Cataract Surgery: Recovering the light in your eyes

The term "cataract" refers to an opacity of crystalline, the natural lens in our eyes that allows us to focus objects located at different distances.
As we age, crystalline gradually loses clearness, until it starts interfering with vision. This can't be corrected with glasses, so surgery is indicated as the only solution.
Author:
Dr. John Zabala
Ophthalmologist Universidad del Valle.
Sociedad Colombiana de Oftalmología
Asociación de Oftalmología del Valle

What is a cataract?

The term "cataract" refers to an opacity of crystalline, which is the natural lens that we have in our eyes and which allows us to focus objects located at different distances.

Usually, through the years, crystalline gradually loses clearness, until it gets to a point, around the sixth decade of life, when this opacity significantly interfereswith vision. This condition can not be corrected by using glasses. At this point, surgery is indicated as the only solution.

Cataract Surgery

Extraction of opaque crystalline

In this surgery, opaque cristallyne (cataract) is removed, and then it ir replaced by a syntheticIntra-ocular Lens. This is an ambulatory procedure, and it is performed under local or regional anesthesia.

Currently, cataract surgery is a very safe procedure, where a special ultrasound equipment is used to extract opaque cristallyne through a 3 milimeter incision in the eye’s front portion (cornea). After that, a flexible lens is implanted to replace the damaged cristallyne.

Intraocular lens

In some advanced cases of cataracts, surgeon needs to make a larger incision in order to remove opaque cristallyne. In this case, some suture is required.

Like every surgery, this procedure has implied risks, including intraocular infection, intraocular hemorrhage, permanent corneal inflammation, and the need to further surgeries if there are problems with intraocular lens, amongst others.  Usually, risk of complications is low, but patients must know them and ask all questions they might have, before undergoing any surgical procedure.

Implanted Intraocular lens

Intraocular lenses are basically flexible implants made of silicone or acrylic, with an optical zone diameter of about 6 milimeter. Lenses can be monofocal or multifocal.

Monofocal lenses provide a clear point of focus, either in the distance or close up. Glasses must be used to complement these lenses effect after surgery.

Multifocal lenses are made with more recent technology and they allow to avoid the use of glasses in most of daily activities.

Multifocal lenses have several advantages over monofocal lenses. One of these advantages is that they also correct presbyopia. This condition usually shows around 40 years of age, and it implies a progressive difficulty to read or focus near objects (such as cellular phone display or price tags in the supermarket).

Because of these advantages, some surgeons offer this intraocular lenses implant as a first line procedure to correct presbyopia in younger patients (from 40 years old). This decision has to be carefully considered, provided that at this age there is no cataract, which is the clearest, most justifiable reason for this surgery. Moreover, when there are several other surgical procedures which are less invasive, such as LASIK surgery or keratoplasty with radio frequency.