What is a cataract? treatment lıke

Understanding Cataract: Causes and Definition

Cataract is one of the most common eye problems affecting vision quality. In a healthy eye, the natural lens is transparent, allowing light rays to reach the retina directly to create a sharp and clear image. A cataract occurs when this natural lens becomes opaque, preventing light from passing through effectively.

This condition results in a significant reduction in vision as the light entering the eye is blocked. Patients often describe the experience as looking through a dirty window, where the sharpness of objects decreases and colors cannot be clearly distinguished. The opacification of the eye's natural lens is typically an ongoing, progressive process.

What Are the Symptoms of Cataract?

Cataract symptoms usually develop gradually. If you experience the following signs, it is essential to consult an ophthalmologist:

• A gradual reduction in vision quality
• Light sensitivity and glare
• Double vision
• Difficulty reading
• Subsequent development of myopia (nearsightedness)
• Fogging and yellowing of vision

Modern Cataract Treatment: Phacoemulsification

Currently, the only effective treatment for cataracts is surgical intervention. It is not possible to stop or reverse the development of cataracts with medical treatment. Modern techniques allow cataract surgery to be performed without general anesthesia or needles, often without requiring an overnight hospital stay.

The most advanced method used today is phacoemulsification. During this procedure, a very small incision is made in the cornea. Ultrasound energy is used to break the cloudy lens into tiny fragments, which are then removed via vacuum. An artificial intraocular lens (IOL), calculated specifically for the patient's eye, is then placed through the same small incision. This method is highly safe, involves minimal complications, and allows for a rapid increase in vision levels.

Details of the Surgical Procedure

Cataract surgery is typically performed under local anesthesia. While patients may be sedated to ensure comfort, they remain awake but will not feel pain, only perhaps a slight sensation of touch. The operation generally lasts between 5 to 10 minutes. During this time, it is crucial for the patient to keep their head and eyes still. Standard monitoring of pulse and blood pressure is maintained throughout the phaco surgery.

Secondary Cataract and YAG Laser Treatment

Once the natural lens is removed during surgery, a cataract cannot develop a second time. However, the thin membrane that holds the new artificial lens can thicken over time. This is not a complication of the original surgery but a natural biological response. If this occurs, it is easily treated within seconds using a YAG laser, which restores clear vision without the need for traditional surgery.

Pre-Operative and Post-Operative Instructions

To ensure a successful outcome, patients must adhere to specific guidelines before and after the procedure.

Before the Operation

• Discontinue blood thinners like Aspirin 3 days prior to surgery (depending on the cataract degree).
• Have a light breakfast on the morning of the procedure.
• Continue taking medications for systemic diseases such as diabetes, hypertension, or asthma.
• Do not stop insulin or oral diabetic therapies; follow your usual diet.
• Ensure your face is thoroughly washed; avoid makeup, lotion, and perfume.

After the Operation

• A follow-up check is usually scheduled within 36 hours.
• Always wash your hands thoroughly before applying eye drops.
• If prescribed two different drops, wait 15 minutes between applications.
• Use the drops consistently throughout the day as directed by your doctor, typically for a period of 15 days.

Multifocal Lenses: Freedom from Glasses

Modern cataract surgery offers the opportunity to eliminate the need for distance and reading glasses through multifocal lenses. Unlike standard monofocal lenses that only correct distance vision, multifocal lenses feature multiple focal points.

Patient Selection for Multifocal Lenses

Multifocal lenses can be applied to almost all cataract patients, as well as high hyperopia or myopia patients who are not suitable for excimer laser surgery. However, the choice of lens must be tailored to the patient's lifestyle and profession.

Surgeons must consider whether the patient is a driver, painter, musician, or heavy computer user. For instance, a professional driver may have different visual requirements for night driving compared to a librarian. Understanding these expectations before surgery is vital for achieving the highest post-operative satisfaction.

Op. Dr. Ahmet UMAY
(Ophthalmology & Podiatric Surgery MD / Bristol, UK)