Cataract surgery and the main information about it.

Cataract surgery and the main information about it.

Cataract surgery is one of the most common surgical interventions in general. This is the only option for the treatment of progressive cataracts (clouding of the lens). In the process of a microsurgical operation, the clouded lens is removed and replaced by an artificial lens. Cataract surgery usually provides a complete recovery of vision. The cataract is a clouding of the eye lens. The eye lens is subject to the aging process, which also leads to the fact that it becomes cloudier during life. A cataract occurs usually in people older than 60 years. Only in rare cases, it is congenital. Often people who are sick with cataract become more sensitive to light. If the clouding of the lens progresses and visual acuity noticeably worsens, the cataract surgery is the only treatment option.

Throughout the world, cataract is the most common cause of blindness because this disease leads to loss of vision without proper treatment. The clouding of the lens develops slowly. It can be seen only after a long time. Clouding of the lens (cataract) can be successfully cured only through cataract surgery. During a cataract surgery, the cloudy lens is removed and replaced with a transparent artificial lens, which parameters are pre-calculated accurately.

Cataract surgery and its development

Ophthalmic surgery has developed in recent years in such a way that cataract surgery can be classified as the safest. The timing of such an operation is determined primarily depending on how much the disease has a negative impact on the daily life of the patient. In most cases, the operation can be performed on an outpatient basis and patients can return home within a few hours after the end. If the disease struck both eyes, then the operation is only performed on one eye and later on the second.

Mention of the clouding lens that develops in the eyeball is found even in ancient Indian medicine thousands of years before Christ. Monuments of Ancient Assyria and Egypt indicate the cataract surgery. In 1705, the French surgeon proved that cataract is a clouding of the lens. In 1748, Jacques Daviel described the technique of removing the cloudy lens. Since that time, the history of modern cataract surgery has begun. Currently, for the operation with cataracts, there is no need to wait for her ripening. This is a common misconception. Many years ago, when cataract surgery only appeared, the removal of the clouded lens was performed only at full maturity of the cataract.

In recent decades, due to the introduction of a variety of modern technologies, modification of the procedure of surgery, improvement of microsurgical instruments, the issue of indications for surgery has been substantially revised. With modern possibilities of eye microsurgery, it became possible to perform a cataract extraction operation with practically no complications. This contributed to a significant increase in indications for surgical treatment of cataract.

At present, the operation can be performed with a visual acuity of 0.1-0.2 (in some cases, visual acuity can be higher if it is necessary to preserve professional activity).Removal of the clouded lens (cataract surgery) is “a pearl” of modern microsurgery of an eye. At today’s level of its development, cataract surgery has reached a qualitatively new stage, which is characterized by the extensive use of so-called “energy methods” (use of ultrasound or laser energy to crush the lens).

Currently, there are several types of cataract surgery:

  • Extracapsular extraction of cataracts
  • Intracapsular Cataract Extraction
  • Ultrasonic phacoemulsification
  • Laser cataract surgery (laser phacoemulsification)

In the last decade, the actual standard of cataract surgery was the ultrasonic phacoemulsification first applied by Kelman in the early 70s of the last century. The principle of the method is that the tip of the ultrasonic device (phacoemulsifier) is inserted into the anterior chamber through a minimal incision (usually about 3 mm). Under the influence of ultrasonic vibrations, the substance of the lens is crushed to the state of emulsion. Then, according to the tube system, the lens masses are removed from the eye.

Continuous improvement of the technique of operation contributed to the emergence of numerous new phacoemulsification techniques, the use of which allows minimizing the operational trauma by reducing the operating time of ultrasound, to obtain higher functional results and a quiet course of the postoperative period. In the last 20 years, several technologies for laser cataract extraction have been proposed, based on the use of different types of lasers (Er: YAG, Nd: YAG, excimer laser, etc.). The most suitable for cataract surgery was the Nd: YAG laser.

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