Surgery to treat cataracts. Cataract removal - important recommendations for patients

01.03.2018 Cataract is a pathology in which clouding or discoloration of the lens occurs. She is the most common cause blindness all over the world. Cataract surgery sometimes the only way preserve vision.

Lens

This part eyeball It is a transparent, biconvex structure. Together with the cornea, it helps refract light rays that are focused on the retina, changing its shape and adjusting the focal length.

They make up more than 90% of the total dry mass of the organ. Other components that can be found are sugars, lipids, water, several antioxidants and low-weight molecules. Lens human eye selectively absorbs ultraviolet and short-wavelength light, and this absorption increases steadily with age. As a result, the light spectrum reaching the retina is constantly changing.

As the body ages, various structural and metabolic changes, which leads to a gradual decrease in the transparency of the media, opacification, presbyopia and increased scattering and aberration of light waves, as well as deterioration of optical properties.

The lens consists of a nucleus, cortex and capsule. It is considered the second refractive medium after the cornea due to its position, curvature and refractive properties, which in an adult human are about 20 diopters in its natural environment. This function is controlled by autonomic innervation nervous system and ciliary muscle.

The capsule consists of type IV collagen, laminin and fibronectin. It is a smooth transparent membrane capable of allowing small molecules to pass both in and out.

Causes of cataracts

The first signs of clouding are observed at the age of 40-50 years. At the moment, the exact etiology and pathogenesis of caratogenesis is still unknown. The theory of free radical oxidation is popular in ophthalmology.

« Free radicals"are molecules that have a free electron. They easily enter into biochemical reactions and cause very strong oxidative stress in the cells of the lens fibers. Free radicals disrupt the synthesis of DNA and RNA, interfere with the synthesis of protein microstructures, reduce energy balance, and destroy cellular enzymes.

The main metamorphoses that occur with aging:

• Reduced water diffusion in internal microstructures;
• Crystal rearrangements due to the accumulation of high molecular weight agents and insoluble proteins (denatured alcohols);
• Accumulation of advanced glycation end products (AGEs), lipids, reduction of reduced glutathione and destruction of ascorbic acid.

Free radicals in the body are formed mainly from ultraviolet radiation and smoking.

Disruption of metabolic processes and the appearance of areas of opacity are sometimes associated with changes in chemical composition intraocular fluid. The trigger mechanism is severe physical exhaustion after viral and infectious diseases, anorexia, anemia, radiation exposure, acute and chronic poisoning (for example, mercury).

Pathologies that increase the risk of catarrhal changes include diabetes, high blood pressure, obesity and skin diseases such as atopic dermatitis(a type of eczema). They are sometimes associated with parathyroid tetany, which occurs due to atrophy or thyroidectomy of the parathyroid glands.

Congenital types of the disease, occurring at birth or early childhood, are caused by inherited disorders (Down syndrome) or infections (such as rubella or herpes).

Cloudiness develops after injuries, burns, and interventions. Radiation or electromagnetic radiation can stimulate the exfoliation process, which leads to disruption of the structure of the lens fibers and oxidative systems of the organ.

A person has the following clinical symptoms: “blurred” vision, night vision deteriorates, color perception is weakened, increased sensitivity to bright light and diplopia. In this condition, optical or contact correction is impossible. On last stage the pupil becomes milky white.

Cataract treatment

To slow down development pathological process carried out conservative therapy, in advanced cases, cataract surgery is indicated. The surgeon completely removes the pathologically altered lens. It is replaced with an artificial lens of optimal power.

Cataract surgery in Moscow at the Fedorov Clinic is performed in outpatient setting. Hospitalization in a hospital is used only in complex cases, for example, in the presence of concomitant diseases, such as severe bacterial or viral infection, glaucoma or retinal detachment.

Before the procedure, a person undergoes a full ophthalmological examination, during which a specialist determines what type of IOL needs to be implanted. Since the procedure involves replacing the patient's biological lens with an artificial implant, choosing the correct optical power is critical.

First, the specialist collects a thorough medical history, asks the patient whether he has had allergic reactions before, what medications he is taking, and whether there are any problems with blood clotting. Consultation with specialists is carried out: cardiologist, therapist, dentist. It is necessary to do an electrocardiogram and fluorography.

A few days before the intended manipulation, ophthalmic drops with an antibiotic are prescribed according to a specific regimen. They are necessary to reduce concentration pathogenic bacteria on outer surface eyes and prevent the development of intraocular infection.

The duration of surgery, as a rule, is no more than 30 minutes or one hour. Anesthesia is selected individually, taking into account somatic pathology. In most cases it is used local anesthesia or in combination with intravenous administration certain sedatives. During the procedure, the patient does not feel pain; “light flashes” and red laser lights are possible.

Cataract surgery

Intracapsular extraction involves microsurgical removal of the pathologically opaque body directly along with its capsule. In this case, the ophthalmic surgeon makes an incision relatively large size, then carefully removes the biological lens.

This is an outdated technology, as it is considered more traumatic. It requires intraoperative sutures and long-term visual rehabilitation.

The extracapsular method involves the extraction of the opaque masses along with the anterior capsule, the posterior part is preserved and acts as a barrier between the anterior and posterior segments, and also serves as a site for implantation. This technique is less traumatic compared to the intracapsular one, however, it is currently used quite rarely, due to the emergence of improved techniques.

Ultrasound and femtolaser phacoemulsification

During surgery, the surgeon makes a very small hole in the membrane. Using a very fine stream of sterile water-salt solution, the solid and white matter is gently separated from the surface structures. A hollow titanium phacoemulsifier needle is inserted into the bag. Its peculiarity is that it emits ultrasonic waves of a certain frequency. They fragment the nucleus into tiny particles. The resulting emulsion is simultaneously aspirated through the hole at the end of the needle. Once the capsular bag is completely emptied, additional viscoelastic material is injected into it to maintain space and implantation is performed. The prosthesis cannot be seen or felt. The main advantage of phacoemulsification is that very small micro-incisions are made. They heal on their own almost immediately and do not require stitches.

Phacoemulsification is less invasive, has fewer complications, and results in faster and more stable visual rehabilitation. Since there are no age restrictions, it is used even in children. Contraindications: diabetes mellitus, corneal dystrophy, conjunctivitis.

Small incisions have two main advantages. Firstly, the cornea is less injured. Secondly, the manipulation is performed in a closed environment with less vibration intraocular pressure. Injection of a bolus of cefuroxime into the anterior chamber significantly reduces the risk of postoperative endophthalmitis.

Modern types of prostheses are compact. They are foldable and small in size, and therefore they can be inserted through micro-incisions, and straightened and fixed inside.

Most ophthalmic surgeons in their practice do not use ultrasonic fragmentation of the nucleus, but laser. The advantage of this emulsification method is a higher fragmentation rate and finer crushing. In addition, as practice shows, the intraoperative use of ultrasound during phacoemulsification can lead to damage to the endothelial cells of the cornea due to mechanical trauma from high frequencies and thermal damage.

Femtolaser phacoemulsification is used to create very thin corneal incisions, anterior capsulotomy and nuclear fragmentation. The laser performs capsulorhexis more accurately, improving the centering of the intraocular implant. This procedure is expensive and requires special equipment.

For fragmentation during femtolaser surgery, the so-called hybrid model is recommended: the central 3.0 mm core is liquefied, and the periphery is fragmented into 4-8 incisions.

This method allows the surgeon to easily remove the central area and provides access to peripheral areas, reducing the energy and duration of ultrasonic phacoepilation.

Rehabilitation period

Restoration of visual function does not occur immediately operating table, in most cases within a few days. The ophthalmologist should warn the patient in advance that the image will not be clear at first. There may be lacrimation and slight redness of the sclera. To speed up healing and prevent complications, drops with antibiotics, anti-inflammatory drugs, hormones, as well as “artificial tears” are prescribed.

There may be discomfort and mild itching for 2 days. Sensitivity is restored within 24 hours.

Getting dressed after prosthetics sterile dressing. It protects against dust particles, ultraviolet rays and pathogenic bacteria. It is very important to avoid splashing water or getting soap on your face for two weeks.

In the early postoperative period there is no need to adhere to strict bed rest, a person should lead a normal lifestyle, but should limit watching TV and reading books. To protect your eyes, you need to wear special glasses for several weeks.

Cataract is an ophthalmic disease in which the clear lens of the eye becomes cloudy, causing blurred vision. This disease has been known since ancient times, and surgical treatment was already carried out then.

The lens is the part of the eye that is normally transparent. It focuses light rays entering the eyeball onto the retina, a light-sensitive layer of cells. To create a clear image on the retina, the structures of the eye placed in front of it must be transparent, including the cornea, lens and vitreous.

Light hitting the retina initiates a chemical reaction in its cells. Chemical reaction, in turn, causes an electrical response that travels to the brain along the optic nerve. The brain interprets what the eyes see.

In a normal eye, light passes through the clear lens to the retina. If the lens becomes cloudy due to cataracts, the image on the retina will be blurry, distorted, and unclear. The degree of visual impairment depends in this case on the degree of clouding of the lens.

Most cases of cataracts are associated with aging. This disease is very common in older people. For example, more than half of people aged 80 years have cataracts, and at 95 years old the figure is almost 100%.

Cloudiness of the lens can develop in one or both eyes at once. People with cataracts in one eye tend to develop cataracts in the other eye over time. This disease is not transmitted from one person to another. Cataracts do not hurt and do not cause redness or irritation of the eye.

Although eye surgery can restore vision in people with the condition, age-related cataracts are still the most common cause of blindness in the world. This is because people in many third world countries do not have access to such treatment.

As advances in modern technology and medicine continually increase the life expectancy of people in developed countries, the incidence of cataracts is also increasing.

Types and symptoms of cataracts

Cataracts are classified according to their origin, anatomical location and degree of opacification.

Two main types, distinguished by the origin of lens opacities:

• Congenital cataracts can be present at birth or develop immediately after birth.
• Senile cataract is the most common type of this disease, which develops due to age-related changes in the lens.

According to their anatomical location, they are distinguished:

• Subcapsular cataract – cloudiness develops at the back of the lens. This form develops more often in people with diabetes and in patients taking hormonal medications.
• Nuclear cataract – clouding occurs in the central zone (nucleus) of the lens. Typically, this form of the disease is associated with aging.
• Cortical cataract - this form is characterized by the presence of a white, wedge-shaped opacification that begins at the periphery of the lens and penetrates into its center.

According to the degree of maturity they are distinguished:

• Immature cataract - the lens has not yet become completely opaque.
• Mature cataract – the lens is completely clouded.

Lens clouding begins with symptoms that have little effect on vision. The person may notice that their vision has become slightly blurred, as if looking through a cloudy piece of glass.

As the disease progresses, other symptoms appear:

• Small dark spots or dots in the field of vision.
• Vision deteriorates in dim light.
• Colors are perceived with less brightness and clarity.
• Reading becomes difficult and eventually impossible.
• Frequent replacement of glasses becomes necessary.
• In some cases, people see halos around bright objects (for example, around headlights at night).
• Double vision in one eye (rare).

The type of disease also affects what symptoms a person experiences. At the beginning of the development of nuclear cataracts, there may be a temporary improvement in near vision, which quickly passes as the cloudiness of the lens increases. On the other hand, subcapsular cataracts may long time do not cause any symptoms.

Indications and contraindications for surgery

Surgery for cataracts is the only effective method treatment of this disease.

Previously, it was believed that it was better to perform surgery when the cataract was already mature, but nowadays lens replacement can be done earlier.

The main indication for surgical treatment is the presence of lens opacity, which affects a person’s ability to carry out their daily activities. For example, surgery is performed if poor vision interferes with reading or driving.

Removal of the affected lens is also carried out in case of:

• The presence of diseases caused by its pathology (for example, phacolytic glaucoma).
• The need for visualization of the fundus (for example, in case of diabetes mellitus, cataract surgery is necessary to enable examination and treatment of retinopathy).

Contraindications to cataract surgery:

• Patient's refusal to undergo surgery.
• Correction with glasses or lenses provides vision that meets the patient's needs and desires.
• The surgery will not improve a person's vision (unless there are other indications for lens removal).
• The patient is unable to safely undergo surgery due to concomitant systemic or ophthalmic diseases.
• It is not possible to provide the necessary postoperative care.

In what cases is surgery necessary?

In the initial stages of the disease, surgical intervention may not yet be performed. Vision is improved with glasses and stronger lighting. However, these are only temporary measures - the disease continues to progress and gradually worsens vision more and more.

At the stage of mature cataract, as well as in the case of its complications (for example, phacolytic or phacomorphic glaucoma), surgery is necessary to improve vision.

How to prepare for surgery?

Preparing for cataract surgery begins with full examination eyes and establishing the correct diagnosis.

For this purpose, they carry out:

• Determination of visual acuity.
• Measuring intraocular pressure.
• Examination of the lens, macula, retina, optic nerve and vitreous body with a dilated pupil.
• Optical coherence tomography.
• Keratography.
• Refractometry.

Once a cataract diagnosis is made, a person must choose where they can have eye surgery. Currently, such surgical interventions are carried out in many institutions - public and private. When choosing a place for treatment, an important role is played by how much cataract surgery costs, because in public clinics it can be done for free.

Each medical institution where eye surgery is performed has its own list of additional examinations and tests that need to be taken for cataract surgery.

These usually include:

• General blood and urine tests.
• Blood glucose.
• Electrocardiography.
• Consultations with a therapist, urologist (men) or gynecologist (women).

How is the operation performed?

Many people are interested in how eye surgery for cataracts is done and is it dangerous? Surgical treatment for this disease is carried out in most cases on an outpatient basis under local anesthesia, it has a low risk of complications and is practically not dangerous for the patient.

Almost all medical institutions To treat cataracts, a minimally invasive surgery called phacoemulsification is performed. Before the operation, a drug with a local anesthetic is instilled into the eye, which numbs the procedure.

The principle of phacoemulsification is to destroy the naturally clouded lens using ultrasound. To do this, a special probe is inserted into the eye through a tiny incision in the cornea, which emits ultrasound waves. Once the lens is destroyed, its particles are washed out of the eye. An artificial intraocular lens (IOL) is inserted in its place.

Very important role The choice of IOL type plays a role in the effectiveness of the operation.

There are several types:

• Monofocal IOLs - these lenses have one fixed refractive power, so they are suitable for good vision at only one distance.
• Multifocal IOLs - these lenses can have 2 or more refractive powers, therefore improving vision at near and far distances.
• Accommodative IOLs - These lenses are most similar to a natural lens, they allow the eye to focus on close and distant objects.

Due to its small size, the corneal incision closes independently and there is no need for stitches. All interventions are performed under a microscope. The duration of such an operation is, as a rule, 15-20 minutes, it is easily tolerated by patients.

In the postoperative period, a repeated examination is carried out by an ophthalmologist. The patient must visit a doctor within 4-6 weeks to monitor the results of the surgical intervention.

Risks and possible complications of surgery

Although modern technologies have made cataract operations quite safe, as with any surgical intervention, certain complications may develop after they are performed. Most are completely curable and have no long-term effect on vision.

The risk of complications is increased in people with other ophthalmological diseases such as uveitis, severe myopia or diabetic retinopathy. They also develop more often in patients with severe systemic diseases.

The main complication that can occur after surgery is opacification of the posterior capsule of the lens, which is also called secondary cataract. It occurs in less than 10% of patients who have undergone this intervention. It should be noted that the frequency this complication depends on which IOL was implanted. To eliminate secondary cataracts, an operation is required in which the clouded lens capsule is removed using a laser.

Other complications of surgery are much less common.

It can sometimes happen during surgery:

• The impossibility of removing the entire clouded lens.
• Rupture of the lens capsule.
• Bleeding inside the eyeball.
• Damage to other parts of the eye (such as the cornea).

In the postoperative period, the following complications sometimes occur:

• Swelling and redness of the eye.
• Retinal swelling.
• Corneal edema.
• Retinal detachment.
• Infectious complications.

Prevention of cataracts

Every person, if he lives long enough, will develop cataracts sooner or later. There is not a single method of preventing its development that would have scientific evidence its effectiveness.

The progression of cataracts can be slowed by limiting ultraviolet exposure, quitting smoking, avoiding eye injuries, and eating a healthy diet.

Cataracts are responsible for approximately half of all cases of blindness in the world, although their treatment with surgery is characterized by high efficiency and safety. Modern technologies surgical interventions on the eyes can improve vision in this disease in 95% of patients.

Useful video about recommendations for patients undergoing cataract surgery

Cataract- visual impairment due to clouding of the eye lens. According to some sources, in more than 20,000,000 people in the world, this disease began the onset of blindness.

A person suffering from cataracts experiences serious inconvenience. Sees the contours of objects as blurry, indistinct, double. As cataracts develop, it is necessary to frequently change the lenses in glasses to increasingly stronger ones. The disease is widespread.

Cataracts can begin to develop at any age, but people over 40 are especially susceptible to it. Cataracts can be congenital. Cloudiness of the lens can be caused by long-term consumption of certain medications. The development of cataracts can be caused by diabetes and some other diseases. Harmful radiation and eye trauma also contribute to lens clouding.

Types of cataracts

The three main types of cataracts are:

Nuclear cataract

The cloudiness is localized in the nucleus of the lens. With its development, a person can change the lenses in his glasses towards myopia.

Cortical cataract

Cloudiness forms in the substance of the lens. The person sees blurry.

Posterior capsular cataract

Cloudiness under the lens capsule. Vision deteriorates very quickly. Urgent treatment is required.

Causes of cataracts

Cataracts are caused by certain eye injuries, such as mechanical and chemical injuries.

Also, the occurrence of cataracts is influenced by some eye diseases, for example, glaucoma or high myopia, as well as diabetes mellitus, vitamin deficiency or long-term use some drugs.

Cataracts can also be caused by poor ecology, poisoning by various toxic drugs, ultraviolet or radiation exposure, microwave radiation, and smoking.

Main causes of eye cataracts

• Smoking (nicotine causes constriction of intraocular vessels).
• Toxin poisoning.
• Strong radioactive background.
• Long-term medication use.
• Different types of radiation.
• Endocrine imbalance (postmenopause, hypothyroidism).
• Eye diseases (myopia, glaucoma).
• Traumatic injuries.
• Heredity.

Cataracts in the elderly

Cataracts are most common in older people, and many experts even consider their development to be a natural part of the aging process. In most cases, it affects both eyes, although often one lens is more cloudy than the other. Typical symptoms age-related cataracts:

Sometimes older people experience symptoms of glaucoma and cataracts at the same time, and the patient himself cannot always distinguish one from the other. The main symptom of chronic open-angle glaucoma is a gradual deterioration of vision, which is also characteristic of cataracts.

Less common is acute open-angle glaucoma, the symptoms of which include: severe pain in the eyes, headache, redness of the eyes, increased sensitivity or soreness of the skin around the eyes.

These symptoms usually appear for one to two hours, at more or less long intervals, but each time they occur, the vision deteriorates a little more.

If any of the above symptoms appear, you should seek help as soon as possible.

In acute open-angle glaucoma, especially if it is accompanied by cataracts, vision can decrease very quickly, and this process is irreversible; If left untreated, acute glaucoma can lead to complete loss of vision.

Symptoms of cataracts

Cataracts usually develop slowly and do not cause pain. At the beginning, cataracts may only occupy a small part of the lens, and you may not notice any problems with your vision. Over time, the size of the cataract increases. At the moment when the number of light rays reaching the retina significantly decreases, your vision is impaired.

Symptoms of cataracts include:

• blurred vision;
• deterioration of night vision;
• increased sensitivity to bright light;
• frequent changes in the level of diopters in glasses and contact lenses Oh;
• weakening of color perception;
• double vision if the opposite eye is closed.

The disease usually does not cause any external changes to the eyes. Pain, redness, itching and irritation of the eyes are not symptoms of cataracts, but can be manifestations of other diseases.

Cataracts are not dangerous to the eyes unless the lens becomes completely white. In these cases, inflammation, pain and headaches may develop. This type of cataract is rare and requires urgent surgical treatment.

Don't forget that it is recommended to undergo an examination by an ophthalmologist every 2-4 years for people under 65 years of age and every 1-2 years for people over 65 years of age, as well as after the appearance of new vision problems.

Descriptions of cataract symptoms

Cataract stages

Cataracts, the symptoms of which appear depending on the course of the disease, have four stages of development:

Stage I (initial)

Vision decreases insignificantly, the person begins to see poorly in one or both eyes. During observation by an ophthalmologist, streak-like cloudiness of the lens is visible from the periphery to the central part. Symptoms are varied: some patients do not experience deterioration in vision, others complain of the appearance of “floaters” in front of their eyes, and others experience changes in refraction, which requires a relatively quick change of diopters in glasses.

Stage II (immature)

A distinctive characteristic of the disease is noticeable changes in the level of vision. The visual image becomes very blurry and lacks clarity. The stage is characterized by the fact that the clouding of the lens extends to the central optical zone. An enlarged lens often provokes an increase in intraocular pressure.

Stage III (mature)

It is characterized by the fact that vision is reduced almost to light sensations, there is a clear visible clouding of the lens, which completely reduces vision. The patient only sees hand movements near the face.

IV stage (overripe)

The lens shrinks or liquefies. The patient has a milky, almost white lens. The only way to avoid vision loss at this stage and prevent the appearance of secondary glaucoma is to use laser exposure.

Diagnosis of cataracts

Cataract - insidious disease and determine whether you have it only qualified specialist. Unfortunately, many patients pay attention to the health of their eyes only when it begins to bother them.

The main method for diagnosing cataracts is examining the fundus of the eye in good lighting. Sometimes such an inspection already indicates certain problems. A more in-depth study is carried out using a light (slit) lamp - eye biomicroscopy, which provides directed illumination and magnification.

Its light beam is shaped like a slit. The basis for the development of this technology was the discovery of the Swedish physicist Guldstrandt. In 1911, he created a device designed to illuminate the eyeball, which later became known as the slit lamp.

To illuminate the eye, the scientist did not use the light source itself, but its actual inverse image, projected in the area of ​​the slit-like diaphragm.

A narrowly limited beam of light made it possible to create a clear contrast between the studied (illuminated) and unilluminated parts of the patient’s eye, which later experts began to call light activity.

Biomicroscopy allows the ophthalmologist to see all the details of the eyeball and examine in detail not only the external ones, but also the deeply located ones. tissue structures eyes.

In addition to examining the fundus using a slit lamp, the diagnosis of cataracts includes: techniques that allow you to calculate the strength of the artificial lens (intraocular lens).

Individual calculation of parameters is carried out thanks to a unique device in Russia - “IOL-master” (ZEISS). Such a device allows you to simultaneously measure not only the length of the eye, the curvature of the cornea, the depth of the anterior chamber, assess the condition of the natural lens, but also optimally calculate the parameters

Today, the most popular types of cataract surgery are phacoemulsification of cataracts and extracapsular cataract extraction with IOL implantation. Both of these surgical interventions are performed under local anesthesia.

Phacoemulsification of cataracts with IOL implantation

The principle of the operation is that the surgeon inserts an ultrasonic instrument through 2-3 mm incisions in the cornea, breaks the lens substance with it and removes its remains using microsurgical suction. After this, an artificial lens rolled into a tube is implanted into the freed lens sac, straightened and centered.

The operation lasts on average 10-20 minutes. There are no stitches. Pain relief is provided by preliminary instillation of anesthetic drops.

How do you prepare for cataract surgery?

After examining the eyes by a surgeon and deciding on the method of surgical intervention, the patient receives a list of necessary laboratory tests and consultations with other doctors.

After all surgery even this small organ, like the eye, is a big load for the body, and the ophthalmic surgeon must be sure that the person will withstand it, and that his eye will heal quickly and without complications.

Antibacterial drops will need to be instilled 3-5 days before surgery to minimize the risk of eye infection.

How does cataract surgery work?

Before the operation, the anesthesiologist instills drops or injects an anesthetic into the lower eyelid under the eye.

The patient is conscious but will not feel anything due to the anesthesia.

The patient will be asked to lie down on a couch in the operating room and will be covered with sterile drapes.

A sterile film is glued around the eye, the surgeon adjusts the microscope and begins the operation.

The patient's eyelids and eyebrows will be treated with an antiseptic, then the eyelids will be fixed with a special dilator to prevent involuntary blinking.

If surgery is performed only under the influence of drops, the ophthalmologist will definitely warn that the patient constantly looks up at the light and does not move his eye. When injected under the eye, it will be immobilized, this will wear off along with the effect of anesthesia.

After cataract surgery

A healing gel and protective bandage will be applied to the eye. When the anesthesia wears off, the patient may feel mild discomfort and pain in the eye. These unpleasant sensations are relieved with painkillers. Before being discharged home, the patient will be instructed on how to clean and properly place the drops in the eye.

Recovery after cataract surgery

Vision will begin to improve a few hours after surgery and will be fully restored within a month. The result after surgery depends primarily on initial state eyes.

Since the fundus of the eye is not visible behind the cloudy lens, the ophthalmologist can judge the retina and optic nerve only based on the results of additional studies - tomography, perimetry (assessment of lateral vision) and ultrasound of the eye.

If the patient has been suffering from diabetes mellitus for a long time or has glaucoma, this may worsen the prognosis and the postoperative result may not be satisfactory.

For 2 months after cataract surgery, it is necessary to protect the eyes from excessive strain, avoid sudden bending and heavy lifting.

The patient can watch TV, read, write, sew, swim, eat any food, sleep in any position – within a week after the operation. If bright light causes discomfort, you can use sunglasses.

To shorten recovery period After the operation, the attending physician will determine the order of use of eye drops and schedule a visit to the doctor for a preventive examination.

Strict adherence to all doctor’s instructions will reduce tissue recovery time and protect the patient’s eyes from any side effects, will speed up adaptation to new vision and restore binocular vision.

Rules of conduct after cataract surgery

While your eye is healing, your doctor may ask you to follow one or more special precautions that will help protect your new artificial lens and make the healing process faster and safer.

These may include the following precautions:

For the first few days, sleep on your back or on the side opposite your operated eye.

Unnecessarily, do not tilt your head down for a long time. This may increase intraocular pressure.

Ask for help if you need to lift something up. Lifting objects can also increase the pressure in your eye.

Do not drive while your eye is healing.

Do not rub your eye or put pressure on it.

Wear sunglasses to protect eyes from ultraviolet radiation.

Avoid getting soap and water into your eyes. Wash only up to neck level.

When watching TV or reading, take breaks if your eyes feel tired.

Follow your doctor's instructions.

Drops for cataracts

In cases where cataract surgery is undesirable, doctors prescribe eye drops for cataracts. In fact, such drugs cannot completely cure this disease. They are designed to slow down the process of lens clouding.

It should be remembered that the earlier such treatment is started, the greater the results can be achieved. Therefore, at the first suspicion of the presence of such a disease, you should immediately seek medical help.

It is worth understanding that cataracts are a chronic disease, and therefore drops must be used almost constantly. Long breaks can lead to even greater progression of the disease and decreased vision. Such drugs, as a rule, have virtually no side effects, which means they are very safe.

Eye drops for cataracts can be prescribed to any sick person. The only contraindication for such drugs is individual intolerance to its components. human body. They are very often prescribed even before surgery.

Today there are many similar drugs, which differ in price, effectiveness and the presence of contraindications.

For example, popular ones are:

• "Vitafacol"
• "Quinax"
• "Taufon"
• "Vitaiodurol"
• "Vicein" and many others.

In most cases, the effect of the drug is based on protecting the protein part of the lens from further clouding. In any case, only a doctor who is familiar with your medical history can prescribe suitable eye drops for you. Self-medication and unauthorized taking of such drugs are fraught with negative consequences.

Treatment of cataracts with folk remedies

For the treatment of cataracts, traditional medicine offers its own methods and medicinal plants. Here are some common recipes:

Dilute fresh comb honey in a warm boiled water 1:3 and instill 1-2 drops into both eyes four times a day. Always prepare the drops fresh. Treat like this for 1 – 2 months. This product is very helpful in maintaining vision.

Blueberries can be dried and made into an infusion or decoction. Infusion: leave 20 g of dry berries in a glass of cold water for 8 hours and drink a glass of infusion per day. Decoction: 20 g of berries are boiled for 10 minutes in a glass of water and drunk 50 ml before meals.

Blueberry leaves also have healing powers; an infusion or decoction is prepared from them. Infusion of leaves: leave 15 g of leaves for an hour in 0.4 liters of boiling water. Drink half a glass 3 times a day. Decoction of leaves: boil 60 g of leaves for 20 minutes in 1 liter of water and drink 50 ml 3 times a day.

Squeeze juice from geranium leaves, dilute with boiled water 1:1, instill in the morning and evening, inhibit the development of cataracts. The use of geranium juice is only one of the components complex treatment, you need a certain diet, taking vitamins and so on, requires a lot of patience and punctuality.

To stop the clouding of the lens of the eye (the development of cataracts), as well as to improve your vision, you must constantly drink a decoction of non-roasted sunflower seeds without restrictions. Pour 250g of seeds into 3 liters of boiling water, keep on low heat for 15-20 minutes, cool, strain.

On a bunch of parsley add 3 stalks of celery, two endive leaves, five medium-sized carrots. Squeeze out the juice. The resulting drink is popularly called: “ emergency treatment eye".

A bunch of parsley, the tops of two turnips without leaves, five medium-sized pieces, carrots and one cabbage leaf. Squeeze out the juice.

Prevention of cataracts

A balanced diet, abstaining from smoking and alcohol, physical activity may prevent the development of cataracts. Regular examination by an ophthalmologist for people over 50 years of age.

When an ophthalmologist diagnoses a patient with early cataracts, eye drops are often prescribed to improve metabolic processes in the lens. Data medicines necessary to slow the progression of lens opacities.

Unfortunately, eye drops are not always an effective means of prevention, and the patient almost always experiences further progression of cataracts.

Questions and answers on the topic "Cataracts"

Question:What is the optimal time between surgeries on the right and left eyes? That is, having had cataract surgery on one eye, when would ideally be surgery on the other eye?

Answer: Hello. As a rule, at least in a month.

Question:I have an early stage of cataract, how long will it take before surgery?

Answer: Hello. There is no medicine that can cure cataracts. Drops and vitamins can only slow down the clouding process, but after some time you will still have to contact a surgeon. It is better to operate on initial stage development of the disease when there is no strong progression. Listen to your doctor's recommendations.

Question:My neighbor had cataract surgery, as they explained to him, with a hard lens. At first everything was fine, but then my vision began to deteriorate. He went back to the clinic and was again diagnosed with cataracts. How can this be? What should he do? Are you undergoing treatment? What advice should I give him?

Answer: Most likely, your neighbor has developed secondary cataracts (clouding of the remaining posterior capsule of the lens where the artificial lens is implanted), which most often happens with implantation hard lenses. But other eye diseases that led to decreased vision cannot be ruled out. Therefore, you first need to be examined, and then make decisions about treatment methods together with your doctor.

Question:How long will an artificial lens last after cataract surgery?

Answer: During cataract surgery, an artificial lens is placed once, which lasts for the rest of your life.

Question:You are concerned about a 69-year-old pensioner. I lead an active lifestyle and do gardening. What restrictions will there be after cataract surgery? Will I be able to lead my usual lifestyle?

Answer: Restrictions after cataract surgery are not to be in drafts, not to lift more than 10 kg, and this is all only for one month. One month after cataract surgery, you will be able to lead a full, active lifestyle.

Question:Hello. Is cataract removal a painful procedure?

Answer: Hello. Using pain-relieving drops and medications to help you relax, discomfort during surgery will be kept to a minimum.

Question:Hello. Is there any way to prevent the development of cataracts?

Answer: If we talk about age-related cataracts, it is extremely difficult to prevent it, since the main reason for its appearance is the general aging of the body, and this process is inevitable for no one. In this case, we can only recommend monitoring your health and leading a healthy lifestyle. This is especially important for patients with diabetes. As always, recommendations can be general: don’t smoke, don’t drink too much alcohol, lead an active lifestyle, walk more, exercise regularly physical exercise, monitor your own weight, but even if you follow all these recommendations, you cannot guarantee that you will not develop cataracts.

Question:Good day! I had cataract surgery on my left eye, and now my vision is minus 1.5. There is also a cataract in the right eye, vision is plus 2.5. I can’t find my glasses and I can’t see well. Everything is blurry. After the operation, about a month later, a “cloud” began to appear when moving my gaze. The local doctor said that it is imperative to clean it with a laser. Isn't this dangerous? And what should I do with my right eye? Just a month ago my vision was much better, I could read SMS on my phone, but now I can’t see them. Can vision deteriorate in the operated eye? Or is it the vision of the right eye that is falling due to the big difference? Thank you.

Answer: Hello! There may be several reasons for your vision deterioration. Lens replacement surgery is sometimes complicated by the development of secondary cataracts, which occur immediately after surgery or after some time. Previously, secondary cataracts were removed surgically. However, reoperation- This is a risk to the eye. Today, laser treatment of secondary cataracts has become possible. It is performed under local drip anesthesia (pain-relieving eye drops). Effect laser treatment occurs immediately - visual acuity will improve. Repeated interventions will not be required. For adequate treatment, you need to consult an ophthalmologist.

Question:Hello, my 80-year-old grandfather has glaucoma and cataracts in both eyes, tell me, is surgery possible? Will such an old man be able to bear it? Stroke and heart attack suffered.

Answer: Age in itself is not a contraindication; we have also treated patients who are over 90. But with vascular pathology, the consequence of which is a heart attack and stroke, it is necessary to undergo, in addition to a general examination, an ECG and an examination by a cardiologist (or local physician). If the cardiologist concludes that there are contraindications to outpatient surgery no, then we will carry it out. For more accurate answers about the prognosis for vision and the need for surgical treatment, we recommend undergoing an examination.

Question:I am 45 years old and was recently diagnosed with incipient cataracts. I have virtually none chronic diseases. Only since childhood, since I was 9 years old, have I had high myopia. Now I wear -7 glasses. My mother also has myopia, but medium degree. There are no other eye diseases. In the last year, my blood pressure has been rising slightly, at normal 120/80, it rises to 130/90. I went to the doctor because of strange sensations in my eyes, it seems to me that it is impossible to concentrate when reading, then there is a feeling of lack of light, sometimes there is a slight fogginess in the eyes, at such a moment I want to wipe my glasses. How can you stop the development of cataracts? And what could be the reasons for this?

Answer: There is such a diagnosis as senile cataract. Indeed, this disease is typical for the age category of patients. But in your case we are talking about complicated cataracts - the cause was 3rd degree myopia. Unfortunately, with cataracts, only surgical methods restore high visual acuity. Medication is only possible to slow down the clouding of the lens. For this purpose, the following drugs are used topically (in the form of eye drops): Taufon 4% method of application: for 3 months with an interruption for a month, then repeat the course. 2 drops 3 times a day.

Question:The child is 12 years old and disabled since childhood. In the summer, the eye turned very red, it seemed like a blood vessel had burst, they treated it with sulfacyl, but the eye remained slightly red. And recently we noticed a film on the pupil itself and realized that the child cannot see with his left eye. I have a question - the fact is that I’m just sure that we will most likely be denied surgical treatment under anesthesia, is there any effective folk remedy, not just by hearsay, but that will really help?

Answer: Cataracts are treated only surgically. It is necessary to perform surgery on the lens as soon as possible because in the blind eye, irreversible atrophic phenomena will occur over time (atrophy of the retina and optic nerve) - and even successful operation for cataracts will not give the expected result. Cataract surgery for children is performed under general anesthesia (the child sleeps during the operation). The operation lasts 20 minutes, the recovery period lasts for 2/3 days. Be sure to consult an ophthalmologist about cataract surgery.

Cataract surgery, is one of the most common surgical interventions in general. This is the only treatment option for progressive cataracts (clouding of the lens). In progress microsurgical operation, produced removal of cloudy lens and its replacement with an artificial one. Cataract surgery almost always provides virtually full recovery vision.

Which specialist doctor performs cataract surgery?

Cataract: definition

Cataract called clouding of the eye lens. Like everything in our body, eye lens also susceptible normal process aging, which also leads to the fact that it becomes cloudier throughout life. This happens to each person at his own pace, with certain medications, as well as smoking or eye injuries, can accelerate the process of clouding of the lens and, consequently, the onset of cataracts. Most often, this disease is caused by age, which is why it is also called senile cataract. Age-related cataract usually occurs in people over 60 years of age. Only in in rare cases it can be congenital.

The disease is initially perceived as a thin veil over the eyes, which becomes denser over time. People with cataracts often become more sensitive to light. Sometimes their visual acuity improves for a short time because the refraction of the eye may change. However, this positive change will be negated by clouding of the lens as the disease progresses. If the clouding of the lens progresses and visual acuity noticeably deteriorates due to this, cataract surgery is the only treatment option.

All over the world, cataracts are the most common cause of blindness, because without proper treatment, this disease leads to loss of vision. If treatment is carried out through surgery, as is done in Germany, the hopes for success are very high. Typically, cataract surgery can completely restore visual acuity. This operation is one of the most common in Germany: about 700,000 cataract operations are performed every year. This is one of the safest operations among all existing ones.

Features of congenital cataracts

With congenital cataracts, the signs of the disease mentioned in our review are most often not observed. Therefore, it is all the more important to carefully examine newborns for availability possible signs cataracts or other eye diseases. With congenital cataracts, a quick diagnosis plays a decisive role, because then the chances of curing the disease and preventing the development of asthenopia in the affected eye are optimal. Unlike with cataracts that arose in adulthood, when the timing of the operation depends on the patient’s limitations caused by it, with congenital cataracts the operation should be performed as soon as possible after diagnosis.

Cataract: symptoms of the disease

When cataracts develop in adulthood, clouding of the lens develops slowly and is noticed only after a long time has passed. The following may be symptoms of cataracts: the world around us suddenly appears fuzzy or slightly faded, as if viewed through milky white glass. The colors fade, the surroundings seem shrouded and distorted. Contrasts lose clarity due to increasing clouding of the lens; Those with cataracts become sensitive to light, especially if something blinds them. In some cases, the first symptom of the disease cataracts There is a strong feeling of blinding from the sun or when looking into the light of oncoming cars.

A symptom that is sometimes not associated with cataracts

Cataracts can also change the refraction of the lens because a cloudy lens refracts light differently. For this reason, some people with the disease find that their visual acuity changes and are glad that they suddenly no longer need reading glasses. The phenomenon of myopia accompanying cataracts, which initially compensates for existing senile farsightedness, also contributes to the fact that the disease is often diagnosed late.

Cataract: diagnosis of the disease

In the progressive stage, cataracts can be distinguished with the naked eye: the lens takes on a whitish-cloudy appearance. However, for early stage Ophthalmology has enough tools to recognize this disease.

Cataract: slit lamp examination

If the cataract has not yet progressed too much, a doctor (ophthalmologist) can make a diagnosis using a slit lamp examination. In this case, the eye is examined through slit lamp, acting like a microscope. Perhaps, before this, the doctor will drop medication into the eye to dilate the pupil. The special path of the slit lamp light rays allows an optical incision to be made through the eye. In this way, an accurate assessment of the location and extent of changes can be made various structures eyes. If patients were given drops to dilate the pupil, they should not drive for several hours after the examination.

Examination and preparation at the preoperative stage

If the decision has been made to undergo cataract surgery, the patient will undergo a series of preliminary examinations, during which the entire eye will be examined. With the help ultrasonic measurement the doctor can determine exactly which artificial lens (intraocular, see below) should be implanted. Next, the doctor will check the patient's general health and write down what medications he is taking in case it becomes necessary to stop taking medications for a short time before cataract surgery (for example, blood thinners).

Cataract surgery: method of execution

Cataract surgery: general information

Cataract(cataract) can only be successfully treated by surgical intervention. During cataract surgery, the clouded lens is removed and replaced with a transparent artificial lens, the parameters of which are previously accurately calculated (see above). Ophthalmic surgery has evolved over recent years Thus, cataract surgery can be considered the safest. The moment of such an operation is determined primarily depending on the extent to which the disease affects negative impact on the patient's daily life. In most cases, the operation can be performed on an outpatient basis, and patients can return home within a few hours after completion.

If the disease affects both eyes, then, as a rule, surgery is performed on only one eye first. The ophthalmologist decides together with the patient how long after surgery should be performed on the second eye.

Cataract surgery: anesthesia

To perform cataract surgery, in most cases, it is enough to perform only local (local) anesthesia. If desired, the patient can take a mild sedative before surgery. During the operation, your pulse, blood pressure, oxygen saturation and heartbeat (via ECG) will be monitored.

Lens introduction

Modern ophthalmological surgery allows, as a rule, to remove during cataract operations not the entire lens, but to leave, as far as possible, the lateral and posterior capsule of the lens. In the most common operation performed in ophthalmic surgery (called phacoemulsification), the lens capsule is opened by making a tiny incision. The harder core of the lens is liquefied using ultrasound and sucked out along with the softer cortex. Nowadays, instead of ultrasound, the so-called femtosecond laser. A folded soft artificial lens is usually inserted through the incision. If a rigid lens must be used, the eye surgeon may make the incision larger. The lens is then centered and placed into the capsular bag using small arms. As a rule, all cataract surgery lasts 15-20 minutes, although, of course, you need to have more time in reserve, since preparation for the operation also requires time.

Cataract surgery: intraocular lenses

What are intraocular lenses?

Intraocular lenses are placed in the patient's eye during cataract surgery after removal of the clouded lens; they are centered and secured. - These are transparent plastic lenses that have a certain refractive power. They are made from various materials; acrylates or silicones are used. Lenses can be made either hard, stable, or soft. Today, soft lenses are typically used that can be folded or rolled so that cataract surgery requires only a small incision in the eye. Usually optical part has a diameter of about 6 mm. Elastic arms are attached along the edge of the lens, with the help of which it is fixed in the capsular bag of the lens of the eye.

What are the types of intraocular lenses?

There are intraocular lenses with different refractions. The choice of refraction depends on the result of the ultrasound measurement and whether the patient after cataract surgery wants to see well near or far without glasses. In addition to these lenses, which clearly reproduce objects located at a certain distance (near, far), in recent years they have begun to use artificial lenses, which function like multifocal and progressive lens glasses, allowing you to see clearly at both near and far distances. There are also so-called special lenses - these are lenses that can compensate for the curvature of the cornea (astigmatism) or are equipped with a color filter that can have a protective effect for certain diseases of the retina.

Tolerability of intraocular lenses

Today, almost all patients have the opportunity to receive intraocular lenses, which they usually tolerate throughout their lives. Intraocular lenses do not have to heal like other implants in the body and do not need to be replaced over time due to wear and tear.

Calculation of refraction of an artificial lens

After thorough examination How general condition the patient and the eye, and after ultrasound measurements, the refraction for the artificial lens is calculated. Optical power The lenses used during cataract surgery can be designed in such a way that the patient can see clearly either near or far after surgery. However, it is impossible to make a 100% prediction about the refractive index of the eye after cataract surgery. The choice of lens will be made individually together with an ophthalmologist.

Cataract surgery: complications

Although cataract surgery is one of the safest procedures available, in rare cases it can lead to complications.

Complications during cataract surgery

In rare cases, during cataract surgery it may not be possible to insert an artificial lens. This can happen if the capsular bag into which the lens is to be inserted is damaged or ruptured during surgery. In most cases, at the second stage it is still possible to insert the lens into the inside of the eye. And also for patients who have been operated on for a long time using the old method - with the removal of the capsular bag - a lens can be sewn in behind the pupil or an anterior chamber lens can be inserted.

Complications after cataract surgery

To insert a lens when modern methods During cataract surgery, a very small incision is made, so the likelihood of developing astigmatism (ametropia resulting from curvature of the cornea) is extremely low. Increased intraocular pressure or, more often, temporary corneal clouding is very rare, as are infections after cataract surgery; they respond well to drug treatment. After cataract surgery There is also a small risk of retinal detachment. If a so-called “secondary cataract” is detected, in which, after a few weeks or months, gradual decline visual acuity, it can be eliminated with a special laser or during a short surgical intervention.

Cataract surgery: postoperative treatment

An ointment bandage is applied to the operated eye. It usually takes several days for complete restoration of visual acuity. It is important not to scratch or apply pressure to the operated eye under any circumstances. mechanical pressure. Moreover, in the first days after operations Do not overstrain your eyes by reading or watching TV for a long time. Also, for the first time after surgery, you should avoid physical activity and do not use the sauna. If the patient requires glasses, the power of new spectacle lenses can only be determined several weeks after cataract surgery, because at first visual acuity fluctuates greatly.

1. Do not press or rub your operated eye. During the first nights after cataract surgery, wear an ointment bandage to protect your eye.
2. When taking a shower, be careful not to splash water on your face. Tilt your head back when washing your hair.
3. In the first days after cataract surgery, do not expose your eyes to excessive load, avoid reading and watching TV too much.
4. Resume physical activity and sports such as swimming and diving only after consulting your doctor. The same applies to visits to the sauna.
5. Maybe, sunglasses will bring relief in bright light, because the artificial lens transmits more light than its own. Goggles can protect your eyes even in adverse weather conditions.
6. Discuss with your eye doctor personally when you can go back to work and when you can drive again.
7. Do follow-up postoperative and ongoing examinations with your ophthalmologist; take the medications prescribed to them.
8. If you notice a deterioration in your vision during the first time after cataract surgery, severe redness or eye pain, contact your eye doctor immediately.

Cataract is an eye disease in which the normally transparent lens becomes opaque and becomes clouded. The main role of the lens of a healthy eye is to refract light rays, which ensures that they hit the retina. After transmitting information and analyzing it with the brain, a person clearly sees the objects around him. Cloudiness leads to deterioration and distortion of vision. The formation of cataracts is a gradual process that affects all people to one degree or another as they age.

The reliable etiological factor for the development of cataracts is unknown. From the point of view of pathophysiology, changes and aggregation of the protein structures of the lens occur, which leads to a violation of its transparency. It is extremely rare that cataracts appear in early age, this scenario is most often associated with congenital enzymatic defects, genetic diseases, or systemic congenital infections. Heavy traumatic injuries, surgical interventions, intraocular inflammatory processes can also be a trigger for the development of cataracts, as well as ionizing radiation, smoking and diabetes mellitus. However, it is the patient’s age that is still the main reason for the development of ocular cataracts.

Symptoms of cataracts, indications for surgery

Cataracts always form gradually and are not accompanied by redness of the eye or painful sensations. Expressed external signs are missing. The exception is a very running process.

A person who develops cataracts sees the world around him as if through dirty glass - a cloudy veil forms before his eyes. The symptoms of lens opacity have different variations:

Blurred vision, which was already mentioned above.

Pronounced glare, especially in bright sun or at night from cars with headlights on.

Colors become dull and dull.

Frequent replacement of glasses or contact lenses is required due to progressive deterioration of vision. However, as cataracts progress, the choice of glasses or lenses no longer helps to cope with poor vision.

Double vision.

Previously, it was believed that in order to perform cataract surgery, you need to wait until it “ripens.” That is, the development of an advanced stage of the disease. Now, thanks to the development of microsurgical technologies, approaches to cataract surgery have changed dramatically. The mere fact of having a cataract is not an indication for its removal until clinical manifestations do not begin to significantly influence daily life. Have you ever thought about whether you can drive a car, work, or do housework without outside help and severe discomfort?

Waiting for cataract surgery within reasonable limits does not complicate the surgeon's work and does not increase the risk of complications. After a thorough examination, the attending physician will always advise the optimal timing of surgical intervention.

After the patient has decided to undergo surgery, he needs to undergo a standard preoperative examination and a number of diagnostic procedures. First of all, an ophthalmologist conducts a thorough examination of the organ of vision. It is necessary to ensure that vision loss is associated specifically with cataracts, especially in the presence of concomitant diseases such as diabetic retinopathy, glaucoma or macular degeneration.

Visual acuity and intraocular pressure are measured, color perception and contrast sensitivity are assessed, and the fundus is examined. If necessary, assigned ultrasound examination, optical coherence tomography or fluorescein angiography.

In addition to studying the ophthalmological status, assessing the general condition of the patient is equally important. During preoperative preparation the patient is prescribed:

General and biochemical blood test

General urine analysis.

Assessment of coagulability when indicated.

Electrocardiography.

Fluorography or radiography of the chest organs.

Testing for HIV, syphilis and hepatitis markers.

Sanitation of the oral cavity.

If there are concomitant cardiovascular and other diseases, consultation with specialized specialists is carried out.

After a comprehensive examination and in the absence of contraindications, a surgery date is set. The surgeon talks in detail about the progress of cataract surgery, possible risks and complications, after which the patient signs an informed consent for surgical treatment.

Hospitalization and lens replacement

The patient is hospitalized at the clinic on the eve of the surgery date. If necessary, some laboratory and instrumental studies. It is necessary to tell your doctor about the medications you are constantly taking, especially for anticoagulants and antiplatelet agents. The specialist will give appropriate recommendations. On the day of surgery, you need to be on an empty stomach and refuse to eat or drink.

Anesthesia during cataract surgery is exclusively local - eye drops with a local anesthetic. Thanks to minimally invasive technologies, the operation is virtually painless. 1-2 hours before the operation, the patient is instilled with mydriatics - medications that dilate the pupil, which is necessary for the surgeon to work fully.

The surgical field is treated with an iodine-containing antiseptic, and an eyelid dilator is used to prevent involuntary blinking of the eyelids. The patient is positioned supine. Under visual control through a microscope, the surgeon performs a self-sealing puncture of the cornea, the width of which does not exceed 2-3 mm. It is because of this that sutures are not required at the end of the operation, which significantly speeds up the recovery process. Then a viscoelastic drug is injected into the eye cavity, performing protective role for nearby intraocular anatomical structures.

The next stage is capsulorhexis or incision of the anterior capsule of the lens. The posterior capsule is not removed during the operation - it serves to fix the intraocular lens. Capsulorhexis provides the surgeon with access to the cloudy lens. Then a phacoemulsifier is inserted into the eye, the titanium needle of which emits ultrasonic waves, which leads to the grinding of the lens substance into a suspension. This process is called phacoemulsification. The resulting mass after grinding is removed by aspiration.

Then, through the previously performed access, an intraocular lens rolled into a tube is inserted - an artificial lens. Such an artificial lens is already straightened directly in the eye and fixed in correct position. At the end of the operation, the eye is covered with a protective bandage.

Taking medications after cataract surgery

Depending on the clinic and the patient’s condition, the patient is allowed to go home on the day of surgery or the next day. In this case, the doctor sets the date and time of the subsequent follow-up visit, and also gives recommendations on behavior, regimen, restrictions and use of medications. All appointments must be strictly followed; this is the key to rapid restoration of vision.

In the postoperative period, as a rule, the following medications are prescribed:

Nonsteroidal and steroidal anti-inflammatory eye drops. During the first few days, patients experience pain, burning, itching, and severe redness of the operated eye. To relieve discomfort, it is permissible to take painkillers according to the generally accepted dosage regimen.

In the early postoperative period, it is necessary to wash the eyelids with antiseptic solutions - furatsilin and chloramphenicol. The goal is to prevent infection.

Antibacterial eye drops are necessary to prevent bacterial infection. The drug is selected wide range, active against many microorganisms.

Drops to reduce intraocular pressure. They are prescribed under the supervision of the latter; the decision on prescription and cancellation is made only by the doctor.

Complex local remedies, containing preparations for corneal regeneration and elimination of excessive dryness.

All medications are prescribed only by the attending physician. Whenever adverse reactions It is important to contact a specialist immediately.

Rules for using eye drops

The vast majority medicines in ophthalmology they are prescribed locally in the form of eye drops. Therefore, it is important for patients to know how to properly instill eye drops in order not to harm themselves and to ensure adequate delivery of the drug to the target.

Download and print the rules

Some rules:

Before starting the manipulation, it is important to wash your hands thoroughly with soap.

You need to bury it lying down or sitting on a chair/couch, with your head thrown back well.

It is better if an assistant applies the drops to your eyes.

It is necessary to carefully pull back the lower eyelid and drip the drug into the conjunctival sac.

The pipette should not touch the eye, eyelid or conjunctiva.

After instillation, it is advisable to lie down/sit quietly for a few minutes and press the lower eyelid with a clean, if possible sterile, gauze pad.

Complications in the postoperative period

Cataract surgery is one of the most commonly performed and safest surgical procedures in the world. However, even after this operation there is a risk of complications. Here are some of them:

Dislocation of the intraocular lens.

Endophthalmitis is an inflammatory process of the eyeball.

Increased photosensitivity.

Photopsia.

Macular edema.

Retinal detachment.

Hemorrhage into the vitreous body (hemophthalmos).

Intraocular hypertension and the development of glaucoma.

The formation of secondary cataracts is a process in which, due to cell division, clouding of the posterior capsule of the lens is formed. The symptoms resemble those of ordinary senile cataracts. The treatment consists of laser exposure.

Almost all complications respond well to treatment with timely diagnosis. That is why it is important to visit the doctor according to the appointed time. If the condition worsens and pain occurs, or a sharp deterioration in vision against the background of positive dynamics, it is necessary to urgently visit a specialist.

Rehabilitation period

The time frame for vision restoration after IOL implantation for cataracts varies from person to person. Some patients notice improvement within 1-2 days. The total duration of the recovery period is approximately one month, during which the following recommendations must be followed:

For the first day, stay in bed.

Avoid mechanical impact on the operated eye (do not press or rub the eye).

Avoid direct sun rays, wear sunglasses.

Limit the use of eye makeup for 2-3 weeks.

Make sure that shampoos and detergents do not come into contact with eyes during hygiene procedures.

Avoid intense physical activity and lifting weights over 10 kg.

Taking good care of yourself helps to quickly restore vision and minimize the risk of complications.

Cost of cataract surgery, public and private clinics

Cataract surgery can be performed free of charge in government agency healthcare. There are quotas for such interventions, their number depends on the region. More often, free interventions are provided to social categories of citizens - pensioners, disabled people of all groups. However, in such a situation you must wait your turn. If a patient wishes to implant an imported lens, it must be purchased for a separate fee.

For a fee, cataract surgery can be performed without a queue. The cost varies depending on the complexity of the intervention, the degree of maturity of the cataract, the type of artificial lens, the reputation and equipment of the clinic. There are a lot of ophthalmology clinics, but not all of them have a good reputation. You can get acquainted with the cents on their websites on the Internet and based on patient reviews. On average, the cost of cataract surgery is 45,000-100,000 rubles, depending on the authority of the clinic and surgeon, the model of artificial lens and the category of complexity of the operation. The following Moscow clinics have won trust:

Clinic named after Svyatoslav Fedorov - named after the founder of ophthalmological microsurgery in Russia. Long-term traditions and scientific activity make the Fedorov Clinic one of the most popular among patients.

Center for Diagnostics and Eye Surgery. Gained the trust of patients thanks to modern equipment and experienced specialists, which allows cataract surgery to be performed in the most difficult cases, including concomitant pathology.

Research Institute of Eye Diseases named after. Helholtz. Known good attitude to patients and good results treatment. It is one of the very first eye clinics in Moscow.

The number of people suffering from cataracts is increasing everywhere. It is important to understand that surgery is the only way to return good eyesight people with this disease.

Video: cataract, operation progress, rehabilitation