What complications are possible after cataract surgery and how dangerous are they? Feelings after cataract surgery Tearing after lens replacement.

An effective and gentle method of phacoemulsification does not eliminate the risk of complications after replacing the eye lens for cataracts. The advanced age of patients, concomitant diseases, and violation of sterility requirements by medical staff provoke undesirable consequences of the operation.

Eye cataracts are incurable with conservative methods: there are no means that can make the clouded lens transparent again. Phacoemulsification, an operation involving the replacement of a worn-out “biological lens” with an artificial one, can restore lost vision with a minimal percentage of complications. To crush the lens that has lost its quality, an ultra-thin needle is used - a phaco tip, which works under the influence of ultrasound. Microscopic punctures (1.8-2 mm) are made for the needle tip; they do not require subsequent sutures, because heal on their own. Through these holes, the crushed lens masses are removed, and an elastic lens is implanted in their place - an artificial lens substitute. The intraocular lens (IOL) expands inside the lens capsule and provides the patient with high-quality vision for the rest of his life. However, even during such a high-tech operation, there are complications:

Rupture of the capsule wall and loss of parts of the crushed lens into the vitreous region. This pathology provokes glaucoma, damage to the retina. After 2-3 weeks, a secondary surgical intervention is performed to remove the clogged vitreous.
Displacement of the implanted lens towards the retina. A malpositioned IOL causes swelling of the macula (the central part of the retina). In this case, a new operation is necessary to replace the artificial lens.
Suprachoroidal hemorrhage is the accumulation of blood in the space between the choroid and the sclera. This complication is possible due to the patient’s advanced age, glaucoma and hypertension. Hemorrhage can lead to loss of the eye and is considered a rare but dangerous aspect of lens replacement surgery.

Intraoperative problems during phacoemulsification are not excluded, but occur rarely - in 0.5% of cases. Postoperative complications occur 2-3 times more often (1-1.5% of cases).

Complications of the first postoperative weeks

For the first two weeks after surgery, it is necessary to protect the operated eye from bright light, infections and injuries, and use anti-inflammatory drops for tissue regeneration.

Despite preventive measures, complications are possible in the first and second weeks after cataract removal.

Pathologies amenable to conservative therapy

Uveitis is an inflammatory reaction of the choroid of the eye, manifested by pain, photosensitivity, spots or fog before the eyes.
Iridocyclitis is an inflammation of the iris and ciliary zone, which is accompanied by severe pain and lacrimation.

Such complications require complex treatment with antibiotics, anti-inflammatory hormonal and non-steroidal drugs.

Hemorrhage into the anterior chamber. Associated with minor damage to the iris during surgery. Minor bleeding inside the eye can be treated with additional irrigation and is not painful or interferes with vision.
Corneal edema. If a mature cataract (with a hard structure) is removed, complications after cataract surgery on the cornea are caused by the increased effect of ultrasound during its crushing. Corneal swelling occurs, which goes away on its own. When air bubbles form inside the cornea, special ointments and solutions and therapeutic lenses are used. In severe cases, the cornea is replaced - keratoplasty.
Postoperative astigmatism. Surgery changes the shape of the cornea, causing refractive error and blurred vision. It is corrected with glasses and lenses.
Increased eye pressure. Postoperative (secondary) glaucoma can occur due to various circumstances:

the remains of the gel-like suspension (viscoelastic) that were poorly washed off during surgery impede the circulation of fluid inside the eye;
the implanted lens moves forward towards the iris and puts pressure on the pupil;
inflammatory processes or hemorrhages inside the eye.

As a result, symptoms appear: redness, pain, pain in and around the eyes, tearing, retching and fog before the eyes. The pressure returns to normal after the use of special drops; sometimes a puncture is done to wash the clogged ducts of the eyeball.

Pathologies requiring surgical intervention

intraoperative complications;
contusions of the operated eye;
high degree of myopia;
diabetes mellitus, vascular diseases.

If symptoms of retinal detachment appear: light spots, floaters, a dark veil before the eyes, you should immediately consult an ophthalmologist. Treatment is carried out with laser coagulation, surgical filling, and vitrectomy.

Endophthalmitis. Inflammation of the internal tissues of the eyeball (vitreous humor) is a rare but very dangerous complication of eye microsurgery. It is connected:

with infection entering the eye during surgery;
with weakened immunity;
with concomitant eye diseases (conjunctivitis, blephatitis, etc.)
with infection of the tear ducts.

Symptoms: sharp pain, significant blurred vision (only light and shade is visible), redness of the eyeball, swelling of the eyelids. Emergency treatment is required in an inpatient eye surgery department, otherwise eye loss and the development of meningitis will occur.

Remote pathological changes

Undesirable consequences may appear 2-3 months after surgery. These include:

blurred vision, especially in the morning;
blurry wavy image of objects;
pink tint of the image;
light aversion.

An accurate diagnosis of macular edema is possible only with optical tomography and retinal angiography. The disease is treated with antibiotics in combination with anti-inflammatory drugs. With successful therapy, after 2-3 months the swelling resolves and vision is restored.

"Secondary cataract". Late postoperative complication occurs after 6-12 months. The artificial lens, which replaces the removed “biological lens,” works properly, so the name “cataract” in this case is inaccurate. The opacification does not occur on the IOL, but on the capsule in which it is located. On the surface of the shell, the cells of the natural lens continue to regenerate. Shifting into the optical zone, they accumulate there and prevent the passage of light rays. The symptoms of cataracts return: fog, blurred outlines, decreased color vision, spots before the eyes, etc. Pathology is treated in two ways:

surgical capsulotomy - an operation to remove the clogged film of the capsular bag, during which a hole is made to allow light rays to access the retina;
cleaning the back wall of the capsule using a laser.

The correct choice of IOL reduces the likelihood of developing complications: the lowest percentage of post-cataract development is achieved by implantation of acrylic lenses with square edges.

Modern medical technologies offer safe replacement of the lens in the eye. But sometimes, in 2% of cases, complications develop after cataract surgery.

Complications after surgery to replace the lens of the eye for cataracts arise due to many factors. If vision has not been restored or other adverse consequences have developed after surgery, the person makes an appointment with an ophthalmologist.

Cataracts are differentiated as primary and... The second form appears after the first and has characteristic mechanisms of occurrence. The reasons for the development of such a complication after cataract phacoemulsification include:

disruption of the endocrine system;
unusual cell reaction, applies to people with systemic diseases;
formation of a dense film at the back of the lens capsule.

Secondary cataracts are detected only by examining the structure of the visual organ using special equipment.

Intraocular pressure

The increased intraocular pressure in the early postoperative period after phacoemulsification is explained by:

disruption of the natural outflow of aqueous fluid from the posterior chamber of the orbit;
accumulation in the drainage system of viscoelastics, viscous drugs that are used during phacoemulsification to protect the structural surface of the visual organ;
development of the inflammatory process or sedimentation of particles of the removed lens.

If there is such a complication after cataract removal, eye drops are prescribed. In special cases, another surgical procedure is performed - puncture of the anterior part of the chamber and cleansing.

Why do my eyes water and hurt?

If the eye itches and waters after surgery, this indicates the development of an inflammatory process after cataract removal. The appearance of symptoms is explained by the penetration of infection into the cells during the operation.

Additional symptoms include:

severe pain;
profuse lacrimation;
the occurrence of swelling and swelling of the eyes;
purulent discharge;
the eye partially or completely does not see.

For diagnosis, if the eye hurts and festeres after cataract surgery, an analysis of tear fluid and vitreous particles is used. Next, therapeutic therapy is prescribed. In severe cases, additional surgery is performed to remove the pus.

Fog in the eyes, or Irvine Gass syndrome

Or Irwin Gass syndrome, which appears a month after cataract surgery. Fluid accumulates in the central part of the retina, causing the macula to swell. Symptoms of the development of Irvine Gass disease include:

pinkish fog appearing before the eyes;
distortion of objects;
fear of light.

To identify the disease, the fundus of the eye is examined using a microscope and an optical tomograph. People with this complication are prescribed anti-inflammatory drugs in tablet or injection form. If treatment fails, a surgical procedure is prescribed.

Corneal edema

When removing mature cataracts, which have a hard structure, the risk of complications due to ultrasound exposure increases. Therefore, a film forms on the cornea after surgery. But the symptom cannot be treated.

If air bubbles appear in the cornea, solutions, ointments and lenses are prescribed. In especially severe cases, the cornea is changed surgically.

Astigmatism, nearsightedness or farsightedness

If the surgical process for removing cataracts with replacing the lens of the eye is disrupted, a complication appears - myopia, farsightedness or astigmatism. This happens for several reasons:

use of low-quality tools;
increased intraocular pressure;
seam overtension.

Diagnosis of the complication is carried out if a person’s vision sharply deteriorates after cataract removal. An ophthalmologist examines the eyelid with a special instrument. Treatment involves wearing lenses or glasses if a person, after cataract surgery, cannot see near or far.

Lens displacement

The ligaments and capsules of the optic organ are torn when the surgeon performs incorrect actions. Therefore, a complication appears after cataract surgery - lens displacement.

The following symptoms are characteristic of this defect:

there is something in the eye that is disturbed and double;
bright flashes;
swelling, tumors;
pain;
darkness before the eyes.

As a diagnostic measure, fundus examination is prescribed. The complication is treated surgically. During the procedure, the doctor lifts and fixes the lens in its proper place.

Retinal disinsertion

If black spots appear in the eyes after cataract surgery, this indicates the development of retinal detachment. More often, people with myopia are susceptible to this complication. In addition to black dots, flashes and a veil may appear, blocking the view.

To diagnose pathology, several studies are used, intraocular pressure is measured. The defect is corrected through a surgical procedure.

Bleeding

A large artery is located in the choroid of the optic organ. After cataract removal, the occurrence of a rupture of this artery is explained by the presence of the following diseases:

diabetes;
glaucoma;
impaired functioning of the cardiovascular system;
atherosclerosis.

Sometimes bleeding occurs during a surgical procedure. This is considered a serious complication and requires prompt sealing of the wound.

When bleeding occurs, a person's eyelid becomes red and capillaries are visible. The mucous membrane of the organ swells.

Prevention

To prevent complications in the eye after cataract surgery, you must follow the recommendations of the specialist who replaced the lens. The postoperative period includes the following preventive measures:

Elimination of visual and physical stress.
Applying a tight bandage to the eyelid for the first 5 days after replacing the lens.
Instillation of drops to promote tissue healing. For example, drugs such as Vitabact and Diclof are used.
When there is no longer double vision and vision has been restored, it is necessary to monitor the cleanliness of the visual organ and wear glasses as recommended by a doctor.

Almost all people with cataracts removed do not experience any visual impairment. The recovery period lasts several months.

Additionally, we invite you to watch a video where an ophthalmologist will talk about complications and their prevention:

New treatment methods and computer equipment help to perform phacoemulsification with minimal risks of subsequent complications. But at the first signs of a developing defect, you need to visit an ophthalmologist.

Comment on the article and tell us and other readers about your experience. Share the article with your friends by reposting it. Be healthy.

Modern surgical treatment is low-traumatic, so the postoperative period after it is almost painless and does not last long. As a rule, vision is restored almost immediately. However, for a certain time after, a person must adhere to the regime and carefully follow the doctor’s recommendations.

Many people underestimate the importance of the rehabilitation period, which leads to undesirable consequences. As a result, these patients develop complications that could have been avoided. To avoid damaging the cornea, dislodging the implanted lens, and causing infection in the eye, you need to know how to behave after cataract surgery.

In the postoperative period, people have to face such problems:

Eye pain after cataract surgery. The appearance of pain is caused by tissue damage and is completely normal. Drops prescribed by your doctor will help relieve discomfort.
There was profuse lacrimation and itching in the operated eye. This symptom occurs due to irritation of the eye during surgery. This often happens during cataract surgery; special eye drops also help correct the situation. As a rule, doctors prescribe Indocollir, Naklof or Medrolgin - drugs that have analgesic and anti-inflammatory effects.
Red eye after cataract surgery. Hyperemia of the eye occurs due to dilation of the conjunctival vessels. The phenomenon is harmless and does not pose a serious threat to vision. However, if extensive subconjunctival hemorrhage occurs, it is better to consult a doctor immediately.
After cataract surgery, the eye cannot see or sees very poorly. This happens if a person has diseases of the retina, optic nerve or other structures of the eye. This is not the doctors fault. Slight blurred vision may occur in the early postoperative period due to swelling of the cornea after cataract surgery. As a rule, it soon goes away completely, and the person begins to see much better.

Unpleasant sensations may persist for several days. After this, the eye calms down, the redness goes away, and vision improves significantly. A few more weeks are required for the tissue to heal. Special eye care after cataract surgery helps speed up the process of vision restoration.

How to choose the right glasses

After the lens is removed, a special intraocular lens is placed in the eye. It is designed in such a way that a person can see well into the distance, but has difficulty reading newspapers and working at a computer. This is due to the fact that the implanted lens cannot accommodate, that is, focus the gaze at different distances. This is why many people require reading glasses after cataract surgery. They should be selected 2-3 months after surgical treatment.

Nowadays, there are multifocal intraocular lenses (IOLs) on the market that provide good visual acuity at different distances. Unfortunately, they are expensive and many people cannot afford them.

Sunglasses are used to protect the eyes from ultraviolet radiation after cataract surgery. They prevent harmful rays from reaching the retina and protect the visual organ from the harmful effects of the sun. It is better to give preference to glass glasses from trusted companies.

Rules for using drops

Patients who have undergone surgery are interested in which eye drops are best to use after cataract surgery. However, all necessary medications are selected by the attending physician. All a person needs to do is follow the recommendations indicated in the extract.

After cataract surgery, the following drops are prescribed::

anti-inflammatory drugs - Indocollir, Naklof;
antibiotics - Tobrex, Floxal, Tsiprolet;
combination drugs containing antibiotics and corticosteroids - Maxitrol, Tobradex.

Medicines should be instilled regularly throughout the period recommended by the doctor. Under no circumstances should you pause or spontaneously stop treatment. In the postoperative period after cataract removal, be sure to follow the regimen and all prescribed restrictions.

What is strictly prohibited after surgery

Human behavior in the postoperative period is of great importance for the restoration of visual functions after cataract surgery. Heavy physical activity, prolonged bending and heavy lifting can lead to serious consequences, including displacement of the IOL or curvature of the cornea.

refusal to play sports and work in an inclined position;
limiting computer work and TV viewing;
complete refusal to lift weights weighing more than 3 kg.

It is recommended to adhere to these restrictions for a month or more. During this time, the person should sleep on the back or side opposite the operated eye. Before going outside, you should put a clean bandage over your eye for at least a week to prevent infection.

Many people wonder if they can watch TV and ride a bike after cataract surgery. Working on a computer and watching TV in moderation is allowed for a person just a few days after being discharged from the hospital. But cycling, horseback riding, and lifting weights over 5 kg are prohibited for the operated person for the rest of his life.

Why is it so important to follow a routine?

It is not enough to simply know what work is prohibited after eye cataract surgery. All restrictions must be strictly observed, since a lot depends on this. If the patient does not follow the recommendations, the lens may become dislodged or the cornea may become deformed. Naturally, this will lead to deterioration of vision, due to which the results of the operation will not be satisfactory.

Surgery to replace a lens clouded by cataracts is the only possible treatment for the disease. Such surgical interventions are performed frequently and in many clinics. However, complications after replacing the lens of the eye are possible. What are they and can they be avoided?

Why do negative consequences occur after lens replacement?

If the operation to replace the lens for cataracts is performed by an experienced ophthalmic surgeon, then it does not entail any special problems. For professionals who have performed more than one surgical intervention, removing the lens and placing an implant in its place - an intraocular lens - is a simple and quick operation. The recovery process is smooth for most patients. The likelihood of complications occurs infrequently. But still they cannot be excluded, although they are quite rare phenomena.

Each type of complication has specific causes. After surgery, swelling of the eye often occurs. Many patients encounter this problem during the postoperative period. It is usually associated with a weakened cornea. Another reason is the peculiarity of the body’s reaction to ultrasound. It is used in cases where the patient seeks medical help too late. If the cataract has been advanced, then ophthalmic surgeons need to use more powerful ultrasound waves. This often has an increased impact on the eyeball.

A possible cause of complications after lens replacement for cataracts can also be medical error. Such situations are not so common in medical practice, but they cannot be excluded. Problems may arise due to technical or tactical errors of the doctor who performed the operation. Medical errors usually occur accidentally. Therefore, it is difficult to predict their risk. Cataract surgery is the only possible method of treatment and ophthalmic surgeons have sufficient experience in performing it. But this does not negate the likelihood of complications arising due to the doctor’s fault.

What are the intraoperative complications during lens replacement?

Lens replacement for cataracts is considered a well-established procedure. But even with this high-tech operation, complications are possible. One of them is the rupture of the wall of the capsule, inside of which the clouded lens of the eye was previously located, and the loss of its crushed particles into the area of the vitreous body. This complication often entails the development of glaucoma and retinal damage. Repeated surgery can help correct the situation. Typically, optometrists monitor the patient for 2-3 weeks. After this, the clogged vitreous is removed surgically.

Displacement of the intraocular lens towards the retina is another type of complications that are possible after replacing the lens for cataracts. This happens due to improper placement of the implant. This provokes swelling of the macula - the very center of the retina of the eye, in which light rays are focused. In this case, the only possible way to eliminate this problem is to perform a repeat operation and replace the “wrong” lens with a new one.
A special type of complication is suprachoroidal hemorrhage. This is an accumulation of hemorrhagic contents in the space between the sclera - the white membrane of the eye - and the choroid. In most cases, hemorrhage due to cataracts occurs in patients of advanced age or concomitant diseases: glaucoma or hypertension. The danger of such a complication is that it can lead to a rapid decrease in vision and loss of the eye.

Inflammatory processes as complications after lens replacement

They should be used for 2-3 weeks. The regularity of use is selected individually.

If the patient’s immunity was weakened even before the diagnosis of cataract, then the usual signs of inflammation may be accompanied by symptoms of uveitis or iridocyclitis. With uveitis, various parts of the choroid of the eye become inflamed:

iris;
ciliary body;
choroid.

This disease manifests itself as redness, pain in the visual organs, photosensitivity, blurred vision, and increased tearfulness. In some cases, floaters and floating spots may appear before the eyes. The basis of treatment for uveitis is the use of mydriatics, steroids, and immunosuppressive drugs.

Another ophthalmological disease that can be a consequence of the inflammatory process is iridocyclitis. This pathology affects the iris and ciliary body. The disease “makes itself felt” with swelling, redness, and pain. In particularly difficult cases and with advanced cataracts, the iris may change color, the pupil may narrow and become deformed.

Conservative treatment of iridocyclitis includes the following types of therapy:

antibacterial;
anti-inflammatory;
antiviral.

Types of complications that can be treated conservatively

Hyphema is a negative consequence that can occur after cataract surgery. This is a hemorrhage into the anterior chamber of the eyeball, filled with intraocular fluid. That is, there is an accumulation of blood between the lens and the iris. Hyphema occurs due to the fact that during the operation the ophthalmic surgeon accidentally damaged the vessels of the ciliary body or the iris of the eye. This condition does not pose a serious danger to the patient, although it may persist for several months. Hyphema does not cause pain and does not impair vision. It is treated with additional rinses. Doctors most often prescribe hormonal drops, for example, Dexamethasone, and mydriatics, for example, Atropine.

Unsuccessful cataract surgery can cause increased intraocular pressure. This condition is often called "postoperative glaucoma."

Reasons that cause increased intraocular pressure include:

inflammatory processes or hemorrhages inside the eye;
gel-like suspensions used during surgery are not washed off well enough;
displacement of the artificial lens closer to the iris and its pressure on the pupil;
moisture entering the operated eye within a week after surgery;
exposure to too much bright light on the iris.

Patients with postoperative glaucoma report pain in the eyes, increased lacrimation, and blurred vision. The pressure is normalized after using special drops, for example: Timolol, Brinzopt, Pilocarpine. If treatment with drops does not help, then the ophthalmologist prescribes a puncture with washing of the clogged ducts of the eyeball.

Postoperative astigmatism is another possible complication that can occur after cataract removal. When the lens is replaced, the shape of the cornea changes. Because of this, the refraction of the eye is impaired and vision becomes blurred. Postoperative astigmatism is corrected with contact lenses that have a toric design, cylindrical or spherocylindrical glasses.
It is very important to distinguish between the symptoms of astigmatism, which can develop several months after implant placement, and diplopia, which is a side effect of surgery. With diplopia, the functions of the eye muscles are impaired, causing the image to appear in two. This condition resolves within a few days and does not require treatment.

What complications after lens replacement require surgery?

Serious complications may occur after cataract removal. They require repeated surgery. If the intraocular lens, which is placed inside the capsular bag instead of the clouded lens, is not properly fixed, the IOL can independently move back, forward or to the side. In such situations, the patient complains of a double image of distant objects and rapid fatigue of the visual organs. This type of complication is considered quite severe. Its danger is that if no measures are taken, the patient may develop glaucoma or retinal detachment. Conservative treatment in this case will be useless. The situation can only be corrected by repeating the operation. During this procedure, the ophthalmic surgeon will adjust the position of the artificial lens.

One of the complications that arise after cataract removal is rhegmatogenous retinal detachment. This is a rather serious pathology that requires surgical intervention. Rhegmatogenous detachment occurs because the retinal layer, when separated from the wall of the eyeball, loses access to nutrients and begins to die. This condition is dangerous because it can lead to complete loss of vision. It can be identified by the patient’s complaints about the appearance of a veil before the eyes. Treatment is carried out by:

laser coagulation - a medical procedure with which ophthalmic surgeons eliminate dystrophic and degenerative changes in the retina;
vitrectomy - a surgical operation used for hemorrhages in the vitreous body, retinal detachment, injuries to the visual analyzer;
extrascleral filling - a method of treating retinal pathologies by squeezing it with a special filling fixed on the outside of the sclera.

A rare, but very dangerous complication after removal of cataracts is endophthalmitis. This is a severe inflammatory process in which pus accumulates in the vitreous body. It occurs due to infection entering the eye during surgery, when the tear ducts become infected. Endophthalmitis often develops in people with weakened immune systems and in those who have suffered other ophthalmic pathologies, for example: blepharitis, conjunctivitis, etc. Symptoms of the disease:

sharp pain in the eyes;
swelling in the eyelid area;
significant decrease in vision;
redness of the sclera.

In case of endophthalmitis, emergency hospitalization in the ophthalmology department is necessary. If the necessary measures to treat the disease are not taken in a timely manner, this may lead to loss of the eye or the development of meningitis.

Can complications arise after a few months?

Some types of complications may “make themselves felt” several months after surgery. The main one is the development of secondary cataracts. This condition usually occurs after 6 months to a year. In this case, the cloudiness does not form on the lens. The capsule, inside of which the intraocular lens is located, suffers. Patients note symptoms typical of cataracts. The complication is characterized by:

blurred image outlines;
weakened color rendering of objects;
the appearance of “floaters” before the eyes.

Treatment of secondary cataracts is carried out using two methods. The first is surgical capsulotomy. This operation removes the clogged film of the capsular bag. The second method is to clean the back wall of the capsule using a laser.
Another type of complication that can occur after replacing a lens that is clouded by a cataract is cystoid macular edema. The inflammatory process develops in the central part of the retina. It is caused by rupture of the lens capsule or infections in the vitreous. Cystoid macular edema involves damage to the corpus luteum, the most important part of the retina where light rays are focused.
The danger of this condition is that early diagnosis is difficult. Symptoms are not clearly expressed. An accurate diagnosis can only be made by optical tomography of the eye and retinal angiography. Anti-inflammatory drugs play an important role in the treatment of the disease.

How to avoid complications after lens replacement?

In order to avoid complications after cataract removal, you should follow the recommendations of the ophthalmologist. This will speed up the rehabilitation process and avoid complications.

You should not tilt your head sharply.
It is better to sleep on the side where the healthy eye is located.
Make sure that no water gets into the operated eye during hygiene procedures.
Avoid visual stress. Read less, watch TV, work on the computer.
Take vitamins, eat more fruits and vegetables.
Give up bad habits, especially smoking.
Do not lift anything weighing more than 10 kg.
Refuse to drive.

I am 65 years old. I am a doctor. In 2013, he removed a cataract in his right eye. In 2016 - on the left. Both operations were performed at the Lege artic clinic on Federative Avenue. Both lenses are from the same company, AcrySof IQ.

The postoperative process went well. Vision was perfectly restored. Two months after the operation, a feeling appeared in the right eye that something was interfering. I went to the clinic, where after an examination they discovered demodex. A course of treatment was prescribed. Another two months passed, but there was no effect. The feeling of a foreign body that interferes with life does not go away. I went back to the clinic. They replied that everything was fine. The operation went great, you have a symptom of “dry eye”. Drop Artelak into the right eye.

Another 2 months have passed. The sensation of a foreign body persists only in the right eye. There was constant tearing from this one eye. Currently, in addition to the feeling of “disturbance” in the eye, double vision has appeared when reading. When you close one or the other eye, the picture is clear and reading is a pleasure. When reading with two eyes, reading is impossible due to double vision. We were sent for a consultation to the Eye Surgery Center. There I had an optical coherence tomography scan of the retina. Diagnosis of OD AMD, “dry” form.

Considering all of the above, I want to ask. Can you continue to live with this feeling of “getting in the way”? By and large, this is not fatal. Maybe after 2-3 years I'll get used to it. I will read less. Listen more. I'm asking for advice.

Asked by: Vladimir

Answer from a cataract specialist

Hello.

Foreign body sensation is unlikely to be associated with demodex and is more often associated with dry eye syndrome. However, to rule out other causes, it is better to see an ophthalmologist. To reduce discomfort, you can try artificial tears (this is a group of drugs that improves the properties of the tear film and has no side effects). Examples of drugs: Hilocomod, Systane, Oftolik, Natural Tear, etc. Drip at least 4 times a day in both eyes for at least two months. However, it is recommended to find out the cause of your problem at an in-person appointment with an ophthalmologist.

After operation

Immediately after cataract surgery

After local anesthesia, you may feel sluggish. These sensations are normal and will pass fairly quickly.

Your doctor may give antibiotic drops to help prevent eye infections and anti-inflammatory drops to minimize swelling. They may cover your eye with an eye patch.

You may be prescribed medications and given instructions for caring for your eye. You will be scheduled for a follow-up visit(s) and then sent home. Your doctor may provide you with dark sunglasses for driving.

Relax and let the person accompanying you buy all the medications for which the doctor will write out prescriptions. The doctor will prohibit you from driving on your own.

Do not touch or rub your eye or remove the eye patch. The eye may remain sensitive and even itchy for several days. You may experience some minor glare or ghosting, but these will disappear over time.

Begin doing your normal daily activities - except driving - within the first 24 hours, unless your doctor instructs you otherwise. Do not lift anything heavier than 7 kg, as heavy lifting can increase intraocular pressure.

Keep your eye patch on while you sleep unless your doctor tells you to, and don't sleep on the operated side of your body.

The next day you will need to come to the doctor for a follow-up examination.

Do not wear eye makeup until your doctor tells you to do so.

If you are in good health, you should be able to resume intense exercise within a week.

The results of the surgery may vary from person to person. The information provided here is in no way a substitute for medical advice.

During the first month after surgery, the eye should recover completely. The brain will continue to adapt to the new IOL. If you have dry eye syndrome, your doctor may prescribe mild anti-dry eye drops.

Come back for a follow-up examination in a month. If you require cataract surgery in your other eye, it will most likely be done within this time frame. If you have a monofocal IOL and are not having surgery on your other eye, you will be prescribed new glasses or contact lenses at this time.

Challenge your vision by doing as many different activities as possible. The more your eyes and brain work in tandem, the more results you will enjoy.

Over the next 2-4 months you will adjust while feeling and seeing great. Your doctor may still want to check how your condition is changing, especially if you had bilateral cataracts.

If you have developed a secondary cataract in which the posterior capsule holding the IOL becomes opaque (which is rare), your doctor will perform a repeat procedure using a YAG laser on an outpatient basis.

After six months, vision should be optimal. Do absolutely everything you can.

After one year, have a full examination with an ophthalmologist and then do so annually.

Treatment of cataracts with earthworms here

How to take Katachrom eye drops correctly

Laser treatment

Laser treatment of cataracts is the most progressive and high-tech method of performing cataract operations today. This is the latest achievement in the field of ophthalmic surgery, which has proven itself well in the world. Cataract treatment using a femtosecond laser is now available in modern clinics.

Benefits of laser cataract treatment:

the highest level of precision in the operation.
Laser technologies used during the intervention provide ultra-precision at all stages;
quick recovery after surgery.
The use of a laser eliminates the use of mechanical instruments, and after surgery, all micro-accesses to the internal structures of the eye quickly self-seal;
gentle effect.
The use of a laser allows us to minimize the effect of ultrasound on the internal structures of the eye during surgery and avoid the risk of postoperative corneal edema;
maximum quality of visual characteristics.
The precision of the laser allows you to achieve maximum quality of vision when implanting intraocular lenses, especially high-tech ones (toric, multifocal, pseudo-accommodating);
rapid restoration of visual acuity.
The laser ophthalmological system allows you to automate the most complex stages of cataract surgery, the quality of which has a direct impact on the final result of the operation - the patient’s visual acuity;
stable predictable results.

The equipment and technologies used during the operation make it possible to carry out a truly personalized operation, taking into account the individual characteristics of the visual system of each patient, and therefore predict the result.

What is the difference between laser cataract treatment and traditional surgery?

The main difference between the new technology and traditional surgery is the method of creating access to the internal structures of the eye, the lens, as well as the mechanism of destruction of the lens. During a traditional operation, these stages of intervention are performed using special microsurgical instruments. When using a surgical laser, manipulations are performed non-contactly using a laser beam. Fragmentation of the lens before it is removed from the eye during traditional surgery occurs using only ultrasound. Laser treatment allows this stage to be carried out using a laser beam, and accordingly, the impact of ultrasound is reduced.

Stages of laser cataract surgery

Based on optical coherence tomography (OCT) studies, all the necessary eye parameters are determined before the operation, on their basis the course of the intervention is calculated and the configuration of the corneal approaches is modeled.
A femtosecond laser forms accesses of a given configuration to the internal structures of the eye and to the lens, the process is broadcast on a special monitor in 3D mode.
The femtosecond laser system exfoliates the nucleus of the lens. Destruction of the lens can be done in two ways: in sectors or circularly.
A femtosecond laser is used to create a hole in the lens capsule. Thanks to the unique properties of femtosecond technologies, as well as ultra-precise research, the hole is perfectly even in shape, and its alignment is absolutely accurate. At this stage, the laser effect is completed, and the ophthalmic surgeon performs further manipulations using a microsurgical system.
The lens, fragmented by a laser beam, is converted into an emulsion using a microsurgical system under the influence of ultrasound and removed from the eye.
Through a micro-access up to 1.6 mm in size, a flexible intraocular lens is inserted into the capsule where the lens was previously located, which unfolds independently inside the eye and is securely fixed.

Equipment used for laser treatment of cataracts

To perform the operation using a new technique, the LenSx surgical femtosecond laser system from Alcon (USA) is used. This is the first femtolaser system of its kind specifically designed for cataract surgery to receive FDA approval. The system has been registered and certified in Russia. The equipment has all the necessary certificates, warranty coverage and multi-level clinical support.

The LenSx surgical laser system is equipped with a built-in intraoperative optical coherence tomograph (OCT). This allows you to study and automatically calculate the parameters of the intervention, and during the operation - to fully control the state of the internal structures of the eye. As a result, the highest level of accuracy and safety of the intervention is achieved. Laser treatment of cataracts can be called a truly personalized operation: the system calculates all parameters individually for each patient.

How does a surgical femtosecond laser work?

The peculiarity of the femtosecond laser is that its beam can be focused to any depth with an accuracy of several microns. This creates a layer of microbubbles that separates tissue at the molecular level without generating heat or affecting surrounding tissue. The femtosecond laser places many bubbles in close proximity, creating a precise profile of the desired configuration. Thus, there is no cutting, but delamination of the tissues.

Results of laser cataract treatment

getting rid of cataracts once and for all in the most gentle and most progressive way to date;

minimal recovery period after surgery;

the risk of postoperative astigmatism is eliminated due to virtually non-contact exposure;

obtaining qualitatively better visual characteristics when implanting high-tech lenses;

rapid restoration of visual acuity after surgery;

predictable results due to ultra-precision and individualization of the intervention;

treatment of cataracts in cases where traditional surgery may be refused due to contraindications.

Rehabilitation

To protect the injured eye from any damage and infection, it is necessary to strictly adhere to the rules of rehabilitation. Usually, they are the same for everyone, but in some cases, an ophthalmologist can develop an individual list of rehabilitation rules.

During postoperative rehabilitation, you must adhere to the following recommendations:

Mode. In the first days after surgery, the patient does not have to adhere to bed or semi-bed rest, but the amount of physical activity should be minimal. Any activity should continue until even the slightest fatigue occurs, not only in the eye, but throughout the body.

Hygiene. Washing your face is strictly prohibited; if ordinary water accidentally gets into the operated eye, it must be immediately rinsed with a solution of furatsilin or chloramphenicol. In the first days after surgery, it is strongly recommended not to wash your hair; any water procedures should only affect the body up to the neck, and no higher. The use of any cosmetics or facial cleansers is prohibited.

Visit doctor. Visits to a doctor should not be neglected, since only he, with knowledge and special tools, will be able to fully examine the operated eye and determine the presence or absence of complications.

Bandage. After the operation, the surgeon applies a bandage to the eye; it can only be removed the next morning. Wearing a bandage is mandatory when leaving home and recommended at home.

Eye drops. Regardless of the activity of the healing processes, eye drops are an indispensable means of rehabilitation. They protect the eye from the development of infectious diseases, protect it from irritation and soothe inflamed tissues. The doctor independently, in accordance with the individual characteristics of the patient, determines the optimal type of eye drops and the frequency of their use. Drops play a vital role in active healing and restoration of functionality of the eye.

Complications

According to the American Society of Cataract and Refractive Surgeons, about 3 million cataract operations (IOL implantations) are performed annually in the United States (there are no data for Russia). Moreover, the number of successful operations is more than 98 percent. The complications that arise are now, in most cases, successfully treated conservatively or surgically.

The most common complication is opacification of the posterior capsule of the lens, or “secondary cataract.” It has been established that the frequency of its occurrence depends on the material from which the lens is made. So, for IOLs made of polyacrylic it is up to 10%, while for silicone ones it is already about 40%, and for those made from polymethyl methacrylate (PMMA) it is 56%. The true reasons leading to this and effective methods of prevention have not currently been established.

It is believed that this complication may be due to the migration of lens epithelial cells remaining after removal into the space between the lens and the posterior capsule, and, as a result, the formation of deposits that impair image quality. The second possible cause is fibrosis of the lens capsule. Treatment is carried out using a YAG laser, which is used to create a hole in the central zone of the clouded posterior capsule of the lens.

In the early postoperative period, an increase in IOP is possible. The reason for this may be incomplete washout of viscoelastic (a special gel-like drug injected into the anterior chamber of the eye to protect its structures from damage) and its entry into the drainage system of the eye, as well as the development of pupillary block when the IOL is displaced towards the iris. In most cases, using anti-glaucoma drops for several days is sufficient.

Cystoid macular edema (Irvine-Gass syndrome) occurs after phacoemulsification of cataracts in approximately 1% of cases. With the extracapsular lens removal technique, this complication is detected in approximately 20 percent of patients. Those suffering from diabetes, uveitis, and “wet” AMD are at greater risk. The incidence of macular edema also increases after cataract extraction complicated by posterior capsule rupture or vitreous loss. Corticosteroids, NSAIDs, and angiogenesis inhibitors are used for treatment. If conservative treatment fails, vitrectomy may be performed.

Corneal edema is a fairly common complication after cataract removal. The cause may be a decrease in the pumping function of the endothelium, provoked by mechanical or chemical damage during surgery, an inflammatory reaction, or concomitant ocular pathology. In most cases, swelling goes away without any treatment within a few days. In 0.1% of cases, pseudophakic bullous keratopathy develops, in which bullae (blisters) form in the cornea. In such cases, hypertonic solutions or ointments, medicinal contact lenses are used, and the pathology that caused this condition is treated. If there is no effect, a corneal transplant may be performed.

Quite common complications of IOL implantation include postoperative (induced) astigmatism, which can lead to a deterioration in the final functional result of the operation. Its value depends on the method of cataract extraction, the location and length of the incision, whether sutures were applied to seal it, and the occurrence of various complications during the operation. To correct small degrees of astigmatism, glasses or contact lenses can be prescribed; for severe astigmatism, refractive surgery can be performed.

Displacement (dislocation) of the IOL is much less common than the complications described above. Retrospective studies showed that the risk of IOL dislocation in patients 5, 10, 15, 20 and 25 years after implantation was 0.1, 0.1, 0.2, 0.7 and 1.7 percent, respectively. It has also been established that in the presence of pseudoexfoliation syndrome and weakness of the zonules of Zinn, the likelihood of lens displacement increases.

After IOL implantation, the risk of developing rhegmatogenous retinal detachment increases. Patients who had complications during surgery, suffered an eye injury in the postoperative period, had myopic refraction, or had diabetes are more susceptible to this risk. In 50 percent of cases, detachment occurs in the first year after surgery. Most often it develops after intracapsular cataract extraction (5.7%), less often - after extracapsular (0.41-1.7%) and phacoemulsification (0.25-0.57%). All patients after IOL implantation should be regularly monitored by an ophthalmologist for early detection of this complication. The principles of treatment are the same as for detachments of other etiologies.

It is extremely rare that choroidal (expulsive) bleeding develops during cataract removal. This is an acute, completely unpredictable condition in which bleeding occurs from the choroidal vessels that lie under the retina and feed it. Risk factors are arterial hypertension, atherosclerosis, glaucoma, aphakia, a sudden increase in IOP, axial myopia or, conversely, a very small anterior-posterior size of the eye, inflammation, taking anticoagulants, and old age.

In some cases, it resolves on its own and has little effect on the visual functions of the eye, but sometimes its consequences can lead to loss of the eye. For treatment, complex therapy is used, including local and systemic corticosteroids, drugs with cycloplegic and mydriatic effects, and antiglaucoma drugs. In some cases, surgical treatment may be indicated.

Endophthalmitis is a rare complication of cataract surgery, leading to a significant decrease in visual functions up to their complete loss. The incidence, according to various sources, ranges from 0.13 to 0.7%.

The risk of development increases if the patient has blepharitis, conjunctivitis, canaliculitis, obstruction of the nasolacrimal ducts, entropion, when wearing contact lenses and a prosthesis of the fellow eye, after recent immunosuppressive therapy. Symptoms of intraocular infection are severe redness of the eye, pain, increased sensitivity to light, and decreased vision. In order to prevent endophthalmitis, instillations of a 5% povidone-iodine solution are used before surgery, antibacterial agents are introduced into the chamber or subconjunctivally, and possible foci of infection are sanitized. It is important to preferentially use disposable or carefully reprocess reusable surgical instruments.

Contraindications for removal

In order to somehow cope with the disease, it is necessary to perform an operation. But, like any other surgical intervention, there are also contraindications for cataract surgery. The operation itself can be performed using several methods, but the choice of method depends on which clinic the operation is performed in and how advanced the disease process is.

There are no true contraindications for eye cataract removal yet. That is, the operation can be performed at almost any age. However, there are so-called relative contraindications that you should definitely pay attention to.

Such contraindications include the following diseases:

Diabetes of any type and any complexity

Hypertension to any degree

Heart diseases – congenital and acquired

Chronic diseases

These contraindications to cataract surgery should be taken into account, but this does not mean that the operation will be impossible with them. Just before removing a cataract, you should definitely consult with your doctor and find out exactly how the above diseases will affect the course of the operation itself and the healing process.

After the operation, restoration of a person’s vision can take up to a week. However, everything here is strictly individual. This will depend on the method used to carry out the operation and how successful it was.

After cataract surgery, the patient is simply obliged to follow a number of rules.

Firstly, he should not lift more than three kilograms of weight for a long time.

Secondly, you should not make too sudden movements and do not tilt your head too much down. This may cause poor performance in the postoperative period, and in some cases may lead to a repeat operation.

Thirdly, limit exposure to the open sun, do not visit a bathhouse or sauna, and do not use too hot water when washing.

Fourthly, when leaving home at any time of the year, be sure to wear sunglasses.

If, after the operation, the patient has some other diseases that affect vision and the condition of the eyes, then the rehabilitation period can drag on for quite a long time.

Complications during lens replacement

After lens replacement, complications are minimal. The most common occurrence is opacification of the posterior capsule of the implant. This condition is called secondary cataract. But this interpretation is incorrect, since cataract itself cannot occur. This pathology is not scary and can be successfully corrected with a laser. After surgery, lens displacement, inflammation and infection are also possible. To avoid infection, ophthalmologists recommend using special anti-inflammatory drops after lens replacement. With a properly organized postoperative period, possible complications are minimized.

Drops

It should be remembered that eye drops can only slow down the development of the disease, but not heal it completely. But in some cases, surgery cannot be performed, and then eye drops become the main method of treatment. The sooner you start drug treatment, the better the result. Since cataracts are a chronic disease, treatment with drops must be carried out constantly; breaks lead to progression of the disease.

Pharmaceutical companies have developed a huge number of drugs for the treatment of cataracts. Eye drops vary in price, effectiveness and side effects.

The most common drops for cataracts are vitaiodurol, vitafacol, Smirnov drops, quinax, oftan-catachrome. The composition of any drops against the progression of cataracts includes vitamins B and C, potassium iodide, amino acids and antioxidants.

The situation in ophthalmology is that none of the cataract drugs have had comprehensive efficacy studies conducted independently of the pharmaceutical company. This means that numerous cataract drops do not have an evidence-based scientific basis for use. Vitamins, of course, won't do any harm. But whether they will cure cataracts is a big question.

Experts believe that of all the variety of drops, only Quinax eye drops for cataracts deserve special attention. For a stable result, you will need regular use; you need to instill it into the sore eye - one drop three times a day.

Cataract

Cataract is a clouding of the lens, leading to a decrease in the passage of light rays and a decrease in visual acuity. In most cases, cataracts are an age-related pathology. The disease can be diagnosed in children as congenital or develop at any age due to injury, inflammation or the presence of general pathology. MORE DETAILS

The only way to eliminate the pathology is a microsurgical operation, which consists of removing the clouded lens of the eye and replacing it with an artificial lens (IOL).

Currently, the practice of the Eye Microsurgery MNTK uses a high-tech method of sutureless surgery, in which cataract removal is carried out using ultrasonic phacoemulsification. and an artificial lens is implanted through an ultra-small incision or laser crushing of the cataract is performed, followed by suctioning out the lens fragments. With these operations, the incision is so small that it does not need to be sutured.

Today, the Eye Microsurgery MNTK uses advanced femtosecond technologies to perform key stages in cataract surgery.

Most of the stages of cataract surgery, previously performed directly by the surgeon, are taken over by the femtosecond laser system. The laser independently forms a corneal incision, a circular capsulorhexis and crushes the lens.

The advantage of using a Femtolaser is:

remote (without the use of surgical instruments) destruction of the lens, which avoids many complications

unsurpassed precision in performing the main stages of the operation.

safety of the operation with predictably high functional results.

the ability to ensure the ideal and stable position of modern models of artificial lenses for many years.

reducing the rehabilitation period to several hours, which makes it possible to perform such operations on an outpatient basis.

In some cases, when phacoemulsification or laser removal of cataracts is impossible, the surgeon uses other methods for removing the cloudy lens, in which the surgical incision is sutured with a special ultra-thin thread.

The Eye Microsurgery MNTK has accumulated enormous experience in surgical interventions for cataracts, more than 1 million operations have been performed over 20 years. Thanks to the works of S.N. Fedorov and his school, these interventions have become available to many patients around the world, and their prospects for the coming decades have been determined.

DIAGNOSIS OF CATARACTS

TREATMENT

Constant improvement of phacoemulsification technology for cataracts, introduction into clinical practice of new models of intraocular lenses and devices for surgical treatment have made cataract surgery a safe, highly effective and predictable treatment method that practically does not reduce the performance of our patients. Modern techniques for performing cataract surgery make it possible to obtain maximum visual functions already on the first day after surgery.

What is cataract

Cataract- visual impairment due to clouding of the eye lens. 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.

Causes of cataracts

Cataracts are caused by certain eye injuries, such as mechanical and chemical injuries. Also, the occurrence of cataracts is influenced by such reasons as certain eye diseases, such as glaucoma or high myopia, as well as diabetes mellitus, vitamin deficiency, or long-term use of certain medications. According to some sources, in more than 20,000,000 people in the world, this disease began the onset of blindness. 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 a narrowing of intraocular vessels);

Toxin poisoning;

Strong radioactive background;

Long-term use of medications;

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 of age-related cataracts:

Blurred vision;

The appearance of more or less large “blind spots” in the field of view - areas where visible objects seem to be hidden by fog. At the same time, there is a feeling that a person is looking through glass, which has stains of dirt on it, making it difficult to see clearly;

Deterioration in color perception;

The appearance of vision problems in sunlight or bright artificial lighting;

The appearance of a halo around light sources - lamps, traffic lights, and so on.

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 eye pain, headache, redness of the eyes, and increased sensitivity or tenderness 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 from a doctor 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:

blurry vision - “like in a fog”;

deterioration of night vision;

increased sensitivity to bright light;

the need to use brighter light when reading, etc.;

the need to frequently change the level of diopters in glasses and contact lenses;

weakening of color perception; double vision if the opposite eye is closed.

Cataracts do not usually 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. If you have symptoms of cataracts, it is recommended that you visit an ophthalmologist for an examination.

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

Cataracts are an insidious disease and only a qualified specialist can determine whether you have it. 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, but also the deep tissue structures of the eye. 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

Cataract surgery

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 on even such a small organ as the eye is a big burden for the body, and the ophthalmic surgeon must be sure that the person will endure 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, first of all, on the initial condition of the eye. 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 the recovery period after surgery, 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, protect the patient’s eyes from any side effects, 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 your 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 by the human body. They are very often prescribed even before surgery.

Today, there are a lot of similar drugs that differ in price, effectiveness and the presence of contraindications. For example, “Vitafacol”, “Quinax”, “Taufon”, “Vitaiodurol”, “Vicein” and many others are popular. 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 warm boiled water 1:3 and drop 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 of a complex treatment; you need a certain diet, taking vitamins, and so on, it requires a lot of patience and punctuality.

To stop clouding of the lens of the eye (cataract development). and also improve your eyesight, you should constantly drink a decoction of non-roasted sunflower seeds without restrictions. Pour 250g of seeds into 3 liters of boiling water and 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 eye treatment.”

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

To prevent cataracts, it is recommended to replenish certain substances in the body, such as antioxidants. These include: glutathione, lutein, vitamin E. A balanced diet, abstinence from smoking and alcohol, and physical activity can prevent the development of cataracts. Regular examination by an ophthalmologist for people over 50 years of age.

When an ophthalmologist diagnoses a patient with initial cataracts, eye drops are often prescribed, which improve metabolic processes in the lens. These medications are 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.