Treatment of cataract
Cataract surgery at Eye Clinic Spreebogen
Treatment of cataract
There is no reliable medical treatment for recovery of the cataract. There must be an operation to achieve an improvement in vision. This procedure is the most common eye surgery and also one of the safest.
The purpose of cataract surgery is to rebuild the earlier vision again by removing the clouded lens. In general, the cataract surgery is performed under local anesthesia and takes less than 30 minutes. The anesthesia can be performed not only with syringe but also with drip- or gelanesthesia. Basically there are two ways of lens removal:
the intracapsular and extracapsular surgical technique.
Intracapsular: At intracapsular method, the lens and capsule is completely removed. This technique is used only rarely these days.
Extracapsular: During the extracapsular surgery the anterior capsule is opened in order to remove the interior of the lens, while the surgeon can pass the posterior capsule wall. Therefore the eye's natural barrier between the posterior and anterior segment remains. The modern and most common form of extracapsular surgical technique is called phacoemulsification. Here, the lens nucleus is broken up by ultrasound and subsequently aspirated.
A cataract surgery by laser is possible, but the ultrasound is clear superior to the laser.
Lens replacement: Cause after removal of the lens, the eye has lost a part of its optical system (which can be compared with the lens in a camera), you must compensate this deficit. There are basically three correction options:
- Star Glasses
- Contact lens and
- Intraocular lens (one eye planted artificial lens).
The last option is particularly useful, because it is most similar to the natural conditions. The intraocular lenses are distinguished by their implantation. They are divided into anterior chamber lenses, iris supported lenses and posterior chamber lenses, which can be differentiate in posterior chamber lenses with capsular bag fixation or sulcus fixation. The implantation of a posterior chamber lens in the capsular bag is now the most common method of cataract surgery. In exceptional cases, this form of operation is not possible and an alternative method must be chosen.
In the past the intraocular lenses were made of poly-methyl-meth-acrylate (PMMA), which is better-known as plexiglass. Increasingly, foldable lenses made of modified acrylic, silicone or hydrogel are implanted. Because the artificial lenses are rigid, they can not play part of the function of the human lens, called accommodation (the "focusing" from near to far). For this reason, you also need a pair of glasses after the surgery, usually for reading. Therefore, the manufacturers have been developed in addition to conventional mono refractive lenses, lenses with two or more focal points, the so-called multifocal lens. Often, these lenses allow the patient to live without glasses.
Complications of surgery: With an overall rate of 1-3% the probability of a complication of cataract surgery is very low and most complications can be treated well. Extremely rare is, bleeding in the eye occurring during the operation or an infection of the eye caused by introduced bacteria that can happen in the first days after surgery. More frequently a so-called secondary cataract can be formed after surgery (months to years after the surgery). This can usually be removed with a laser treatment.
Cataract surgery at the Eye Clinic Spreebogen
Cataract surgery will be done as an ambulant surgery in the Eye Clinic Spreebogen or on demand made stationary in the eye clinic in the Ring Center. We offer patients the highest standard of surgical technique, with different alternatives to be discussed with the patient and depending on the initial findings and needs.
Type of anaesthesia: As an alternative to the mostly taken local anaesthesia by injection under the eye, we offer the possibility of local anaesthesia only by administration of eye drops and gels without syringe.
Type of incision: Depending on the preoperative astigmatism and to be implanted lens the location and the length of the section will be selected by the operator. The length of the incision is usually between 2.5 to 3.2 mm. The cut normally closes by itself and no additional stitching is required (so-called tunnel interface).
Type of intraocular lens: We generally offer lenses of all available materials. The appropriate selection will be choose to the needs of the patient. For some patients, the implantation of a multifocal lens is recommended, which requieres a particularly intensive screening process.
After surgery the patient has to use eye drops and salve (initially up to an hour, the frequency are usually reduced in the days following). In addition, the operated eye has to be checked regularly, initially on a daily basis. This is performed at out-patients on the following day in the eyeclinic or at the referring ophthalmologist. The same applies to a hospital performed surgery; the stay is in the hospital about 2-3 days.
The patients can return just a few days after the operation to work. A new pair of glasses can be prescribed about 4 to 6 weeks to after surgery.