Today, the definitive treatment for cataracts is surgery. There is currently no effective treatment for cataracts other than surgery.
The lens, which lost its transparency in the surgery, is taken out of the modern eye and replaced with artificial, manufactured intraocular lenses. Some of our patients make statements such as "I do not want lens implantation". It is obligatory to place a lens in the eye in cataract surgeries.
How Is Cataract Surgery Performed?
The most current cataract surgery method is phaco surgery. Today, phaco surgery is known as laser cataract surgery among the people. In fact, laser is not used in phaco surgery, but because it is a seamless operation, it is known as laser cataract surgery among the people.
The advent of modern cataract surgery has led to a significant improvement in surgical technique. Smaller incision surgery has become possible. The need for stitches was eliminated after the surgery.
Cataract Surgery Stages
- The patient is placed on his back and his whole body is covered with sterile covers, except for the eye to be operated.
- Anesthetic drops are placed in the eye and numbed. The eye is sterilized with a number of solutions.
- The eye is usually entered through 3 very small incisions. One of these incision sizes is between about 2.2 mm and 2.8 mm, while the others are less than 1 mm.
- It is aimed to work in a comfortable environment by injecting a substance called viscoelastic into the eye.
- The lens material is taken out of the eye by entering through an entrance hole opened on the front of the lens that has become a cataract. In the meantime, the grip of the phaco device is used.
- After the part remaining in the lens capsule is completely cleaned, artificial intraocular lenses are placed in the resulting pocket.
- The viscoelastic substance given into the eye is taken out.
- The entrance areas are slightly edematous and self-closing is ensured and the operation is terminated.
How Long Does the Surgery Take?
The duration of the surgery depends on the physician's experience, ability and the intensity of the cataract. In the hands of experienced and experienced physicians, cataract surgery takes about 10 minutes. However, if the cataract is very intense and advanced, the duration may increase by a few minutes. These times are the times for experienced physicians.
In some cases, cataract surgery takes between 1 hour and 1.5 hours. However, this situation is usually encountered in situations where there is not enough experience. For this reason, the duration of the operation is a very important parameter and is usually related to the competence of the physician. We recommend that our patients do research on the physician they will be operated on before cataract surgery.
Is Cataract Surgery Risky?
Yes, it's risky! It is important that the operation is performed by an experienced ophthalmologist. In the hands of an experienced physician, it can be done without any problems to a great extent. However, there are some situations in which the probability of problems to be encountered during surgery may increase. For example, if the patient has waited too long and the cataract has hardened, then the risk of surgery is slightly higher than in normal surgeries. This increased risk is not related to the physician, but is a risk directly related to the eye.
In addition, in the case of a cataract that occurs in a person who has had a blow to the eye before, there may be some risks depending on the blow. All these risks should be explained to the patient by the physician. However, despite all these risks, it usually ends without any problems in the hands of an experienced surgeon.
Is it painful in cataract surgery?
Cataract surgery is usually performed under local anesthesia. Eye drops are used to numb the eye. With the anesthetic drops dripped into the eye, the feeling of pain in the eye disappears and the patient does not feel pain during the operation. In addition, extra anesthesia can be performed in the eye with painkillers injected into the eye after starting the operation. We can easily say that the patient does not feel pain and pain in cataract surgeries.
How Long Does the Eye Remain Closed After Cataract Surgery?
There are differences in practice among physicians regarding how long the eye will remain closed after cataract surgery. It is generally recommended that patients keep their eyes closed for 2 hours and then open their eyes. After the patient opens his eyes, he starts the drops and does not close his eyes again.
Lenses Used in Cataract Surgery
There are some types of intraocular lenses that are replaced after the natural lens that has lost its transparency in surgery is removed. The type of lenses placed in the eye varies depending on whether the person has astigmatism in the eye or depending on the person's goal of seeing both far and near at the same time. In recent years, after cataract surgery, smart lenses have been used that allow the person to see both near and far clearly.
Procedures After Cataract Surgery
After the operation, the patient goes home after resting for 1 hour in the hospital. Antibiotic eye cream is applied to the patient's eyes by the operating team and the eyes are closed with eye closure tapes and sent to his home. When the patient goes home, he opens his eyes 2-3 hours later without pressing the eye.
After the surgery, 3-4 eye drops are prescribed for the patient to use. The patient is told how to instill these drops and is also given a printed information form. These drops are usually dripped for 3-4 weeks after the surgery. These drops are instilled more frequently for 3-4 days immediately after the operation, and then the drip frequency is reduced.
On the first day after the surgery, the patient is checked by an ophthalmologist. If there is a cataract in the other eye after the control, the operation of that eye can also be performed.
How Long Does Cataract Surgery Heal?
After cataract surgery, the patient starts to see on the 1st day. It is normal to see hazy on the day of the surgery. If the cataract is not very advanced, then the person usually starts to see well on the 1st day. On the 2nd and 3rd days, there is clearer vision. If the operated cataract is hard, that is, if the patient has waited too long for the operation, then a picture called corneal edema may occur after the operation, and the resolution of the edema sometimes takes up to 1 week. However, this is a rare occurrence.
Is there a risk of cataract surgery?
Like any eye surgery, cataract surgery carries risks. However, the success rate of the surgery is very high despite the risks it carries. With today's technologies, cataract surgery methods have been developed and they are performed with micro incisions and without stitches. After cataract surgery performed by a specialist surgeon, the patient can quickly return to his daily life. As we have mentioned before, it is of great importance that cataract surgery is performed by specialist physicians. Therefore, you should be careful when choosing a hospital.
When Should Cataract Surgery Be Performed?
In modern cataract surgery, waiting for an increase in the density of the cataract, as in the old technique, increases the risk of complications in the surgery. In a cataract that has waited too long, the duration of the operation is prolonged. Due to the prolongation of the operation time and the increase of some other risks, it should be taken when the density of the cataract reaches a reasonable level and it is not appropriate to wait longer than necessary.
Degree of Visual Impairment and Timing of Surgery
How much should the patient's vision be affected before surgery? This situation varies depending on the type of cataract and the patient's complaints. For example, in a type of cataract we call posterior subcapsular cataract, it can be operated even if the patient's central vision is 100 percent. Because in this type of cataract, the person has a lot of light discomfort and when he enters lighted environments, the person's vision level decreases. However, in the case of nuclear cataract, it is a general approach to operate when the patient's visual level drops to 0.7 or below. Although these are general principles, it is the most appropriate approach to evaluate the timing of surgery for each patient.
In cataracts seen in infants, urgent surgery is very important in terms of preventing lazy eye.
What Happens If Cataract Surgery Is Delayed?
If the surgery is delayed, the density of the cataract increases and becomes a hard cataract. In hard cataracts, the visual level of the person decreases and the surgery becomes more difficult. When the cataract becomes hard, the risk of encountering problems in surgery increases.
What should be considered after cataract surgery?
- After cataract surgery, the patient should be fed with light foods.
- Heavy loads should not be lifted for 1 week after the operation.
- The person who had the surgery should not drive the day after the surgery.
- As for taking a shower, it is possible to take a shower as long as the water does not touch the eyes.
- After the operation, pressure should not be applied to the eye and should be protected from impacts.
- On the first day after the operation, the eyes can be blurred and it is a normal phenomenon. Support can be obtained to walk in a healthy way.