What is cataract?
Cataract is a decease leading to loss of transparency of the crystalline lens located inside the eye behind the pupil. This results in less light rays penetrating the eye and serious eyesight deterioration, the latter being the main symptom for the disorder. Besides the person suffering from cataract may have a sensation of flickering lines, streaks and spots and dazzling glitter around objects in bright light. Also there may be problems when reading, writing and handling small items. When the decease progresses the pupil colour turns from black to white. See more on symptoms and treatment of cataract.
What is the reason for cataract development?
One of the causes is the change in the bio-chemical composition of the crystalline lens, largely due to age-related disturbance of its vascular supply and nutrition.
Therefore nobody is safe, technically everyone at an age of 120 or 150 is sure to have it.
Which factors may trigger cataract development?
They are a few: genetic predisposition, metabolic disturbance, diabetes mellitus, vitamin deficiency, UV and radiation exposure, bad ecology. But most common is the age-related cataract. It is caused bybthe changes occurring in the whole human body with age. Usually it develops after 40 or 50 years.
What should one do after getting a cataract diagnosis?
Unfortunately no medication can cure cataract. Medicines can only slow down the decease progress. The only way to get rid of cataract is a surgery that is called lensectomy. The modern surgical methods replace the opaque crystalline lens that disturbs normal vision with an artificial intraocular lens.
Which cataract treatment technique is the most effective?
At present the most effective, safe and sparing cataract treatment technique is the ultrasonic phacoemulsification followed by an artificial intraocular lens implantation. This technique is offered to patients at the Excimer clinics.
Can cataract be extracted using a laser?
Laser assisted cataract extraction is now possible, moreover it is a most advanced procedure up to date. Laser technologies have been used in ophthalmology for quite some time now, in laser vision correction in particular, and a real recent breakthrough is the use of Femto-second Lasers in cataract surgeries. This technique is available at EXCIMER Clinics in Moscow and St.Petersburg.
What is phacoemulsification surgery?
Unlike the classic (old) method, there is no need for suturing as the microincision is so small (up to 1,6 mm) that it is self-sealing. The surgery takes only 10 to 15 minutes, outpatiently in one-day-mode. The local eye-drop anaesthesia used in the course of phacoemulsification totally excludes any pain and cardio vascular complications. The cloudy crystalline lens is turned into emulsion in the course of the surgery using ultra-sound, and the emulsion is extracted consequently. It is replaced by a folded intraocular lens, that unfolds and secures itself inside the eye. The obvious advantage of this technique is that there is no need to wait for the cataract to mature, phacoemulsification is possible at the early cataract stages. The surgery is performed outpatiently and the patients returns home the same day. Limitations for physical and visual loads are minimal.
Eye sight: what it is going to be like after the surgery?
The sensations one gets after a cataract surgery can be described as follows. Imagine that in your younger years you saw the world through a clear glass. In time layers of dust have been building up and colours have become less bright and vibrant, the objects have lost the sharpness of outline. After the surgery all this will come back as the time went backwards, you will see as well as you used to. Of course the result may be affected by associated problems like glaucoma and macular dystrophy. They can seriously influence the eye functions and prevent full eyesight recovery. Although another situation is possible: a patient could have suffered from high myopia and he could not do without spectacles. He has built up cataract with age. He got the crystalline lens replaced with an IOL. The IOL parameters are calculated based on the given eye features, this means the patient can get rid of myopia, hyperopia, astigmatism if he had any. This means the eyesight may be improved compared to the state before the cataract. In most cases the modern techniques can consider the patient’s wishes regarding the future vision. The intraocular lenses used nowadays has practically all the features of the natural crystalline lens, allowing good vision both far and near, thus enabling to reduce the spectacles use or to abandon them at all.
Which artificial lenses are the best at the moment?
It is difficult to give a definite answer to this question, as there many lenses and finally they are very individual. So it is best if the clinic had different models so that the doctor can chose the right one for the patient depending on his needs. Lens manufacturers are trying to make the lenses as close to the human crystalline leans as possible. For instance the lens with the yellow filter. These lenses have the filter similar to that of the natural lens. This filter protects the retina from harmful impact of UV and blue light, bringing down the risk of age-related retina deceases. Aspheric lenses having the special shape provide for sharper and more contrast vision under low light conditions, e.g. in the evening. And multifocal lenses simulate the natural lens features providing for optimal vision far and near allowing to reduce dependence on spectacles or get rid of them at all.
Nowadays the new accommodating artificial intraocular lenses are used that can change shape like the human natural crystalline lens does providing proper focusing ensuring good imaging at various distances.
Is it necessary to have the vision check and general examination before the surgery?
The comprehensive visual system diagnostic examination is a must for to ensure a successful treatment. The diagnostics at the Excimer clinics is performed using the modern computerized system that provides for obtaining the objective and complete knowledge of the condition of the cornea, crystalline lens, the retina and the visual system as a whole. And chose the proper treatment based on this info.
Will spectacles be needed after the surgery?
The patients will often need after a cataract surgery to use spectacles for reading, writing and manipulating small objects. The surgery extracts the crystalline lens damaged by cataract but does not restore the accommodation (good vision far and near altogether) ability. At present however thanks to the developments in intraocular lenses there has been presented a possibility to reduce the spectacles dependence or even drop them at all. The intricate design of a multifocal lens allows to simulate the natural crystalline lens operation. This sort of lens will have several “focuses” each providing proper vision at a given distance range, both far and near. According to clinical research data around 85% of patients having had a multifocal lens implanted do not use spectacles or contact lenses ever.
How often they use phacoemulsification for cataract treatment worldwide?
Today phacoemulsification is very popular. This procedure has been mastered to such perfection that it is considered to be the gem of ophthalmic surgery!
The World Health Organization has recognized the ultrasonic phacoemulsification as the only completely rehabilitating method of cataract treatment.
Are there limitations after the surgery?
The limitations after the modern phacoemulsification surgery are only few. But the doctors warn the patients that during the first month after the surgery they should protect eyes from overstrain, avoid making sharp body ducks and strong temperature differential, never rub treated eyes and be easy on alcohol. However no restrictions on TV watching, reading, writing, bathing or foods. If bright light is bringing discomfort sunglasses are advised.
Till what age cataract is treatable?
The high safety and predictability of phacoemulsification technique allows to treat patients of any age. The oldest patient of the Excimer who underwent a cataract surgery is 98, and the youngest is 5 months.
How soon normal eyesight is back after the surgery?
A patient who went through a phacoemulsification procedure can see pretty well in several hours and the complete vision stabilization is achieved within a week.
Has one to be admitted to a hospital?
No need to stay in hospital.
The surgery is performed outpatiently. It takes 15 to 20 minutes. The patient goes home the same day, after the final check by the doctor.
How often one has to come back for a check?
The doctor will fix the visits schedule after the surgery. Normally the patients are checked the next day after the surgery, then one week later, after one month and after 3 months. May be oftener if necessary. It fully depends on the individual features of a visual system.
What is included in the surgery cost?
The Excimer clinics include the following services in the cost: the cataract surgery itself, all the necessary disposable materials and medications, the intraocular lens and the necessary after-surgery examinations.
More questions and answers on cataract can be found in FAQ.
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