home All hormones Cataracts - conservative treatment, types of operations to replace the lens of the eye, folk remedies, prevention. Cost of cataract surgery. Cataract operation video Ready-made eye drops for cataracts

Cataracts - conservative treatment, types of operations to replace the lens of the eye, folk remedies, prevention. Cost of cataract surgery. Cataract operation video Ready-made eye drops for cataracts

In the early stages it can be treated with medication. With a prolonged stage, image distortion occurs and vision decreases. In this case, the only solution is to remove the cataract. If surgery is performed by an experienced doctor and all instructions are followed, recovery occurs quickly.

How are cataracts removed?

In medical practice, conservative methods are used to combat this pathological condition. Methods of performing cataract surgery depend on the characteristics of the disease. There are the following types of surgical procedures:

Ultrasonic phacoemulsification. This is the most reliable method for removing cataracts. It is used at the initial stage of pathology development. A small (3 mm) incision is made on the cornea, through which all further manipulations are carried out.
Laser. An instrument is inserted through a micro-incision made on the cornea. The beam destroys the damaged area of the lens.
Extracapsular extraction. This operation is more traumatic than laser surgery. Through a 10 mm incision, the core is removed, the crystalline sac is cleaned and the implant is inserted.
Intracapsular extraction. The lens and capsule are removed, and the implant is fixed in that place.

Ultrasound cataract surgery

To perform this procedure, you do not need to wait for the disease to “ripen.” This process can drag on for a long period, and the patient’s life will be filled with unpleasant changes: it is impossible to work fully, drive and perform other activities. Cataract surgery will change everything radically. It has beneficial advantages:

safety;
painlessness (performed under anesthesia);
little traumatic;
short rehabilitation period;
quick recovery and so on.

How are cataracts removed with laser?

This type of surgery has many advantages and here are some of them:

Laser cataract removal is “knifeless” surgery.
The progress of the surgical intervention is monitored by the doctor on the monitor, so errors are excluded. A 3D model of the eye is displayed on the screen.
Great precision (up to 1 micron): no experienced surgeon can achieve this with his own hands. The laser gently moves the tissue apart. This incision is self-sealing and quickly heals. Even a circular cut can be made with a laser.
Provides reliable fixation of the artificial lens and stable centration. This result lasts for many years.

Contraindications for cataract surgery

Surgical treatment of a clouded lens is prohibited in some cases. Although cataract removal in old age gives excellent results, we must not forget about contraindications. These include the following ailments:

infectious diseases;
hemophilia;
eye cancer;
ischemic disease;
hypertension;
a short period of time after a stroke (less than six months).

Can cataracts be removed if you have diabetes?

This manipulation has been successfully performed for many years. However, in order for cataract surgery for diabetes to proceed without complications, it should be carried out only with a stable glucose level. Since with this disease, damage to the lens develops more rapidly than in other people, you cannot delay with surgical intervention. This can result in complete loss of vision.

How to prepare for cataract surgery?

Any surgical intervention requires a thorough examination. The following research needs to be carried out:

blood test (detailed, for RW, for hepatitis);
Analysis of urine.

All results are valid for no more than a calendar month from the date of submission. An ECG should be performed 2 weeks before the planned operation. The patient needs to undergo chest x-ray. If this examination was performed within the last 12 months, its results are valid, so there is no need for additional fluorography.

In addition, preparation for cataract surgery includes obtaining consultations from the following doctors:

Seeing all of these specialists is extremely important. They will help identify an infection or inflammatory process in the body. Early detection of a predisposition to the disease helps to prevent it and avoid serious problems. The patient should not take this lightly, since the infection lurking in the body complicates the rehabilitation period.

You should also take medications with extreme caution. The patient must inform the ophthalmologist-surgeon about the medications he regularly takes. In addition, it is important to avoid taking medications with anticoagulant effects one week before surgery. Alcohol consumption is strictly prohibited during this period. The patient should be freed from heavy physical labor.

Immediately before cataract removal is performed, you need to undergo the following preparation:

How is cataract surgery performed?

The strategy for dealing with a clouded lens depends on the method of surgical intervention. If cataract removal is performed using the highly traumatic extracapsular method, the operation is performed as follows:

The area is treated with an antiseptic and anesthesia is administered.
An incision is made with a length of 7 to 10 mm.
The anterior capsule of the lens and its nucleus are removed.
The “bag” is cleaned.
An artificial lens is installed.
Stitches are applied.

When cataract removal is performed using the rarely used intracapsular method, the operation looks like this:

Treat the skin around the eyes with a special bactericidal solution.
Pain relief.
A wide incision is made, as a result of which the edge of the lens should be exposed.
The tip of the cryoextractor is brought to the operated area and the tissue is “attracted” to it.
The damaged lens is removed through the incision.
Using this hole, the implant is inserted and fixed.
Seal the incision.

Ultrasound surgery is considered the “gold standard”. It proceeds as follows:

Antiseptic treatment of the skin is carried out and local anesthesia is applied (drip is often used).
A small incision is made on the cornea (about 3 mm).
Capsulorhexis is performed.
A special liquid is injected into the cavity, which should reduce the stability of the lens.
It is crushed and removed.
Installation of an intraocular lens.
Sealing the hole.

The way laser cataract surgery is performed is somewhat different from previous methods. This surgical intervention is carried out as follows:

Skin disinfection and local anesthesia are performed.
A micro-incision is made on the cornea.
Capsulorhexis is performed.
Fiber optic elements are introduced into the anterior chamber.
The beam destroys the lens.
The masses are removed from the “bag” through tubes.
The back wall of the capsule is polished.
An intraocular lens is installed.
Seal the incision.

How long does cataract surgery take?

The duration of this procedure may vary. The cataract removal itself with lens replacement is carried out in 15-20 minutes. However, the doctor must have time left in order to properly prepare everything for surgery. In addition, after the procedure, the patient must arrive under the supervision of an ophthalmologist for the first few hours.

Cataract surgery – postoperative period

Recovery after extraction of a clouded lens directly depends on the chosen intervention method. The entire period can be divided into 3 phases:

First week after cataract surgery with lens replacement has been performed. Severe pain in the periorbital area and swelling may occur.
From 8 to 30 pm. At this stage, visual acuity is unstable, so the patient should strictly adhere to a gentle regimen.
31-180 days after surgery. Maximum vision restoration is observed.

Restrictions after cataract surgery

During the rehabilitation period, the patient must strictly follow the doctor's instructions. After cataract surgery, you should not lift anything heavy. In addition, physical activity is prohibited, as it provokes a jump in intraocular pressure and can cause hemorrhage. Thermal procedures can cause a similar reaction, so it is better to avoid hot baths, saunas and steam baths.

Restrictions also apply to sleep patterns. You should not sleep on the side of the eye that was operated on or on your stomach. The length of rest is also important. In the first few months after surgery, the minimum sleep duration recommended by ophthalmologists is 8-9 hours. During the night's rest, the body recovers, so you should not neglect it.

Additional restrictions include:

visual stress;
decorative cosmetics (you can use them starting from 4 weeks after extraction and very carefully);
drinking alcohol;
smoking;
refusal of fatty foods, spices and pickles during the first month of rehabilitation.

Complications after cataract surgery

Even an experienced ophthalmologist cannot completely protect against negative consequences. The following complications may develop after cataract surgery:

(this is more often observed in diabetes mellitus);
displacement of the inserted lens;
secondary cataract;
hemorrhage in the anterior chamber;
edema.

Rehabilitation after cataract surgery

A bandage will help protect the eye from external negative factors. It is applied immediately after surgery. To ensure that rehabilitation after cataract removal occurs without complications, the doctor prescribes drug therapy. Eye drops with anti-inflammatory and disinfectant effects are needed for speedy healing of the cornea.

If the patient takes the doctor’s orders with full responsibility, the rehabilitation process will not take long. After surgery, it is important to visit your ophthalmologist regularly. Such visits will help identify pathological disorders at an early stage. It is important to eat well during the rehabilitation period. The daily menu should be enriched with foods high in vitamins A, C, E.

Cataract surgery - consequences

More often, negative complications after surgery are observed in patients suffering from chronic illnesses. These include diabetes, blood diseases, and so on. Undesirable consequences can also arise when the lens is operated on at an overripe stage. For such patients, frequent visits to the doctor are prescribed after cataract removal.

More than 2 million patients undergo radical cataract treatment every year. There are several methods of surgical treatment of cataracts - extracapsular cataract extraction, intracapsular cataract extraction, ultrasound phacoemulsification, laser cataract surgery (laser phacoemulsification).

Indications and contraindications for cataract surgery – who should not have surgery?

The need for surgical intervention for cataracts is determined medical and professional-domestic indications .

Medical indications are common to all patients. The operation, if present, is performed to preserve the normal morphology and function of the organ of vision.

Medical indications:

Overripe cataract.
Inflammatory form of cataract.
Dislocation or subluxation of the lens.
Abnormal shapes of the lens.
The need for fundus examination in case of concomitant diseases (diabetic retinopathy, hypertension, retinal detachment).
The need for partial excision of the vitreous body with an opaque lens.
Drug-resistant lens block.

Professional and household indications are taken into account individual needs of the patient at home and at work. The same indicators may or may not be a reason for surgical intervention in different patients.

Some professions place particularly high demands on vision. For example, vehicle drivers, navigators, pilots, and operators often need surgery with visual acuity of 0.4-0.5.

Professional indications:

Insufficient visual acuity for the patient to carry out usual activities.
Narrowing of visual fields, preventing the patient from performing usual activities.
Low degree of binocular vision, which prevents the patient from carrying out his usual activities.

Contraindications for cataract extraction:

Oncological disease in the eye area.
Inflammatory process in the eye area.
Exacerbation of chronic diseases.
Infectious diseases.
Decompensation of diabetes mellitus.
Uncorrected arterial hypertension.
Coronary heart disease in the stage of decompensation.
Condition up to 6 months after myocardial infarction.
Hemophilia.

In children The decision on surgical treatment is made depending on visual acuity.

The absolute indication is considered sharp decrease in object vision . The operation is performed at the age of 12-24 months for bilateral diffuse, membranous and zonular cataracts with visual acuity of 0.1-0.005 or lower.
The relative indication for surgical treatment of cataracts is local lens opacities of moderate intensity , with visual acuity from 0.2 to 0.1. The operation is usually performed at the age of 2-6 years.

Surgery for congenital cataracts is not performed if visual acuity is not lower than 0.3 under normal conditions. Typically in these cases, lens opacities are polar, cortical, nuclear or polymorphic.

Cataract removal using extracapsular cataract extraction - stages of the operation

Extracapsular cataract extraction is a method that preserves the posterior capsule of the lens. The advantage of this method is the presence after surgery of a natural barrier between the anterior segment of the eye and the vitreous body.

However, this intervention is different highly traumatic for the cornea . In addition, in the postoperative period, the development of film cataracts and inflammation of the residual mass of the lens is possible.

Extracapsular cataract extraction is the procedure of choice with increased density of the lens, advanced glaucoma, rupture or tear of the lens ligaments, inflammatory eye diseases, corneal dystrophy.

The operation consists of the following main stages:

Intracapsular cataract extraction is a little-used method of surgical treatment of the disease.

Intracapsular cataract extraction involves removal of the entire lens in the capsule . This intervention excludes film cataracts in the postoperative period.

Video of intracapsular cataract extraction is available on YouTube

The negative consequences of intracapsular extraction are the occurrence risk of vitreous prolapse . This complication is fraught with vascular damage, hemorrhages, and retinal detachment.
During the operation, a cryoextractor is most often used.

After making a wide corneal incision They move the iris and expose the edge of the lens.
The cooled tip of the device is brought to the lens. After a few seconds, the tissue is securely fixed to the cryoextractor.
Next, the lens is removed through a corneal incision.
The artificial lens is fixed in the pupillary opening, in the anterior chamber or in the ciliary groove.
The incision is sealed using suture material.

Introcapsular cataract extraction is contraindicated in patients under 18 years of age.

The gold standard in surgical ophthalmology is ultrasound phacoemulsification of cataracts.

Ultrasonic lens crushing was first used more than 40 years ago. To date, ultrasound phacoemulsification of cataracts is considered the gold standard for treating the disease.

Videos of ultrasound phacoemulsification cataract surgery can be found in the search.

The advantages of ultrasonic phacoemulsification of cataracts are: low morbidity , short duration of the rehabilitation period.

Complications are possible in 1-1.5% of patients. The most dangerous consequences may be hemorrhages, etc. The cause of such complications is considered to be damage to the structures of the eye by ultrasonic waves. During the intervention, the surgeon tries to minimize the time and intensity of the phacoemulsifier.

Patients with especially dense lens tissue and retinal angiopathy are not referred for ultrasound treatment. They are mostly recommended for classical intervention - extracapsular cataract extraction.

Laser cataract surgery - indications for laser phacoemulsification

Laser phacoemulsification for crushing the lens involves exposure to a beam with a fixed wavelength from .

After micro-incision of the cornea and capsulorhexis, elements of the fiber-optic system are introduced into the anterior chamber
The laser beam destroys the lens tissue.
The masses are discharged in the form of an emulsion through a system of tubes.
Next, the surface of the posterior capsule is “polished”, install an intraocular lens.
The incision is sealed without the use of seams.

Video of laser phacoemulsification surgery is available on Youtube

The choice of surgical treatment technique for cataracts is always made by the attending physician.

According to operating ophthalmologists, ultrasound Phacoemulsification is indicated in almost 95% of patients.

Eye cataract is a complex ophthalmological pathology characterized by clouding of the lens. Lack of timely treatment threatens vision loss. The disease usually progresses slowly in adulthood. However, certain types of cataracts develop rapidly and can lead to blindness in the shortest possible time.

People over fifty years of age are at risk. Age-related changes and metabolic disorders in the eye structures often lead to loss of lens transparency. Cataracts can also be caused by eye injuries, toxic poisoning, existing ophthalmological pathologies, diabetes mellitus and much more.

All patients with cataracts experience a progressive decrease in visual acuity. The first symptom is foggy eyes. Cataracts can cause double vision, dizziness, photophobia, and difficulty reading or working with small parts. As the pathology progresses, patients even stop recognizing their acquaintances on the street.

Conservative treatment is advisable only at the initial stage of cataracts. It is worth understanding that drug therapy protects against the rapid progression of the disease, but it is not able to rid a person of the disease and restore transparency to the lens. If the cloudiness of the lens worsens, cataract surgery is required.

Overview of Cataract Surgery

In the first stages of lens opacification, dynamic observation by an ophthalmologist is indicated. The operation can be performed from the moment the patient’s vision begins to significantly decline.

A direct indication for lens replacement surgery is visual impairment, which causes discomfort in everyday life and limits work activity. A specialist selects an intraocular lens. The procedure is performed under local anesthesia. Anesthetic drops are instilled into the conjunctival sac before surgery. Typically, lens removal takes half an hour. The patient can be home on the same day.

ATTENTION! In case of complete blindness, cataract surgery will not bring any results.

Modern medicine does not stand still, so replacing the lens of the eye with cataracts can be done in various ways. The essence of the procedure is to remove the natural lens. It is turned into an emulsion and removed. An artificial implant is placed in place of the deformed lens.

Surgery may be used in the following cases:

overripe stage of cataract;
swelling form;
lens luxation;
secondary glaucoma;
abnormal forms of lens opacification.

There are not only medical, but also professional and everyday indications for the operation. Workers in some professions place high demands on vision. This applies to drivers, pilots, and operators. The doctor may also recommend lens replacement if a person is unable to perform normal household chores due to decreased vision, or if the visual field is significantly narrowed.

Contraindications

Any eye surgery has a number of limitations, and lens replacement is no exception. Cataract removal with lens replacement is prohibited in the following cases:

infectious diseases;
exacerbation of a chronic process;
ophthalmological disorders of an inflammatory nature;
recent stroke or heart attack;
period of pregnancy or breastfeeding;
mental disorders accompanied by patient inadequacy;
oncological processes in the eye area.

Pregnant women and nursing mothers are prohibited from performing surgery due to the fact that during surgery the patient needs medicinal support. Doctors prescribe antibacterial, sedative, analgesic drugs, which may not have the best effect on the condition of the woman and child.

Age under eighteen years is a relative contraindication to surgery. In each case, the doctor makes an individual decision. It largely depends on the patient's condition.

It is dangerous to perform surgery for decompensated glaucoma. This can lead to hemorrhage and loss of vision. Surgical intervention should be carried out after normalization of intraocular pressure.

If the patient has no light perception, surgical treatment is not performed. This indicates that irreversible processes have begun to develop in the retina and surgical intervention will no longer help. If during the study it turns out that vision can be partially restored, surgery is prescribed.

Complicating factors during surgical treatment include:

diabetes;
hypertension;
chronic pathologies;
age up to eighteen years.

Most often, cataracts occur in old age. Elderly people often have serious illnesses. In some of them, anesthesia is a big health risk. Many modern techniques involve the use of local anesthesia, which does not place an increased burden on the cardiovascular system.

Lens replacement surgery cannot be performed for infectious diseases.

Techniques

Let's talk about four modern techniques that help completely get rid of lens clouding.

Laser phacoemulsification

The operation requires extreme precision and concentration from the surgeon. It is prescribed when hardening is detected in the ocular media, which is absolutely insensitive to ultrasound. Laser phacoemulsification is not available to many patients, as it requires the use of special, expensive equipment.

The operation can be performed in extremely difficult cases:

Before the procedure, the patient is given anesthetic drops. The healthy eye is covered with a medical napkin, and the area around the affected eye is treated with an antiseptic.

Next, the surgeon makes a small incision through the cornea. The laser beam crushes the clouded lens. It focuses deep within the lens without damaging the cornea. After this, the cloudy lens splits into tiny particles. During surgery, patients may see small flashes of light.

Then the capsule is prepared for implantation of an artificial lens (about the rules for choosing an artificial lens). A pre-selected intraocular lens is installed. The incision is sealed using a seamless method.

IMPORTANT! During the operation, the surgeon does not insert instruments into the eye, thereby reducing the risk of postoperative complications.

Complications appear quite rarely, but they are still possible. Negative consequences include bleeding, displacement of the artificial lens, and retinal detachment. Following all doctor's recommendations and observing hygiene rules is the best way to avoid the development of dangerous complications!

Laser phacoemulsification does not require mandatory hospitalization. A few hours after the procedure, the person can return home. Restoration of visual function occurs within several days.

Still, some restrictions will have to be taken into account for some time. During the first two months, try not to overstrain your eyes. It is better to stop driving a car. To minimize the risk of complications, you will have to take medications and vitamins prescribed by your doctor.

Ultrasound phacoemulsification

This technique is recognized as one of the most effective and safe in the treatment of cataracts. If already at the first stage a person experiences discomfort, then, at his request, the lens can be replaced.

The surgical treatment is absolutely painless, the patient does not experience any discomfort during the procedure. Anesthetize and immobilize the eyeball using topical agents. Drops with an anesthetic effect can be used: Alcaine, Tetracaine, Proparacaine. Injections are also given into the area around the eyes for anesthesia.

Using ultrasound, the damaged lens is crushed into small particles, turning into an emulsion. The removed lens is replaced by an intraocular lens. It is made individually, taking into account the characteristics of each patient's eye.

ATTENTION! Concomitant eye pathologies reduce the effectiveness of surgical interventions.

During the procedure, the surgeon makes a small incision. This became possible due to the high flexibility of the IOL. They are introduced in a folded state, and once inside the capsule they straighten out and take the desired shape.

During the recovery period, intense physical activity and high temperatures should be avoided. Doctors categorically prohibit visiting saunas and steam baths. It is not recommended to sleep on the side on which the eye was operated on. To avoid infection, it is better to temporarily stop using decorative cosmetics. Your eyes should not be exposed to aggressive sunlight, so do not forget to use glasses with an ultraviolet filter.

Extracapsular extraction

This is a simple traditional technique without the use of expensive equipment. A large incision is made in the shell of the eye, through which the clouded lens is completely removed. A characteristic feature of EEC is the preservation of the lens capsule, which serves as a natural barrier between the vitreous body and the artificial lens.

Extensive wounds require stitches, and this affects visual function after surgery. Patients develop astigmatism and farsightedness. The recovery period takes up to four months. Extracapsular extraction is performed for mature cataracts and hardened lens.

When extracting a cataract, the surgeon has to make a large incision followed by stitches.

The tunnel technique is most often used. During the operation, the lens is divided into two parts and removed. In this case, the risk of developing postoperative complications is reduced.

Removing sutures does not require anesthesia. After about a month, glasses are selected. A postoperative scar can cause astigmatism. Therefore, to avoid its divergence, injuries and excessive physical exertion should be avoided.

Despite the high effectiveness of modern techniques, in some cases specialists prefer traditional surgery. EEC is prescribed for weakness of the ligamentous apparatus of the lens, overripe cataracts, and corneal dystrophy. Traditional surgery is also indicated for narrow pupils that do not dilate, as well as for detection of secondary cataracts with IOL decay.

IMPORTANT! Vision begins to recover during the operation, but it takes time for complete stabilization.

Intracapsular extraction

It is carried out using a special instrument – a cryoextractor. It instantly freezes the lens and makes it hard. This makes it easier to remove later. The lens is removed along with the capsule. There are risks that particles of the lens will remain in the eye. This is fraught with the development of pathological changes in visual structures. Unremoved particles grow and fill the free space, which increases the risk of developing secondary cataracts.

One of the advantages of IEC is its affordable cost, since it eliminates the need to use expensive equipment.

Preparation

What tests need to be taken before surgery? The visual apparatus and the entire body are checked to exclude contraindications to surgical intervention. If during the diagnosis any inflammatory processes were identified, before the operation the pathological foci are sanitized and anti-inflammatory therapy is carried out.

The following studies are mandatory:

general blood and urine analysis;
coagulogram;
hematological biochemistry;
blood glucose test;
analysis for HIV infection, syphilis and viral hepatitis.

Disinfecting and dilating pupil drops are injected into the operated eye. Eye drops or injections into the area around the eye may be used for anesthesia.

Selecting an artificial lens is a complex and time-consuming process. This is perhaps one of the most important stages of preparation, since the patient’s vision after surgery depends on the quality of the selected lens.

Recovery period

The operation is in most cases well tolerated by patients. In rare cases, specialists complain of unpleasant sensations, including:

photophobia,
discomfort,
fast fatiguability.

After the operation, the patient goes home. A sterile bandage is placed over the person's eye. During the day he must observe complete rest. After about two hours, eating is allowed.

IMPORTANT! During the first time after surgery, patients should avoid sudden movements, lift heavy objects, and abstain from alcohol.

For a speedy recovery, you must follow medical recommendations:

observe the rules of eye hygiene;
for three weeks after surgery, do not go outside without sunglasses;
do not touch or rub the operated eye;
refuse to visit swimming pools, baths or saunas;
reduce time spent in front of the TV and computer, as well as reading;
during the first two weeks, do not drive a car;
compliance with the dietary regime.

Learn more about rehabilitation after surgery.

Surgical intervention for extraction of an opaque lens ( phacoemulsification) and its subsequent replacement with an artificial one is the only treatment method that allows you to completely restore vision. The method has gained recognition all over the world due to its wide availability, safety and speed of execution. Over 400,000 operations are performed in our country every year.

What is a cataract?

Cataract is a decrease in the transparency of the lens, leading to numerous disorders of the visual analyzer, up to complete blindness. The disease is based on the destruction of the structure of the protein that is part of the lens.

The prevalence of the pathology is extremely high: the pathology affects every 6 people in the world after 40 years and 90% of people after 80. Currently, in the Russian Federation, this diagnosis has been established in 2,000,000 people.

Etiology of the disease

Many reasons have been identified that lead to the development of pathology. Among them are the following.

Main symptoms of cataracts

The complex of clinical manifestations is expressed quite clearly and does not present any difficulties when carrying out diagnostic measures.

Why is surgery needed?

In most cases, surgical treatment is used for treatment. Surgery allows you to quickly restore vision without harm to the body. If you do not consult a doctor in a timely manner, one of the following complications may develop:

All changes observed in the lens are irreversible. Therefore, no eye drops, ointments, or gels can help. The only way out is microsurgical surgery!

Features of the operation

Methods for cataract surgery have been improved over the decades. Currently, the safest and most effective is ultrasound phacoemulsification with implantation of an artificial lens. The duration of all manipulations usually does not exceed 10-15 minutes. Previously, intra- and extracapsular methods of extraction of the area of opacification were used, but they led to a large number of complications and their implementation is currently impractical.

Sutures are not required after surgery, as the incision length is only 1.8 mm. With this surgical approach, the wound heals on its own.

Preoperative preparation

Before the operation, the ophthalmologist prescribes a set of diagnostic measures, the purpose of which is to identify contraindications, assess the severity of the disease and determine the tactics according to which the operation will be performed.

Before surgery, the doctor may recommend the patient a course of medication. The goal of the course is simple: to improve the general condition of the eye structures, to have a positive effect on the lens affected by cataracts. To improve metabolic processes, remove free radicals and activate regeneration, doctors recommend the use of eye drops. In Russia, Finnish drops Oftan Katahrom have proven themselves to be an effective and well-tolerated remedy - a preparation containing a vitamin, antioxidant and energy source that does not require special dilution, is immediately ready for use and retains its properties for a long time.

The intervention is contraindicated if:

infectious and inflammatory diseases of the eye;
the presence of chronic pathologies in the stage of decompensation (diabetes mellitus, ischemic heart disease, malignant neoplasms);
pregnancy;
retinal detachment;
glaucoma that cannot be corrected.

In addition to determining the acuity of the visual analyzer, measuring ophthalmotonus and examining the fundus of the eye, the ophthalmologist prescribes the following list of examinations:

UAC;
blood test for hepatitis B and C;
OAM;
used blood test;
determination of antibodies to HIV infection;
electrocardiographic study of heart activity;
consultation with a therapist.

On the day of surgery, the patient leads a normal lifestyle. 20 minutes before surgery, intraocular and systemic pressure are measured. Then drugs that dilate the pupil are injected drip-wise (this is necessary to increase surgical access to the affected area).

Stages operations

The most important stage is the provision of high-quality anesthesia. 99% of patients are prescribed local anesthetics in the form of eye drops. The most common are Proparacaine 0.5%, Leocaine 0.35% and Dicaine 0.25%. The duration of action of each exceeds 15-20 minutes, which is quite enough to carry out the entire complex of surgical intervention.

In some cases (anatomical or physiological defects of the eye), peribulbar, retrobulbar or subconjunctival administration of the drug may be prescribed.

Persons suffering from mental illness with strong productive symptoms (delusions, hallucinations) or newborns are advised to undergo general anesthesia with monitoring of heart activity and the state of the respiratory tract.

The sequence of actions of an ophthalmologist can be presented as follows.

Making a micro-incision with a diamond-coated microsurgical scalpel, which provides proper access.
Introduction into the anterior chamber of the eye through a cannula of an elastic substance that will protect all other internal structures from ultrasound and mechanical impact.
Insertion of the thinnest medical probe with an ultrasonic sensor located on it. The ultrasound emitted by the instrument completely destroys the affected lens.
Removal of remnants of the old lens through a cannula.
Insertion of a flexible intraocular lens in a twisted position. Once in place of the old lens, the optical structure independently straightens in the eye and is securely fixed.
Washing out elastic protective substances from the anterior chamber and treating the surgical wound with antiseptic solutions.

It should be noted that there are currently many types of intraocular lenses. They can not only completely restore vision, but also correct astigmatism. Thus, modern technologies make it possible to completely get rid of glasses when looking at objects, both at close and long distances.

Postoperative period

After the surgeon’s manipulations, the patient is under the supervision of doctors for 30 minutes. As soon as the effect of the anesthetic has completely stopped, he is sent home and returns to his usual activities.

Within 24-48 hours after the intervention, the patient may experience symptoms of discomfort caused by swelling of the perioperative tissues:

burning and itching sensation in the eye;
the appearance of goosebumps or sparkles before the eyes;
dry eye;
decreased visual acuity, impaired accommodation.

As a rule, these manifestations disappear quickly and do not require special treatment.

Table. The rate at which symptoms disappear.

Antibacterial agents(for the prevention of infectious and inflammatory diseases). The drugs of choice are Floxal, Oftavix, Tobrex.
Anti-inflammatory medications. Diclof or Indocolir help relieve swelling. In case of severe inflammation, hormonal agents are prescribed - Oftandexamethasone or Maxidex.
For increased dryness, indicated artificial tear preparations(Oxyal, Systane).

active physical activity;
drinking alcohol and smoking.

Complications after surgery

No surgical method is without its drawbacks. The incidence of complications after phacoemulsification is about 0.5%.

Infectious and inflammatory pathologies are the most common type of complications (90% of all). The main reason is the patient’s violation of personal hygiene measures and the doctor’s instructions regarding postoperative measures. It is extremely rare that infection is iatrogenic.
Severe corneal edema.
Dislocation of the artificial lens. Modern lenses have a reliable fixation device; in rare cases, if the surgical technique is violated or the doctor’s instructions are not followed, it may become dislodged and damage the internal structures of the eyeball.
Secondary cataract is clouding of the tissues of the posterior chamber of the lens.

The described complications are usually quickly diagnosed and, with timely consultation with a doctor, are completely cured.

Price

Medical intervention can be carried out either at the expense of the patient’s personal funds or with the support of the compulsory medical insurance program. The average cost ranges from 25,000 – 45,000 rubles. The price curve is determined by the medical institution’s equipment with diagnostic and treatment equipment and the patient’s condition.

Thus, surgery to replace the affected lens of the eye is the only treatment method that can not only stop the loss, but also completely restore lost vision. All manipulations are extremely simple to perform and carried out quickly. The patient immediately returns to his usual lifestyle and, subject to all the doctor’s recommendations, does not become a victim of complications.

Video - Removal of eye cataracts, ultrasound phacoemulsification surgery

677 09/18/2019 5 min.

One of the most effective treatments for cataracts is surgical removal. This method allows you to completely restore a person’s vision with minimal risks of complications after such an intervention, which is why it is most often recommended to patients at different stages of development of this disease. So that you can also weigh the pros and cons of such an operation and make a decision regarding its implementation, we suggest that you familiarize yourself with the features of its implementation and the recovery process after such manipulation.

What it is

Cataract is commonly called clouding of the lens of the eye. This disease can be congenital, but more often it is acquired and usually manifests itself in patients over 45 years of age. With this pathology, the patient notes a gradual deterioration in vision, the occurrence, and sometimes a change in refraction. Over time, these symptoms may get worse.

Typically, cataracts are extremely difficult to treat with medication. Patients with this pathology need surgery to replace the lens, which will allow them to maintain visual acuity.

Features of the procedure

Cataract surgery is called.

During surgery, the doctor makes a thin incision in the anterior chamber of the eye, removes the damaged lens, and then inserts in its place, which will subsequently perform the functions of the lens itself. The whole manipulation takes half an hour. Sutures are not placed on the operated eye due to the very small incision.

After such an operation, the patient does not have any scars on the eye. If the lens replacement is successful, vision is completely restored.

Patient preparation

If the patient has been scheduled for surgery to remove the lens, he will need to undergo a number of studies a few days before the operation, including ultrasound measurements (they will make it possible to select the most suitable lenses for implantation), as well as examinations of the whole body.

If any abnormalities are found, the doctor may recommend that the patient start taking specialized medications (for example, blood thinners). Also, people suffering from cataracts are often recommended to take before surgery to reduce the risk of complications.

Quinax drops are used in the treatment of glaucoma and cataracts

Also, before such an intervention, the patient will be advised to avoid decorative eye cosmetics, as well. He will be able to return to them after the end of the postoperative period.

Step-by-step process

The procedure for cataracts is carried out in several stages. These are:

After this, the doctor will have to remove a substance from the chamber of the eye that blocks its other parts from ultrasonic influence. After this, the edges of the seam are subjected to special processing. At this stage, the operation is considered complete.

Postoperative period

After such an operation, the patient is covered with a bandage over the damaged eye. To avoid complications after surgery, he may be recommended to use special, as well as some general medications. Complete restoration of vision after such an intervention usually occurs on the seventh day, sometimes later. There is no point in assessing the effectiveness of such an intervention before.

Catarax is used in postoperative care

Those patients who want to choose after surgery should consult a doctor about this issue only a week or two after cataract removal. Even a very high-level specialist would not be able to select earlier.

In order for the patient to avoid any health problems after such an operation, he needs to adhere to a number of general recommendations. In particular, it is especially important during this period:

the patient also needs to monitor his vision after such an intervention. If he notices any deterioration, he should urgently consult a doctor, undergo additional examination and take all possible measures to eliminate postoperative complications.