Cataract is a deterioration of the natural lens due to age which causes it to become progressively cloudy, milky, yellowish or brownish cataract. The light passing through to the retina is partially blocked and this results in unclear image. Left untreated, a cataract can become so dense that it causes blindness. In fact, cataracts are the leading cause of blindness in the world.
Causes of Cataract
Mainly caused by the process of aging- virtually everyone over 65 years old
Abnormal galactose sugar level, a genetic condition
Virus infections passed from mothers during the first three months of pregnancy
Trauma such as head injuries or hard blow/foreign body to the eye
Some eye diseases such as retinal detachment, glaucoma, or corneal infection
Other diseases such as diabetes
Continuous steroid treatment
What are the symptoms?
Early symptoms are painless and can start with slightly blurred vision or foggy image in the eyes which interfere with normal activities such as driving and reading. The blurry vision can worsen in bright light and improve in dim lighting. In some cases, headlights from cars at night can cause scattered light, haloes, and double vision.
If the cataract is left untreated for too long, eye pain, acute glaucoma, uveitis can occur, leading to vision loss and blindness.
What are the advantages?
Option of single or multi-focal lens for wide range of vision
Minimal side effects
Small and foldable for easy insertion
Small Incision which eliminates need for any sutures
Does not alter the tissue of the cornea
Other diseases such as diabetes
Can be combined with other corrective options
Intraocular Lens at TRSC
There are several new models of intraocular lenses but the most popular is the foldable one. The lens can be folded and passed through the tiny 3.5 millimeters incision. After the insertion, the intraocular lens will slowly unfold and stay permanently stable in the eye. The intraocular lens, made from special and safe material, replaces the natural cloudy lens after aspiration of the cataract. The intraocular lens implantation can enhance the sharpness of natural vision. Patients may still need glasses for reading. The ophthalmologist will prescribe the appropriate reading glasses, if needed.
Foldable Natural Acrylic IOL is a one piece lens which is both strong and flexible. It is highly compatible with the natural lens capsule and can help eliminate light dispersion.
There are 3 types of foldable IOLs available at TRSC;
Standard IOL; the original high standard IOL. It is crystal clear and able to filter ultraviolet light, restoring clear distance vision.
Aspheric IOL; developed from the standard IOL by introducing Wavefront technology. This IOL is designed to have aspheric optics which can sharpen images resulting in better visual quality. This lens has a yellow color similar to the natural lens and is able to block blue light from causing long term damage to the retina.
Multifocal IOL; developed especially for age-related far-sightedness. The Apodized Diffractive technology helps to improve the balancing of near and far vision depending on the light conditions and activities. Multifocal IOL allows patients to focus and adjust to see close and distant objects. Clinical studies used to support the March 2005 FDA approval showed that 80 percent of people who received the lens didn't use glasses for any activities after their cataract surgery.
What steps are involved in the procedure?
Cataract treatment is becoming more convenient and less time consuming. Patients are not required to stay overnight in a hospital. This is a unilateral procedure where one eye is treated and has to recover properly before treating the second eye, which normally takes about 1 week.
Before surgery, patients are required to get a health check that includes a panel of blood tests in order to ensure they are in good health to undergo surgery.
Cataract surgery in four steps:
Patients interested in cataract treatment will receive a thorough eye examination, including a retinal check.
The axial length of the eye will be measured using the A-Scan. This is necessary to calculate the power of intraocular lens.
Ordering of the intraocular lens will take 1-2 weeks.
During the surgery, the surgeon makes a tiny incision bordering the cornea and inserts the ultrasound probe through the incision to liquefy the lens, allowing it to be totally aspirated out , using the most advanced technology using ultrasound is known as Phacoemulsification. The incision is self-sealing so no stitches are required. The empty space will then be replaced by an intraocular lens. As the intraocular lens is inserted, it slowly unfolds and is then carefully placed behind the iris and in front of the natural lens. This placement makes the lens invisible to the naked eye.
Since not everyone can have cataract treatment by ultrasound, your ophthalmologist will give you advice for what type of treatment is best for you. For example, sometimes the lens is too rigid to liquefy due to its late stage. On the other hand, in young patients, the lens is still very soft and thus can be aspirated without using ultrasound. Patients with glaucoma receiving long term iris constrictor eye drops could have a high risk for surgery complications.
Patients receive topical or local anesthesia to minimize any discomfort during the procedure. Although the surgery itself takes about 30 minutes, the whole process takes a few hours due to preparation time and dilation of the eyes. It is advised for the patient to have someone drive them home after completion of the procedure.
Postoperative Care
There is a critical follow up care schedule after each cataract treatment. This is to assure proper healing and provide continued care. The postoperative appointments are at the following time increments, from the day of treatment per eye accordingly:
One day
One week
One month
Three months
One year
Your doctor will adjust medications accordingly, and can request additional follow up appointments if necessary. If the other eye also needs cataract treatment, this can be determined at the one week follow up exam.
There are some guidelines and restrictions following the surgery. A list of instructions will be given. A few of the instructions for the first two weeks include:
No swimming or getting water into the eye
Limit activities that would cause sweating
Limit rigorous activities which could cause strain
Refrain from coughing or sneezing forcefully
Be cautious with head, making sure not to shake it or look down
Be cautious with staircases
Avoid cooking and cleaning
Keep a soft light diet
No eye make-up
Refrain from playing with pets and children
What are possible side effects and complications?
As with any surgeries, there are possible side effects and complications. The details will be further discussed on the day of your preliminary exam. Some reported complications include:
Bleeding, swelling
Glaucoma
Inflammation / Infection
Retinal detachment
It is normal to experience some itchiness, irritation, mild discomfort for a few days after the surgery.
Your doctor will be giving you additional information on the risks and the benefits prior to having the procedure to help you decide which type of intraocular lenses are right for you.
