
What are the symptoms of cataracts?
Cataract usually develops over 60 years of age, it is progressive and causes certain symptoms. The most common symptoms are the following:
1. Blurry and cloudy vision.
2. Gradual change of long sightedness.
3. Changes in color vision.
4. Problems occurring with night vision.
How is Cataract Treated?
Cataract can only be surgically treated. Cataract surgery is the most frequent and successful of all ophthalmic surgical procedures achieving immediate results.
The method applied in recent years is called phacoemulcification and is performed with an ultrasonic device. By this method the cataract lens is emulsified and then removed by suction. Subsequently, a small artificial intraocular lens is inserted, thus ensuring vision similar to the one existed prior to the occurrence of the cataract. This procedure is short, painless and a topical eye drops anesthetic is used.
Cataract surgery may be performed at any moment during its maturation while the activities of the candidate have to be taken into account.
This procedure may be decided when the cataract starts affecting the quality of the vision, thereby, creating problems in the patient’s daily activities (safe car driving, reading, television viewing). As with every surgery, preoperative control is necessary. This examination before surgery is performed to assess the overall state of the eyes, the type of the cataract and to perform the necessary measurements that will indicate the right intraocular lens to be inserted into the eye. The comprehensive ophthalmic examination includes measurement of the cornea curvature, the ocular pressure and examination of the fundus.
Cataract surgery is performed as an outpatient procedure. Patients return home immediately after surgery and they can resume their daily activities in the days immediately after surgery.
The patient’s sight is already better right after surgery and their sight improves further in the days that follow. Surgery is performed using topical eye drops anesthetic and the patient leaves the operation room with his eye wrapped in protective gauze which he/she removes when after returning home.
The intraocular lens used can also correct pre-existing refractive disorders such as myopia or hyperopia. A small percentage of patients need a small correction with glasses for some activities (driving, television viewing, reading).
What are the advantages of this method?
This method of removing the cataract via a very small incision using topical anesthesia offers many advantages. This technique allows patients to return immediately to their daily activities.
Patients remain at the operation room for a very short time and do not have to hospitalised. It is stressed that this surgery does not require general anesthesia nor injected anesthetics but only topical eye drop anesthetics. The incision heals quickly and naturally. Therefore, there are less potential intraoperative and postoperative complications. This accelerates vision recovery.
Complications
Complications are not frequent but may occur as in any surgical intervention. For this reason, only one eye is operated each time.
Complication rates are lower than 2% and will be thoroughly discussed with your eye surgeon before the operation. Moreover, they can all be treated either with systemic medication or surgically.
Capsule opacity or secondary cataract
After cataract removal, the thickening of the membrane (capsule), that holds the artificial lens in place, is called secondary cataract. In this case your vision may be significantly and gradually impaired. In that case, the beam of a special laser is used to break the cloudy membrane painlessly and restore the vision impairment occurring after cataract surgery.
This affects approximately 20% of patients operated for cataract.
The procedure lasts for 10 minutes and is performed at the medical practice without admission to hospital. Some of the great advantages of phacoemulcification are the absence of suturing and thereby of astigmatism and the under 3 hour stay at the outpatient clinic.
Prevention
There is no particular prevention advice on cataract. When there is indication for surgery one should intervene at the right time.
However, since solar radiation may be associated with cataract pathogenesis, it is recommended to protect our eyes from the sun from a young age wearing the appropriate sunglasses, i.e. those absorbing harmful ultraviolet and high energy ration of the sun.
The success rates of these procedures are spectacularly high (over 98%).
The final results, that is how well the patient will see depends on the state of the fundus.
If the eye fundus or the optic nerve or generally the optic track have been damaged by other conditions e.g. glaucoma, diabetes mellitus, senile macular degeneration or if the retina is cloudy, this will definitely affect the patient’s final vision.