There is no reliable medicinal treatment for 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 restore the earlier vision by removing the clouded lens. In general, 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 gel anesthesia. There are basically two ways to remove the lens: the intracapsular and extracapsular surgical technique.
Intracapsular: during the 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 also possible, however the ultrasound method is clearly superior to the laser.
Due to the removal of the lens, the eye has lost a part of its optical system (which can be compared with the lens in a camera). This deficit must be compensated. There are basically three methods to correct this:
- Contact lenses, and
- Intraocular lenses (artificial lenses implanted into the eye).
The last option is particularly useful because it is most similar to the natural conditions of the eye. Intraocular lenses are distinguished based on the area in which they are implanted into the eye. They are divided into anterior chamber lenses, iris supported lenses and posterior chamber lenses. The latter can again be differentiated into 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, 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 cannot 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, manufacturers have developed lenses with two or more focal points, the so-called multifocal lenses in addition to conventional mono refractive lenses. Often, these lenses allow the patient to live without glasses.
Complications during 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. In extremely rare cases bleeding in the eye can occur during the operation or an infection of the eye can be caused by introduced bacteria in the first days after surgery. More frequent is a so-called secondary cataract that can appear after surgery (months to years after). This can usually be removed with a laser treatment.
Cataract surgery at the Eye Clinic Spreebogen
Cataract surgery will be done as an outpatient treatment at the Eye Clinic Spreebogen or on demand can be done as inpatient at 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 chosen local anaesthesia by injection under the eye, we offer the possibility of local anaesthesia by administration of eye drops and gels without syringe.
Type of incision: depending on the preoperative astigmatism and the chosen lens the location and the length of the incision will be selected by the surgoen. The length of 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 lenses: we generally offer lenses of all available materials. The selection will be determined by the patient's needs. For some, the implantation of a multifocal lens is recommended, which requires a particularly intensive screening process.
After surgery the patient has to use eye drops and ointment (initially up to an hour, the frequency usually reduces in the following days). In addition, the operated eye has to be checked regularly, initially on a daily basis. For outpatients, this is performed at the eyeclinic or at the referring ophthalmologist. The same applies to a hospital performed surgery; the stay in the hospital is about 2-3 days.
The patients can return to work just a few days after the operation. A new pair of glasses can be prescribed about 4 - 6 weeks to after surgery.