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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.

How to prevent vision drop in first-grade schoolboy?

Starting school is connected to the increasing near-sight activities in the total visual system functioning: the kid learns to read and write. To prevent (or when necessary to immediately start treatment) any dysfunctions of the eye visual system it is important to regularly pass dynamic checks of eye health. Therefore at least once a year the child should see an ophthalmologist. If a kid starts narrowing eyes or is trying to come closer to a TV or a book or complains that some distant objects are not clear, the visit to the eye doctor us urgent. Before starting school it is advisable to have a course of apparatus prophylaxis procedures to prepare kid’s eyes for the school loads. The exercises offer games that train vision, improve blood supply to eyes, activate central segments of vision analyser, and provide vision drop prophylaxis.

I have a cataract. I would like to know about cataract surgery: how long I will have to stay in hospital and how often I will have to come for check ups?

Nowadays well staffed and equipped ophthalmologic clinics carry out cataract surgeries in the most sparing way. Thanks to technology breakthroughs now it is possible to avoid the need for a patient to stay in a hospital, away from home and under stress. The modern cataract treatment procedure is called cataract phacoemulsification with intraocular lens implantation. The procedure itself takes 10 to 15 minutes only. The patient is getting anaesthesia eye drops (no need for general anaesthesia needed in this case, so no hazard for senior people with general health problems). All manipulations are performed through a micro-incision of 1.8 mm. The clouded crystalline lens is turned into emulsion by ultrasound and then aspirated out of the eye. To be replaced using a special probe with an intra-ocular lens. No suturing is necessary for the micro-incision as it is self-sealing. After a post-surgery check the patient may go home. Each patient is getting an individual check-up schedule. Post-surgery restrictions are just few and have to do mainly with extreme strains and hygienic procedures. No self-dependence impaired, one can lead normal way of life.

Why earlier cataract was treated only when matured?

Recently intracapsular cataract extraction has been the only cataract treatment procedure. The procedure demanded crystalline lens extraction as a whole, therefore the lens had to be dens to be successfully removed altogether, so the cataract had to be mature. Moreover it would be extremely difficult to extract crystalline lenses at early cataract stages without assistance of modern microscopes as the lens is still rather transparent. Therefore patients had to live with dropping eyesight, sometimes up to almost a complete vision loss to wait for the necessary cataract maturity.
This was dangerous as well as progressing cataract may cause secondary glaucoma. This disease is very dangerous as it increases intra-ocular pressure possibly causing optic nerve atrophy and endangering vision ability ever.
Modern cataract surgery can manage the disease at any stage, so the treatment may be delivered imeately after the diagnosis is set.

Is it possible to get rid of farsightedness and cataract in one surgery? Or are those different surgeries?

Cataract is quite often is accompanied by age-related hyperopia, especially in senior ages. With time crystalline lenses loose transparency, they get partly or completely clouded – and that is a cataract sign. Besides age-related changes affect elasticity and the ability of the crystalline lens to change its shape ensuring immediate focusing when changing glance from objects located near to others far away. Due to drop in crystalline lens ability to increase its flexion when focusing on objects located near, age-related hyperopia develops. EXCIMER Clinic offers the modern way to get rid of the two problems in one go. Surgery is the only way of cataract treatment. The core of the procedure is to replace the clouded crystalline lens with an artificial intraocular lens, very similar in its properties to the natural lens. A wide range of IOLs allows to get rid of cataract but also correct refraction abnormalities on top. In your case – to manage age-related hyperopia. Modern ophthalmology successfully uses new models of intra-ocular lenses, e.g. multifocal and accommodating, providing solution for two problems at once – hyperopia and cataract. The decision on feasibility and correction method is taken by the doctor based on comprehensive diagnostics testing results.

Our grandmother was diagnosed with glaucoma. She uses eyedrops but her eyesight is still getting worse. Is there any way to help her?

Glaucoma is a serious irreversible disease. Increased intraocular pressure manifesting glaucoma disturbs optic nerve nutrition causing its atrophy. If the disease is not timely attended vision may be lost. Moreover even a timely start of treatment cannot bring back the lost vision, the pathology process can only be slowed down.
Usually they start glaucoma treatment with eye drops reducing intraocular pressure. Medication, dosage and application mode can be prescribed only by a doctor. Patients must strictly all doctor’s recommendations, irregular use of eyedrops and missing a dose are not allowed. Glaucoma patients should visit doctor at least once every half year undergoing examinations including intraocular pressure checks, field of vision measurements, fundus examinations, etc. If testing and examination results witness to the fact that intraocular pressure has not been stabilized, a surgery is suggested. EXCIMER Clinic doctors perform several glaucoma surgery types all aimed at eye fluid balance restoration and preventing further vision deterioration.

I have cataract and glaucoma. Which one to be treated first?

EXCIMER Clinic offers in cases when cataract is accompanied by glaucoma to have a single combined two-stage surgery. The first one is non-penetrating deep sclerectomy to treat glaucoma, it is followed by ultrasonic phacoemulsification with an intraocular lens implantation to treat cataract. So the modern technology allows to manage two diseases simultaneously: cataract and glaucoma. Such surgeries are performed without admission to a hospital, under local eyedrop anaesthesia, and take 15 to 20 minutes only. Patients can very soon come back to their daily life after the surgery.

I am myopic -11 and -12, spectacles are no use, I can’t wear contact lenses as well, and I was refused to have a laser correction. What to do?

To correct high degrees of myopia, hyperopia and astigmatism in cases when natural accommodation is still present we could recommend phakic lenses implantation. Technically phakic lenses are quite similar to contacts, but instead of being worn on the corneal surface they are implanted inside the eye (into anterior or posterior chamber). Phakic lenses are implanted by the ophthalmic surgeon through a micro-incision of 2,5 mm which is self sealing and needs no suturing. The procedure is delivered in one-day mode without a hospital admission.

I have had strabismus from my childhood, now I am 22. They say a surgery cannot restore vision, why to go for it then?

Strabismus treatment is a complex and long process, and it is best managed when started early. If the problem has not been attended in childhood, it may lead to functional vision acuity deterioration of the affected eye called amblyopia. With strabismus images seen by the eyes are very different, and the brain for the sake of visual chaos protection blocks images from the squinted eye. Vision on the eye can be lost forether. Modern conservative and surgical procedures allow to correct strabismus in most cases, however the final outcome forecast can be obtained only after a comprehensive vision testing. Binocular vision (when images from both eyes are merged by brain into integrated image) is restored mainly by apparatus assisted exercises, special training and complex vision stimulation. Indeed strabismus surgery is first of all a cosmetic procedure as in most cases it cannot restore binocular vision. But sometimes it is rather important for professional and private success.

My kid (2.5 years old) has +6 far-sightedness. Is it necessary to wear spectacles at this age?

Hyperopia (far-sightedness) in young children is normal physiologically, it is necessary for normal eye development. In your case the extent is above normal values, therefore spectacles are necessary (uncorrected condition may develop strabismus). Optical correction is a part of treatment procedures in children. By no means spectacles wearing should be neglected! And it is very important to follow all the doctor’s advice.

They say and write very often that young children should not watch TV. Please explain why?

Human eye is ideally designed to look at objects located at a distance, since this is a passive process, similar to sound perception. To look at objects nearby the child’s eye has to actuate an additional adaptive mechanism, the focusing apparatus. When young children spend long hours in front of TV their untrained eyes are subjected to excess strain, sending the distress signal to the brain. Trying to fix the problem the brain commands to elongate the eyeball to allow image focussing on the retina without extra muscle strain. As a result the eyeball is getting elongated causing the eye to become near-sighted, adjusting to the need to constantly look at short distances. And this is a continuous process, sclera (the tough eye protective membrane) becomes less strong, keeps stretching and myopia keeps progressing.

My daughter’s left eye has innate myopia )-6), while the right eye is +1. Is it dangerous?

With such a great difference wearing spectacles is the main treatment procedure in children. You daughter has to wear spectacles, otherwise the left eye may develop resistant vision deterioration. Occlusion (patching) is a procedure recommended in most cases: the better eye is covered for 20-40 minutes one or two times a day for one to 2.5 months period. This procedure should be prescribed and closely watched by your paediatrician ophthalmologist.
After three a child my go for other apparatus myopia treatment procedures. EXCIMER KIDS Clinic has a line-up of modern equipment for this treatment. The therapeutic procedures suggested are: laser, infrared and ultrasonic treatments, laser stimulation, vacuum massage, magneto-therapy, electro-stimulation. The effectiveness of such treatments have been recognised both at home and abroad. The procedures should be treated seriously, scheduled treatments and check-ups are essential for the result. Such systematic approach may ensure treatment long-lasting success. Only combined efforts of doctors and parents may result in happy outcomes.

My son was diagnosed to have amblyopia. How this disease could have developed?

Amblyopia is a disease manifested by resistant vision acuity reduction in one or both eyes. As a rule amblyopia is developed with strabismus, high degrees of far-sightedness, astigmatism, myopia, but sometimes it may occur without “obvious reasons”.
Of course there are reasons, but only detailed diagnostic testing can discover the causes, as they are very much individual. For instance there may be cases when amblyopia can develop with refractive difference in the eyes of only one dioptre, while in another kid the brain can manage even the 4 dioptre difference. To manage the condition it is necessary to activate the “lazy” eye. If amblyopia is congenital, the child does not know that vision can be different and finds the imagery normal. Therefore the child will not complain. The condition can be revealed only through a comprehensive testing of the complete visual system. The period when a patient keeps feeling amblyopia is very short, while the time-span is best for the disease management. Treatment should never be put off! And doctors instructions should be strictly observed.

At what age it is advisable to bring a baby for the first check and how often it should be repeated?

The first eye check is normally performed at maternity hospital, the next one should be at one month of age. Next are a must checks at 6 month and 1 year. The main task for such checks is to timely detect any innate pathology (congenial cataract, retinal underdevelopment, high intraocular pressure) and carry out necessary treatment, if necessary. Besides it is important to evaluate if eye development corresponds to age norm. The first year of life is a period of intensive eye development and growth therefore visits to an ophthalmologist are as important as seeing other doctors. The doctor will advise on future examinations schedule. The general advice is to bring your kid to see an ophthalmologist at least once a year.

Can I come and have a surgery performed straight away if I bring an abstract with all testing resylts from my eye doctor?

Unfortunately it is not possible to have a surgery basing on the diagnostics results from another medical institution. To be able to guarantee quality of the surgical treatment the Clinic has to be 100% sure of accuracy and objectiveness of the pre-treatment testing as well as of the data current validity. EXCIMER Clinic diagnostics equipment array allows to evaluate a patient’s visual system by over 100 parameters. Modern computer-assisted units register even the smallest deviations from a norm, they can detect disease at very early stage and guarantee precision of the diagnosis and provide complete and overall data on the patient’s visual system. All this combined assists in great accuracy in surgery parameters calculations and guarantees the best outcome possible.

I am short-sighted, I heard that one cannot give birth unassisted when this disorder is present. Is it not harmful for pregnant to go for eye testing with the use of computer-assisted devices?

Comprehensive diagnostic testing is pretty safe for a pregnant as well for a future baby. Moreover the testing is recommended for those pregnant women who have never had any eye problems whatsoever. It is recommended to go for an eye check twice during pregnancy: between weeks 10 to 15 and 34 to 36. Endocrine profile of pregnant women changes radically causing change of the visual system condition. The greatest hazard for eye-sight during pregnancy and giving birth is not near-sightedness itself, but the retinal condition deterioration (degenerative or dystrophy changes). It often becomes a reason for natural birth contraindication and the necessity to go for a Caesarean. Therefore it is important that the diagnostics cover both the eye optics and the retinal condition.

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