Cataract Surgery
We all have a natural lens inside the eye called the crystalline lens, which is named for its transparency. Thanks to it, we can focus clearly when looking at different distances.
With age, this lens becomes cloudy due to natural causes, leading to a decrease in the quality and quantity of vision. Other causes of clouding include trauma, congenital abnormalities, metabolic diseases such as diabetes, or chronic use of medications such as corticosteroids.
Any opacity in the lens is known as a cataract, and the only treatment is surgery. In this surgery, the opaque lens is removed and replaced with an acrylic lens that will be housed in the site where the cataract was located and will remain there (inside the eye) for life.
Currently, cataract surgery is usually performed by microincision (i.e., 2.5 mm hand incisions that do not require sutures) using equipment known as a phacoemulsifier that vibrates at ultrasonic speed to pulverize and aspirate the cataract.
After removing the cataract, the intraocular lens, which is always necessary, is introduced into the eye.
There are many types of intraocular lenses. Spherical lenses allow patients with a high risk of developing good distance vision, but they require glasses after surgery to read. When a condition called corneal astigmatism exists, a toric lens is needed to correct it.
Multifocal intraocular lenses are now also available. They allow adequate vision for both distances and near vision, thus offering patients independence from glasses for both distances (which is achieved with this type of lens in more than 90% of cases). However, not all patients are good candidates for this type of lens, and therefore, careful evaluation is required before surgery.
Furthermore, given the efficacy and safety of modern cataract surgery, you don't necessarily need to have a significant cataract to be a candidate for one of these lenses. In those over 50 or 55 years of age who have significant myopia or hyperopia, even when the lens opacity is incipient, they could be good candidates for a procedure called phacorefractive surgery, which seeks to remove the lens to place a multifocal intraocular lens (using the same technique as cataract surgery) but performed to achieve independence from glasses, in cases where refractive surgery treatment with Excimer laser is not the best option.
The most common cataract in our area is senile cataract, caused by aging and deterioration of lens proteins due to age, but there are also other causes of this disease: metabolic, traumatic, inflammatory, congenital, among others.
Some related diseases are:
- Age-related cataracts
- Cataract due to trauma
- Congenital cataracts
The only definitive treatment available today for cataracts is surgery.
Regular eye exams allow for early detection of cataracts, which prevents the problem from progressing and facilitates treatment.
To accurately evaluate each case and make decisions regarding the aforementioned procedures, it is important to conduct a complete medical history, perform state-of-the-art diagnostic tests, and provide a comprehensive approach to the patient by the ophthalmologist. Remember that each surgery has specific indications, and you should receive sound advice before implanting an intraocular lens.