What is it?
What exactly is cataract?
Cataract (cataract) is an eye disease that develops with aging. It is the gradual, over the years, clouding of the natural crystalline lens of the eye behind the iris. The natural lens of the eye is normally transparent so the light can pass through to then reach the retina, the rear surface of the eye, for imprinting the optical pulses.
Over the years, therefore, this lens loses its original composition and blurs (senile cataract). This disease makes its appearance usually over 60, but does not exclude the occurrence of cases and in younger ages as well. Exposure to sunlight (ultraviolet radiation) and poor nutrition accelerate the disease.
The main symptoms of cataract are:
- decreased (blurred) vision (distant or nearby)
- impaired colour perception (colour perception)
- blurred or significantly reduced contrast sensitivity (contrast sensitivity)
- significantly reduced night vision (night vision)
- frequent changes in the eyeglass prescription
- sensitivity to light (photophobia)
- glare, reflections and halos (halos)
At an early stage, cataract can be treated with the prescription of glasses. But this solution is definitely temporary. The complete removal (treatment) of cataract is clearly performed through cataract surgery.
The most widespread method is the technique of phacoemulsification (phacoemulsification) with ultrasounds. It is a surgical process of high security because of the advanced technology used.
What is the technique of phacoemulsification?
The process of phacoemulsification (phacoemulsification) is an absolutely bloodless and painless solution for cataract removal. The method is very fast and has very high success rates. By means of instilling anesthetic drops locally two tiny incisions in the eye (typically 2-3mm) are generated.
Then the capsulorhexis, takes place a circular opening in the anterior capsule for insertion of a special tool (like a small needle) which emits the ultrasounds and crushes – fragments and sucks the fogged cataract lens (phacoemulsification).
Finally, substituting the natural, crystalline lens of the eye, an intraocular lens (acrylic) is placed called an intraocular lens (IOL – intraocular lens). In phacoemulsification we do not use sutures and the patient returns immediately to their daily activities (preventive stay in the clinic is not required – excluded, are complex cases where other diseases are involved as well, such as glaucoma, keratopathy, problems of the fundus etc.). Nowadays a cataract surgery may be combined with the treatment of presbyopia and astigmatism, using the appropriate intraocular lens (intraocular lenses).
Intraocular lenses or intraocular lenses (IOLs):
The intraocular lens used in the process of phacoemulsification is a small, artificial lens (acrylic or silicone) that is implanted surgically, and replaces the existing cloudy lens (is well tolerated by the eye). Intraocular lens technology has made tremendous progress. Traditionally, the lens used for cataract surgery was a monofocal lens. Various types and grades of intraocular lenses and the correct choice of the physician is important for the postoperative patient’s vision. Modern technology now offers a wide range of choice:
- Monofocal intraocular lens (monofocal intraocular lens): a focal point (qualitative distance vision – distant vision)
- Monofocal toric intraocular lens (monofocal toric intraocular lens): a focal point for quality distance vision correction and corneal astigmatism (corneal astigmatism)
- Multifocal intraocular lens (multifocal intraocular lens): multiple focal points for quality vision in nearby, distant and intermediate distance (addressing presbyopia – near, intermediate, distant vision)
- Multifocal toric intraocular lens (multifocal toric intraocular lens): multiple focal points for quality vision in nearby, distant and intermediate distance (treatment of presbyopia) combinatorial and correction of corneal astigmatism (corneal astigmatism)
- Adaptive intraocular lens (intraocular lens adaptive): substantially mimic the possibility of adjusting the crystalloid, the eye’s natural lens for quality vision at all distances
What is actually the secondary cataract?
In a proportion of patients created the so-called secondary cataract or pseudocataract. Essentially it is due to clouding of the posterior membrane of the lens (posterior capsule) which restricts vision (gradual decrease, similar to the core before cataract). In a simple embodiment laser (fission posterior lens capsule with laser – yag laser capsulotomy) in an equipped clinic, the center of the membrane breaks and reverts to normal vision.
Cataract in children: Causes and treatment
If cataract makes its appearance at birth, it is called “congenital cataract” and it is worth mentioning that it occurs at a frequency of 1 in 250 births. The pediatric cataract may be seen by the replacement of normal red reflection of light in the center of the pupil with a white reflection.
The pediatric cataract has mainly hereditary and gene causes (e.g. an inherited gene disorder), but there is a possibility for it to be due to an infection during pregnancy. Microsurgical techniques used by child opthalmologists for removing pediatric cataract. When it is decided to not place an intraocular lens (the artificial lens replaces the “blurred” lens in adults during surgery), children necessarily need, postoperatively, glasses or contact lenses. The immediate surgical repair is clearly imposed because of the presence of a very dense or contralateral cataract in childhood may even cause amblyopia (lazy eye).