Cataracts

What are cataracts?

A cataract is the loss of transparency of the crystalline lens.

Let us imagine that the eye is like a camera. They all have a lens device responsible for focusing the images from the outside onto the sensitive film. In the case of the human eye, this film is the retina. These lenses are formed, firstly, by the cornea, which is the most powerful lenticule in the eye and the most external one, and, on the inside, by the crystalline lens (located behind the diaphragm that forms the iris). This lens is responsible (until about the age of 50) for varying the focus until objects at different distances can be seen clearly.

‍‍With the passage of time, the crystalline lens naturally becomes more and more opaque as it hardens and the amount of light that enters it becomes less and less. The result is that vision gradually becomes blurred. It is precisely the loss of transparency of the crystalline lens that is known as cataracts.

‍While it is important to know what we are talking about when we talk about cataracts, it is also important to know what they are not and to clear up some misconceptions and misconceptions about this pathology. A cataract is not a cloth that covers the eye or the consequence of using it too much. Nor are they a cancer or a contagious disease. They are not transmitted from person to person or from one eye to another.

Cataract surgery

Cataracts can nowadays be easily and quickly removed by surgery. This is the only way to remove them. There are no medications, dietary supplements, exercises or optical devices that can cure or delay the progression of cataracts.

Cataract surgery consists of replacing the altered crystalline lens material with an artificial lens or intraocular lens.

What is the pre-operative period for cataract surgery like?

Diagnostic tests

Bearing in mind that the crystalline lens is the one that allows us to focus images thanks to its dioptric power and that it is going to be replaced by an intraocular lens, we must calculate very precisely what the power of this lens should be.

For this reason, before surgery, a series of diagnostic tests are carried out to check the state of your eye in general and the different structures that make it up in particular (crystalline lens, retina, cornea, etc.).

The tests are non-invasive. The patient only has to look at a light for a few seconds without blinking.

Prior medication

Once all the tests have been carried out, the patient must take a series of pre-medication in the form of eye drops. On the same day as the tests, the patient will be given the appropriate instructions on how and when to administer the medication.

What is cataract surgery like?

What should I do on the day of surgery?

On the day of the operation, the most important thing is to come to our centre fasting from the night before. This includes NO water intake.

‍Once you have completed the admission procedure, you will go directly to the surgical area where you will first be seen by the anaesthetist. He/she will prepare you for the operation by placing an IV through which you will be administered a light sedation that will help you to be completely relaxed, as well as any other type of medication if necessary.

‍Once you are in the operating theatre, you will be given a series of anaesthetic eye drops to completely “numb” the ocular surface. Just before surgery begins, you will be inoculated with a more powerful anaesthetic that will help to completely anaesthetise the eye.

What does the surgery involve?

The purpose of the procedure is to remove the hardened and opacified crystalline lens and replace it with an intraocular lens or artificial lens.

To do this, a small 2.5mm incision is made at the edge of the cornea through which a small probe is inserted. This probe has three functions: to emit ultrasound -to fragment the lens-, to aspirate the opacified crystalline material and to irrigate -to compensate for the loss of extracted material and maintain the intraocular pressure at correct levels-.

Subsequently, the intraocular lens is inserted to replace the natural crystalline lens and the incision is closed by simply moisturising the wound.

At the end of the procedure, the patient will be able to walk out on their own and, although their vision will not be perfect, it will be good enough to lead a practically normal life.

Will I be able to sleep through the surgery?

It is not advisable for the patient to be completely asleep during the procedure as some cooperation is required. They simply have to look at a light that will be placed over their eye. This is important because if the patient is asleep, the eye would not be well positioned and could complicate the surgical manoeuvres and cause the lens to be poorly centred.

Will I feel any pain?

No. The amount of anaesthetic, both topical and local, administered, together with the sedation will ensure that the patient feels absolutely no pain. In any case, they may feel a certain sensation of pressure, but never pain.

What is the postoperative period like?

When will I start to see 100% well?

It should be borne in mind that recovery involves the regeneration of certain tissues that have been manipulated, albeit minimally. Each patient, depending on many factors, will recover more or less quickly. However, in general, we will have more than acceptable vision from 5-7 days after the operation and much more normal vision after 3 or 4 weeks.

What can and cannot I do after surgery?

In general, you will be able to lead a normal life almost from day one. However, there will be certain restrictions:

‍YOU CANNOT:

Drive on the day of the operation. This is because you have been given a sedative and may suffer drowsiness.
Lift weights. For the first few days it is not advisable to lift excessive weight such as a shopping basket.
Swimming. For at least a week it is best to avoid wearing swimming goggles as they can put pressure on the eyes.
Running or impact sports. To avoid risk it is best to wait at least a week before doing any sport, but especially if it is an impact sport.

IF YOU CAN

Watch TV or any other digital device.
Read. Both this activity and the previous one will only be restricted due to the possible discomfort you may suffer during the first few days after the operation.
Work. This will depend on the type of work to be done, but if it is an activity that does not involve any risk, you will be able to return to work quickly.

How long does the intervention last?

The procedure lasts about 10 minutes per eye and, at the end, the patient can go home on their own.

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