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Cataracts

Cataracts

The eye’s natural crystalline lens is, together with the cornea, responsible for focusing images clearly on the retina. Cataracts is caused by the eye’s natural crystalline lens losing its transparency and becoming cloudy, principally due to old age and a phenomenon called photooxidation. Unfortunately, it’s impossible to predict the appearance of a cataract.

What are the symptoms of cataracts?

The first symptoms that a patient perceives when cataracts begins to develop are: loss of intensity of colours, glare and poor vision particularly at night or with little light. As the condition develops, the sharpness of sight gets gradually worse until vision is significantly impaired changing the patient’s quality of life.

How can cataracts be treated?

Currently surgery is the only treatment available with phacoemulsification being the most advanced technique to eliminate the condition. Phacoemulsification consists of fragmenting and removing the cloudy natural crystalline lens using ultrasound. At the end of the procedure an artificial intraocular lens (IOL) is inserted to replace the eye’s natural lens that has been removed. This is all carried out by making a microincision in the cornea which doesn’t require any stitches.

Cataract surgery is a procedure that lasts just a few minutes and is carried out using a local anaesthetic. There is no need for the patient to stay overnight at the hospital and generally does NOT need to stop taking any regular medication. Following a brief stay at the clinic and an initial post-operative check, the patient is able to return home by themselves, normally with their eye uncovered.

Are both eyes operated on in the same day?

This depends on each case.

When does a cataract need to be operated on?

There is no definitive answer to this question. If the condition is preventing you from performing everyday tasks, then cataract surgery is recommended. The speed at which the cataract worsens varies depending on each patient. The stage of development of the cataract is very important as if it’s particularly advanced, it cannot be operated on. In fact, the more advanced the cataract is, the more complications that could appear during surgery.

What complications are involved in cataract surgery?

The risk of complications in cataract surgery performed by expert an surgeon is very low but no surgery is completely risk free. After surgery there may be a temporary increase in intraocular pressure which is easily controlled using eye drops. The most worrying complication would be intraocular infection, despite all the aseptic and antiseptic measures used, although nowadays it’s very rare.

Can the cataract return after surgery?

Following the operation, the cataract cannot return.

Types of intraocular lenses

Thanks to advances in IOL technology it’s currently possible to correct presbyopia (eye strain), short-sightedness, long-sightedness and/or astigmatism at the same time as removing the cataract.

Using state-of-the-art technology, at Clínica Castilla we are able to choose and insert the most suitable intraocular lens for each patient. The different types of IOLs that exist are monofocal, trifocal, multifocal and toric intraocular lenses.

  • MONOFOCAL lenses provide good distance vision but patients will require glasses for near and intermediate vision.

  • MULTIFOCAL and TRIFOCAL lenses provide good vision at all distances: far, near and intermediary, without the need for glasses.

  • TORIC lenses are used to correct astigmatism. There are monofocal toric and multifocal toric lenses available.

Traditionally, a monofocal intraocular lens was inserted following cataract surgery. As mentioned above, patients using monofocal lenses obtain good distance vision but still need glasses for intermediary (e.g. working with a computer) and near vision (e.g. reading or sewing). However, if the patient’s cloudy natural crystalline lens is replaced with a multifocal or trifocal lens in the cataract surgery then they will benefit from good vision at all distances (from watching TV to reading) without having to use glasses.

Although multifocal and trifocal lenses are normally implanted during cataract surgery, they are also used to correct presbyopia in patients whose natural crystalline lens has not yet turned cloudy. Those patients who have had these lenses inserted to correct presbyopia will not require cataract surgery in the future since their eye’s natural crystalline lens has already been removed.

In some cases, cataract and Lasik surgery procedures can be combined to correct defects in vision that cannot be solved by only one procedure.

In any case, in order for the cataract surgery to be a success we know that each patient must be individually assessed. At Clínica Castilla we offer a wide range of intraocular lenses of the highest standard which allow our patients to enjoy the amazing results they had been expecting.

Can intraocular lenses break or get dirty over time?

The intraocular lenses that are used nowadays will not break or get dirty over time since they are made from a biocompatible material that keeps its structure in tact without needing to be replaced.

During cataract surgery, the intraocular lens is supported on a structure of the eye ball called the posterior capsule. Over time the initially transparent posterior capsule becomes cloudy causing a loss of sharpness in vision. The clouding of this posterior capsule is what is commonly known as the intraocular lens “getting dirty”. The clouding of the posterior capsule is easily solved using Yag laser treatment.