Cataracts, a new solution

What is cataract?

Cataract is a physiological change that sooner or later affects everyone and consists of the opacification of the crystalline lens, a natural lens inside the eye. Let’s understand it a little better: in an ocular model (an eye where a transversal cut has been made) we see the retina and the nerve at the back of the eye. In the anterior part is the cornea, which is transparent, behind it we find the iris, i.e. the part that provides the color of the eye, and behind it, surrounded by the ciliary muscle, is the crystalline lens. The crystalline lens, under the effect of this ocular muscle, focuses the near objects. Initially the crystalline lens is transparent and flexible, but over the years it loses its flexibility and then we start to need glasses to see near objects. This refractive problem is known as presbyopia. Unfortunately, the degeneration process of the crystalline lens goes beyond its flexibility and the crystalline lens, initially transparent, gradually loses this characteristic and turns into an opaque lens. This is when we talk about cataracts. What happens is that the light entering the eye is scattered by the opacity of the crystalline lens and the patient will notice difficulties in vision, especially in situations of changes in brightness or driving, although there are remedies before the phenomenon reaches these extremes.

How can we solve the problem of cataracts?

There is no eye drop or laser treatment that can solve cataracts: the only solution is surgical. Surgery consists of replacing the opaque lens with a transparent lens. It is performed by introducing two small ultrasound needles that allow us to undo the crystalline lens inside the eye and replace it with another transparent one. In this way we restore the passage of light through the pupil of the eye. The procedure is performed through a very small incision of less than 2 mm without sutures, without anesthesia and without punctures; this allows the patient to quickly reintegrate to his daily life. No postoperative period is required.

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What are the risks involved in the surgery and what is the recommended age for its application?

There may be a significant risk of infection. Unfortunately, all surgical interventions have this risk. However, in the case of ophthalmology this risk is very low, in fact it is less than one in five thousand patients. But it is still a risk, so before, during and up to two weeks after the operation the patient will be subjected to a course of antibiotics. In case of any doubt or any situation, you should consult your ophthalmologist. The recommended age for cataract surgery is when the patient really shows symptoms; it is not necessary, contrary to popular belief, to wait until the cataracts are mature. On the contrary, with current techniques, it is recommended to undo them inside the eye when they are not too mature: this limits the energy we use and therefore facilitates the immediate postoperative period.

Will it be necessary to wear glasses after the procedure?

The patient will not need glasses for distance vision. Depending on the type of lens we implant, he/she may need glasses for near vision. For some years now we have had new lenses, called multifocal lenses, which create two images inside the eye: a distance image and a near image. The brain must be able, depending on each circumstance, to choose which of the two images is adequate at any given moment for clear vision. Unfortunately, not all patients are willing or able to get used to the difficulties of the adaptation required for the implantation of these lenses. Also, not all patients are suitable for the implantation of these multifocal lenses. It is very important to be evaluated by your ophthalmologist and that the patient understands the limitations and expectations of this type of treatment.