Description of condition
A cataract is a progressive opacity of the lens – the disc-shaped structure inside the eye. The most common form is senile cataract. The condition is painless and manifests as a gradual deterioration of the eyesight, consisting of:
- blurred vision,
- impairment of the perception of contrast and colours,
- frequent change of spectacle correction, near-sightedness,
- double vision in one eye,
- sight disorder in strong light,
- light fission.
To find out more about cataracts and their treatment, watch the film Cataracts.
The most commonly applied operating technique is the phacoemulsification method accompanied by implantation of a foldable lens.
Since 2013, we have been using a femtosecond laser for selected cases of cataracts.
We also operate on complicating cataracts using the intrascleral or iridal fixation method in cases of subluxative cataracts (e.g. in Marfan’s syndrome).
For cataracts co-occurring with glaucoma, we combine the operations with anti-glaucoma treatments; Trabeculectomy, canaloplasty, implanting an express type valve or Xen gel or ECP.
Cataract surgery methods
Cataract surgery using the latest operating methods and equipment gives the patient several vital benefits: short convalescence time, no post-operative stitches – little risk of secondary astigmatism, better patient comfort during the operation due to the shorter operating time (around a quarter hour) and standard local anaesthetic, and use of the most modern lenses which increasingly replicate the functions of healthy, young human lenses provides the patient with better comfort of life and dispenses with at least one pair of spectacles.
The standard for cataract surgery is phacoemulsification, i.e. removing the opaque lens using ultrasound. Then a folding artificial lens is implanted to replace the natural one.
Laser surgery – femtophacoemulsification of cataracts:
The most modern method of removing cataracts involves the use of a femtosecond laser. It was pioneered by Prof. Jerzy Szaflik, who introduced it in 2012 as the first in Poland and one of the first in Europe. Since 2013 it has also been in use at our Clinic. Prof. Jerzy Szaflik and Prof. Jacek P. Szaflik are more experienced in this type of operation than anyone else in Poland. They are also among the leading surgeons in Europe using femtosecond lasers for cataract surgery.
Laser cataract surgery is a very precise technique. The laser, which practically replaced the surgeon’s hand and scalpel, makes ports in the cornea through which to introduce the instruments, the opaque lens is separated with perfect accuracy from the other eye tissues and them broken up. The surgeon then introduces instruments through the ports and removes the fragmented lens. This is replaced with a foldable artificial lens. The precision which a femtosecond laser allows enables excellent effects to be achieved from the operation and the artificial lens to be precisely implanted. Operations of this type are spectacularly effective, especially in patients who decide to use toric or multifocal lenses (TORIC, RESTOR, RESTOR TORIC).
The use of lasers in cataract surgery is another method which has significantly improved the safety of the operation. Using a femtosecond laser to break up the opaque lens makes the operation more precise and less traumatic for the eye tissue, which is vital for patients with degenerative corneal conditions.
The operation itself
All eye operations are carried out as outpatient procedures. This means that the patient leaves the clinic 2-3 hours after the operation.
The patient arrives at the clinic at the designated time on the day of the operation. The patient is prepared for the operation in the pre-operative ward. Every patient is given a bed and can therefore wait in comfort for the operation. During this time, they are given the appropriate local and general medicines necessary for the operation to be carried out safely.
The operations usually take place with the use of anaesthetic drops. In certain cases, e.g. the patient does not cooperate, or the procedure is more complicated such as the operation being combined with glaucoma surgery, there can be anaesthetic in the eye area or general anaesthetic.
The patient then enters the operating theatre. The operation lasts about 15-20 minutes and the patient returns to the post-operative ward to rest, and is given a meal. Before the patient leaves the clinic, a doctor checks the condition of the eye and makes recommendations. A nurse informs the patient and family how to behave at home and how to apply the drops.
What contact lens
During cataract surgery, the patient’s opaque lens is replaced with an artificial one. It is vital to choose the appropriate lens individually for each patient.
The choice of intraocular lens is preceded by ophthalmological tests and a detailed interview with the patient which determines the patient’s expectations. The doctor asks about their lifestyle, occupation, etc.
We can use single-vision lenses, which enable the patient to see well from near or far, or multivision lenses which make spectacles unnecessary to function in any situation. Astigmatism can also be corrected with single-or multivision lenses.
We usually use various lenses by the US company ALCON, such as:
AcrySof Natural lens – a soft folding hydrophobic lens with UV and blue light filters which help prevent AMD (age-related macular degeneration).
The AcrySof IQ lens is a soft folding hydrophobic lens with UV and blue light filters, with an aspherical construction which reduces light scattering and unwanted photo-optical phenomena, and improves the quality of vision.
The AcrySof Toric IQ lens is a soft folding hydrophobic lens with UV and blue light filters, with an aspherical and toric construction. The structure of the lens additionally enables astigmatism to be corrected and patients freed from the necessity to use cylindrical spectacles after the operation.
The AcrySof IQ ReSTOR lens is a soft folding hydrophobic multi-vision lens with UV and blue light filters, with an aspherical construction which has a diffraction grating built into the implant, allowing two images to be obtained for far and near, and presbyopia to be corrected. Patients with this type of lens can function after the operation without glasses for far vision or reading.
The AcrySof IQ ReSTOR Toric lens is a soft folding hydrophobic multi-vision lens with UV and blue light filters, with an aspherical and toric construction which has a diffraction grating built into the implant, allowing two images to be obtained for far and near. It is a multi-focal implant intended for people with co-occurring astigmatism. Patients with this type of lens can function after the operation without glasses for far vision or reading.
The Panoptix lens is a soft folding hydrophobic multi-vision lens with UV and blue light filters, with an aspherical construction which has a diffraction grating built into the implant, allowing images to be obtained for far, indirect distances, and near. Patients with this type of lens can function after the operation without glasses.
The Panoptix Toric lens is a soft folding tri-focal multi-vision lens with UV and blue light filters, with an aspherical and toric construction which has a diffraction grating built into the implant, allowing images to be obtained for far, indirect distances, and near. It is a multi-focal implant intended for people with co-occurring astigmatism. Patients with this type of lens can function after the operation without glasses.
We also use multifocal Reverso lenses combined with a one-off implant of a Acrysof IQ lens for cataract surgery and correction of presbyopia.
Check-ups and convalescence
- first check-up – the day after the operation,
- further check-ups are determined by the attending doctor. Check-ups are free of charge during the first two weeks after the operation.In the case of patients for whom we plan to operate on the other eye, the final check-up can double as an eligibility test. The second eye can be operated on two weeks after the first operation.