Is it possible to change the lens again? Can a modern intraocular lens become cloudy? What is the service life of the artificial lens of the eye? Advantages of surgery in the treatment of cataracts
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Eye lens replacement is one of the laser surgery techniques aimed at replacing the natural lens with an intraocular lens. It involves phacoemulsifying it and installing an IOL in its place, being a panacea for those who suffer from high degrees of refractive error or lens opacification.
Eye surgeries to replace the lens are one of the activities of Professor Eskina's ophthalmology clinic. We help even those patients who are considered hopeless, restoring to them the joy of a clear, colorful vision of the world.
What is a lens and when does it need to be replaced?
The lens is a transparent body, convex on both sides, located inside the eyeball. Being located opposite the pupil, it acts as an optical lens, providing transmission and refraction of light. Its posterior surface is adjacent to the vitreous body, and its anterior surface is adjacent to the iris. In a circle it is fixed to the ciliary muscle, consisting of three types of fibers.
Its contraction ensures the rounding of the lens and a decrease in the radius of its curvature: vision is focused on objects that are nearby, providing a projection of a clear image onto the retina. When the muscle relaxes, the lens again takes on a flattened shape, allowing focusing on objects located at a distance.
The thickness of the adult lens ranges from 3.6 to 5 mm, diameter - from 9 to 10 mm; refractions are heterogeneous and vary in the range from 1.38 to 1.40 depending on the state of accommodation.
Replacement of the eye lens is necessary when it loses its elasticity and is unable to provide the necessary focus due to age-related changes or pathological changes.
The main substance of the lens is epithelial cells that form elongated fibers. Their transparency is ensured by a mixture of proteins that allows it to conduct and refract light. For the same reason, the lens is devoid of blood vessels and nerves.
The pathological condition in which its clouding occurs is called cataract. It develops due to protein denaturation under the influence of a number of destabilizing factors: age-related changes, taking pharmacological drugs, ophthalmological and general pathologies, traumatic damage to the organs of vision.
As the disease progresses, the color of the pupil changes to milky white, and clarity of vision is lost until it is completely lost. The only effective way to preserve visual function is to replace the lens.
Indications and contraindications for replacement
| Indications: | Contraindications: |
|---|---|
|
|
Features of replacing the eye lens with an artificial lens
One of the stages of the operation is phacoemulsification. This is a microsurgical technique that allows you to remove the lens through a micro-incision not exceeding 2.2 mm by grinding it with ultrasound. Once it has acquired the consistency of an emulsion, it is removed by aspiration.
Phacoemulsification is a gentle procedure that reduces to zero the likelihood of damage to adjacent tissues. It is extremely rarely complicated by inflammation and the development of induced astigmatism and is very effective. It can be used even in the most difficult cases, when it would seem that restoration of vision is impossible.
The second stage of surgery is the installation of an intraocular lens. It is a flexible, hemispherical implant that preserves the anatomy of the eye. Its installation occurs through a micropuncture in the cornea.
IOLs can be compared to regular contact lenses - the difference is that the latter must be placed on the eye, while the former are implanted directly into the posterior or anterior chamber of the eye, providing the desired focus on the retina. Installation time does not exceed fifteen minutes. In the process, the microsurgeon creates a self-sealing incision up to 3 mm long and implants a lens into it. No stitches are required because the incisions are self-sealing.
Types of intraocular lenses
In order for the surgery to be successful, it is important to choose the right lens: it will determine the patient’s quality of life in the future. In the process, the patient’s lifestyle and financial capabilities are taken into account and the best option is determined.
| IOL | |
|---|---|
| Kinds | Peculiarities |
| Installation goals | |
| Aphakic | Instead of removing the natural lens for cataracts. |
| Phakic | For the correction of refractive errors. |
| Implantation area | |
| Anterior chamber | Between the cornea and iris. |
| Posterior chamber | Between the iris and the lens. |
| Number of focuses | |
| Monofocal | One focus to get a good image of distant objects. Includes the use of glasses or lenses for work and reading. |
| Bifocal | Two focuses that provide clarity of the “picture” up close and at a distance. They necessitate optical correction to see intermediate objects. |
| Multifocal | The lens has several sectors responsible for image quality at different distances and does not require correction. |
| Ability to accommodate | |
| Non-accommodating | They are not able to change the curvature; they are determined by wearing glasses or lenses. |
| Accommodating | Perform all the functions of the native lens. |
| Rigidity | |
| Hard | Requires a larger incision to insert into the eye. |
| Soft | When installed, they can be rolled up, so the cut can be minimal. |
Which IOL is better?
Preparation and replacement of the eye lens with an artificial lens
The procedure does not require serious independent preparation. It includes a consultation with an ophthalmologist and a comprehensive diagnosis. In our clinic, during this procedure we use the HRK-7000 autorefkeratometer, which allows us to accurately determine the radius and refractive power of the cornea and identify existing disorders.
The correction is carried out under sterile conditions. 60 minutes before it starts, drops are instilled into the patient to dilate the pupils. Drops with an anesthetic effect can eliminate discomfort. The duration of the procedure does not exceed twenty minutes. Its stages are as follows:
- Installation of eyelid dilators to prevent accidental closure;
- Creation of two/three micro-incisions in the area of junction of the sclera and cornea;
- Grinding the contents of the lens with ultrasound through a needle, removing it by aspiration;
- Installation of the graft into the vacated capsule, its fixation.
There are no stitches, the micro-incision is sealed independently. The patient remains under the supervision of medical personnel for an hour, after which he can go home.
In our ophthalmology, the operation is performed using the MICS Phaco Stellaris system, created by specialists from the American company Bausch & Lomb. Along with the skillful actions of our specialists, it ensures the desired results. For replacement, we use IOLs from leading global manufacturers.
Improvement in vision begins almost immediately after replacement; maximum results are achieved after 30 days. It is important for the patient to strictly follow the recommendations of the attending physician:
- Rinse your eyes regularly with sterile water and apply prescribed antiseptic;
- Avoid physical activity and lifting weights of more than 3 kg during the first seven days;
- Wear the bandage for the first two weeks;
- Sleep on your back or on the side opposite to the operated one;
- Avoid hot baths, saunas and steam baths.
Questions and answers
- Advantages of surgery in the treatment of cataracts
- Cataracts: types of lenses
- Surgery to replace the lens for cataracts at the Sfera Clinic
- Choosing an IOL for Cataract Surgery
- Lens replacement: indications and contraindications for cataract surgery
Advantages of surgery in the treatment of cataracts
The modern technique of replacing the lens with an IOL helps relieve the patient from various eye diseases - cataracts, myopia, astigmatism, farsightedness and other diseases, and also helps prevent the development of cataracts in the future. The new lens of the eye will perform its functions for a long time and flawlessly, providing excellent vision and immunity to the development of cataracts, which is important for patients of any age. Cataract surgery:
- easy to carry;
- possible at any age;
- has an easy and short rehabilitation period;
- immediately restores eye health.
This is a minimally invasive operation - today there is no equivalent alternative to replacing the lens of the eye in this way in the treatment of cataracts.
The clinic’s doctors guarantee a successful outcome of the operation - cataract removal is preceded by a careful examination, during which all the nuances of a person’s health are identified and taken into account.
Cataracts: types of lenses
The most famous and common eye surgery is replacing the lens of the eye with an artificial lens. Such operations are now performed all over the world, relieving thousands of people of cataracts and restoring their natural ability to see the world with their own eyes, clearly and clearly.
An artificial lens - an intraocular lens (IOL) - is made from materials that are biologically compatible with the tissues of the eye. The service life of an artificial lens is over 50 years. This is why an artificial eye lens is the best option for successful cataract surgery. It is psychologically difficult for older patients to decide on surgery, but practice shows that in terms of getting rid of cataracts, there is currently no alternative to surgery. The artificial material ensures the full functioning of the eyes and restores their ability to see well.
The intraocular lens, which is used during cataract surgery, has certain properties that completely correspond to a natural organ, despite the fact that it remains an artificial material. It will always be transparent, because the artificial material is not susceptible to disruptions in the molecular bonds and structures of protein molecules, which result in the development of cataracts. This means that there is no chance of recurrence of cataracts. Surgery will allow you to maintain visual acuity into old age; in this sense, there is no alternative to replacing the lens. After the operation, the patient has the opportunity to note with pleasure the returning ability of the eyes to see clearly and well.
The Sfera clinic uses the best IOLs (lenses) from the world's leading manufacturers to treat diseases such as eye cataracts:
- monofocal: spherical and aspherical;
- multifocal;
- with an additional protective light filter (to protect the retina from ultraviolet radiation);
- with improved aspherical profile;
- toric;
- with anti-glare surface.
IOLs used to treat diseases such as cataracts have varying degrees of stiffness. In modern ophthalmology, when removing cataracts and installing an artificial lens, soft lenses are mainly used. When replacing the lens of the eye, surgery is performed using minimally invasive methods. This means that the surgeon makes a micro-incision that is only about 2.5 mm long. Through such an incision during surgery, only a soft artificial lens can be inserted, which is rolled into a tube. The use of hard artificial lenses was widespread in past years, when cataract treatment was carried out using the cavity method - the surgeon cut the human eye almost in half, which made it possible to introduce a rigid lens. Such operations are characterized by a long and rather uncomfortable recovery period. Nowadays, they are used for cataracts only in really special cases, if the patient has diseases that exclude laser and ultrasound operations - in this case there is no alternative to replacing the lens with a hard lens.
Depending on the method of refraction of sunlight, artificial lenses are divided into spherical and aspherical. A spherical artificial lens refracts the beam differently at the center and at the periphery of the eye lens, which leads to light scattering. At the same time, the clarity of the picture decreases, and flare and glare may occur. The aspherical artificial lens refracts light rays equally everywhere, which ensures excellent color rendition after surgery and remarkable picture clarity. Such lenses are especially important for drivers and those who work at night, as they eliminate the risk of blinding their eyes in the dark.
Artificial lenses also differ in how they correct vision. A lens with a monofocal lens allows you to get rid of vision problems that arise from cataracts and are associated with viewing objects in the distance. Such a lens cannot provide a complete replacement for the human eye, since it does not provide proper focusing at different distances. A patient who has had this type of lens replaced will need glasses after the operation, in which he will perform close work - reading, embroidering. An artificial lens with a multifocal lens does not have these disadvantages. This type of lens works on the principle of a natural eye and allows a person, after lens replacement surgery, to have excellent vision, clearly distinguishing objects both near and far. According to their structure, such lenses have complex optics, consisting of several zones, each of which solves its own problem.
Surgery to replace the lens for cataracts at the Sfera Clinic
Cataract surgery is performed using an innovative method using ultrasound phacoemulsification. Such lens replacement operations are an example of an ideal surgical intervention. The operations are performed quickly, safely, have a minimal recovery period and are the gold standard for cataract treatment.
Over the years, the clinic’s doctors have gained extensive experience in performing such operations, which eliminates negative results and side effects. The treatment will be effective in 100% of cases. The cataract that was preventing vision will disappear and the patient's vision will be completely restored.
Operations to install an artificial lens are completely painless for the patient. Our clinic uses drip anesthesia and minimal, 1.2 to 1.8 mm long microincisions of the corneal edge. Minimally invasive intervention is carried out without sutures, since the micro-incision is instantly sealed by the body immediately after the operation.
A visit to the clinic for eye cataract removal and lens implantation takes several hours. If a patient arrives for removal surgery in the morning, he can go home after lunch. In this case, a follow-up examination by a doctor after the operation is mandatory.
In our clinic, all patients undergo comprehensive preoperative diagnostics before surgery, during which the optimal lens option is selected.
Choosing an IOL for Cataract Surgery
Removal and replacement of the lens will help to cope with eye cataracts - there will be no chance for cataracts. Removal is a radical step that will completely and permanently get rid of eye cataracts.
An experienced surgeon at the clinic will help you choose the best artificial lens, with which the operation will bring the clearest and most comfortable vision. We offer a selection of lenses from the world's best manufacturers. Thanks to this, lens replacement occurs flawlessly, and the service life of the new lens after surgery is more than half a century.
Lens replacement: indications and contraindications for cataract surgery
Cataract is a serious and widespread disease that leads to complete or partial disability. To remove a cataract means to give yourself full vision and freedom, limited by the disease.
Indications for surgery:
- Cataract of the eye of any degree.
- High degrees of myopia (from -9 D, especially above -12, when laser vision correction can only partially help).
- Moderate and high hyperopia and presbyopia (above +5 D).
We understand the condition of patients who find it difficult to decide on surgery - our specialists pay special attention to lens replacement.
Do you want to get rid of cataracts? Come to our clinic!
Cataract is a condition associated with clouding of the lens of the eye and causing varying degrees of vision impairment up to its complete loss. Cataracts can be congenital, but most often acquired cataracts develop under the influence of various factors (inflammatory diseases, eye injuries, poisoning, age-related changes). Physically, clouding of the lens is caused by denaturation of the protein that makes up this organ. For cataracts accompanied by decreased vision, surgical treatment is performed - phacoemulsification of the cataract and implantation of an artificial lens.
Depending on the category of complexity (excluding the cost of the implant)
- 50,000 - 80,000 rub.
Included in the price:
surgery, dressings, medications, food and hospital stay, postoperative observation by the attending physician for 2 months. The cost of an artificial lens is paid separately. Price -
from 10 to 20 thousand rubles.
10 - 20 minutes
(duration of procedure)
from 2 hours to 1 day in hospital
Indications
Any disturbances in the structure and shape of the eye lens that cannot be treated by other means and can lead to complete loss of vision:
- Myopia—reduced visual acuity, in which objects located at a distance are poorly visible, and difficulties arise in performing any work that requires straining the eyes;
- Cataract is clouding of the lens, leading to blurred vision, typical for older people, arising due to injuries, pathologies of internal organs, congenital anomalies;
- Astigmatism is a pathological condition characterized by deformations of the lens, leading to loss of the ability to focus vision, blurriness and distortion of images;
- Dislocation of the lens, disruption of its refractive ability due to poor tolerance of optical or conservative correction or pathologies of internal organs;
- Presbyopia is a disease characterized by sclerosis, i.e. loss of elasticity in the lens tissues and their hardening, which leads to farsightedness and difficulty reading or doing small work.
Contraindications
Relative
- Infections and inflammations of the eye tissues (blepharitis, conjunctivitis, keratitis), after successful treatment of which surgery becomes possible;
- Pregnancy and lactation - surgery is performed after childbirth and the end of the lactation period. If the disease progresses, medications are prescribed;
- Diseases of internal organs - surgery is possible after consultation with the attending physician and his approval.
Absolute
- The size of the eyeball is too small, which prevents surgical intervention;
- Decompensated glaucoma can lead to loss of vision or serious complications after surgery due to high intraocular pressure;
- The presence of such a serious dysfunction of the retina as lack of light perception.
Lens replacement surgery: choosing an implant
Surgery to replace a damaged lens involves the use of an implant called an “intraocular lens.” Its competent selection determines the success of the operation as a whole, affects the patient’s quality of life after it, and the functioning of his visual apparatus. The choice is made on an individual basis, based on the patient’s indications and financial capabilities. In this case, the doctor takes into account the parameters presented in the table below:
| Characteristic | Kinds | Peculiarities |
|---|---|---|
| Rigidity | Soft | They are more expensive, but they minimize trauma to the eye tissue during surgery, since they can be rolled up before installation, which will require a smaller incision. |
| Hard | They use hard material for manufacturing, are cheaper, but are not functional enough. | |
| Number of foci (foci are points that form image clarity: the more there are, the less need to use glasses or lenses) | Monofocal | Used for cataracts, they have only one point at which image clarity is achieved. Outside of it, objects remain blurry. Provide clarity at a distance, require the use of glasses for close-up work. |
| Bifocal | They have two focal points, which ensures clear images of objects at two fixed distances: near and far. Images of objects located between them may be blurry, so correction by optical means is necessary. | |
| Multifocal | They have three or more focuses due to the division of the implant into functional areas responsible for the quality of vision at different distances. They provide good visual effects and do not require additional correction by optical means - that is, in fact, they completely replace the natural lens. | |
| Accommodative ability (adaptation to focusing when contemplating objects that are located at different distances) | Non-accommodating | They are cheaper and are not able to change their curvature, as happens with a real lens, and therefore require the use of optical correction devices after surgery. |
| Accommodating | They are capable of changing curvature in the same way as a real eye lens does, they are more functional and convenient, but they are more expensive. Allows you to stop using glasses after surgery. |
Selection by manufacturer
| Manufacturer country | Brand names | Types of implants | Peculiarities |
|---|---|---|---|
| Russia | bifocal | Provided free of charge if surgery is carried out under a compulsory health insurance policy | |
| Germany |
|
|
They have an aspherical edge and offer a high degree of color rendering. Recommended by many domestic specialists for cataracts complicated by astigmatism. |
| USA |
|
Capable of providing high quality vision in varying degrees of illumination. The back surface of the lens is shaped to focus light rays to one point on the retina, resulting in high image quality. | |
| Great Britain | Rayner | Multifocal accommodating | They have an optimal shape and are made using multizonal aspheric optics technology, which allows you to avoid correction with glasses or lenses after surgery. |
How is an artificial lens implanted in CELT?
Surgical intervention requires a mandatory preparatory stage. It consists of conducting comprehensive diagnostic studies and consultations with specialists in other fields (if necessary).
In order to minimize the risk of infection, the patient is prescribed antibacterial drops three to five days before surgery.
At the CELT clinic, the operation is performed under local anesthesia (anesthetic eye drops). Its stages include the following:
- fixation of eyelids using expanders;
- incision of the eyeball (2‒2.5 mm) and insertion of a special needle;
- the use of ultrasound to whip up the cloudy contents of the eye lens and remove crushed particles of the lens by aspiration;
- placing the implant in the vacant space, straightening it and filling it with liquid;
- applying a sterile dressing.
If the patient has no violations, he is sent home. It is important to understand that after surgery, vision and spatial orientation may be impaired, so it is advisable to come to the operation with an accompanying person.
Lens replacement surgery: postoperative period
The duration of the recovery period varies from person to person. As a rule, patients notice improvement in vision within a few hours; the maximum effect is achieved after approximately 30 days. In order to minimize the risk of complications, it is necessary to follow certain rules:
- Rinse the operated eye daily with sterile water;
- wear a bandage for 7 - 14 days;
- put antiseptic drops into the eyes;
- during the first days, avoid alcohol consumption and physical activity;
- do not lift anything weighing more than three kilograms;
- sleep on the side opposite the operated one;
- sleep on your back if the operation was performed on both eyes;
- minimize visits to baths and saunas in the future.
Lens replacement surgery: possible complications
The development of complications is possible due to refusal to follow the doctor’s recommendations after surgery or due to medical errors. The most common of them:
- retinal detachment;
- corneal edema (goes away on its own);
- development of secondary cataracts (laser correction required);
- increased intraocular pressure (requires the use of special eye drops and timely treatment, as it can lead to the development of glaucoma);
- infection (occurs extremely rarely and requires treatment with antibiotics).
Where to contact?
The specialists of the ophthalmology department have accumulated many years of experience in performing such operations. They allow you to eliminate the cause of the disease, which means achieving long-term good results.
Why do they trust us and choose the CELT clinic?
- We have accumulated vast experience in carrying out such operations; we perform operations for cataracts with significant vision loss, as well as in the presence of concomitant eye pathologies.
- Unlike medical methods, surgical intervention does not just temporarily improve the patient’s condition, but eliminates the cause of the disease.
Surgery to replace the lens of the eye is a serious and technically complex surgical procedure. During the procedure, the patient is conscious. The success of the operation largely depends on how accurately the patient follows the ophthalmologist’s recommendations. Despite certain difficulties, lens replacement is the only radical method of treating cataracts and other diseases of the visual system.
The operation is performed by ophthalmologists. The main indication for its implementation is cataracts, that is, clouding of the lens. The disease mainly affects older people, as the lens loses its transparency due to the aging process. Moreover, some medications, ophthalmological diseases, bad habits and much more can speed up this process.
Cataracts develop slowly. In the initial stages, patients feel a veil before their eyes; as the pathological process progresses, it becomes denser. Visual acuity deteriorates, people with cataracts become more sensitive to light.
How is the operation performed? Do I need to follow any restrictions after surgery? We will get answers to these and other questions in this article.
Indications and contraindications
Replacement of the eye lens is necessary in the following cases:
- cataract;
- lens luxation;
- intolerance to glasses and lenses;
- astigmatism;
- presbyopia;
- myopia;
- deterioration of accommodation processes;
- age-related farsightedness.
Attention! Many experts recommend simultaneous surgical treatment of glaucoma and lens replacement.
There are a number of contraindications to refractive lens replacement:
- inflammatory processes in the visual apparatus;
- the anterior chamber is too small;
- retinal detachment;
- diabetes;
- hypertension;
- progressive farsightedness, accompanied by a small size of the eyeball;
- suffered a stroke or heart attack.
Age-related changes in the lens are the main indication for surgery
Selection of artificial lens
Before choosing a prosthesis, you should first decide on several points:
- at what distance the patient performs the work;
- how often does he need to move his gaze from one point to another;
- whether the patient agrees to wear corrective means in the form of glasses or contact lenses.
To make an informed decision, you should first pay attention to the physical properties of intraocular lenses. Artificial lenses differ in many ways:
- form;
- material;
- light refractive ability;
- rigidity;
- presence of filters.
Depending on the number of foci, intraocular lenses are divided into the following types:
- Multifocal. With their help, the patient is able to focus his gaze on objects that are at near, medium or far distances. Such lenses make it much easier to return to your normal lifestyle and professional activities. If previously after surgery it was necessary to wear glasses, then multifocal lenses eliminate this need. Multifocal lenses have small optical zones, which affects the clarity of vision.
- Monofocal. This type provides clear vision at only one distance - either near or far. Monofocal lenses provide clear vision, but they require the additional use of glasses or contact lenses.
- Bifocals allow the eye to focus on nearby and distant objects. If they are used, there is no need to use corrective agents.
An ophthalmologist will help you choose the right prosthesis after a comprehensive examination.
Specialists can also use a toric lens. This type of lens allows you to combat myopia, farsightedness, and astigmatism. On the outside of the lens there are guidelines that will help the surgeon position the lens in the best way.
Preparation and performance of the operation
Cataract removal with lens replacement is a serious procedure that requires preliminary preparation. The period between diagnosis and surgery should be as short as possible. The doctor must be informed about existing diseases. In addition, you must inform the specialist about the medications you are taking.
Eight hours before the operation, the patient should avoid eating. Most often, elective surgery is performed in the morning. At night, you can take some kind of sedative, for example, motherwort.
Refractive lens replacement is performed on an empty stomach
In some modern clinics, on the eve of surgery, a psychologist works with patients, as well as a surgeon who introduces the patient to the stages of prosthetics, and also stipulates the patient’s actions during the operation. Sometimes patients are asked to look at one point, not blink, and follow all commands. It is important not to panic, but to calmly and quickly respond to the specialist’s demands.
To avoid infection, drops with an antibacterial effect are instilled into the patient several days before surgery.
Attention! The duration of the operation is twenty to thirty minutes.
The procedure is performed under local anesthesia and lasts within thirty minutes. If there are no complications, the patient is sent home the next day. The surgeon makes a micro-incision in the wall of the eyeball and removes the cloudy film. The removal of the lens is carried out using a laser beam. After which he replaces the cloudy film with an intraocular lens. If cataracts affect both eyes, the operation is performed first on one visual organ and only after a while the procedure is repeated.
Rehabilitation period
The recovery period for vision lasts about a month. The doctor will explain in detail what should not be done after the operation. The first stage of the recovery cycle lasts seven days. During this period, the patient already begins to notice significant improvements in the functioning of the visual apparatus, but the body still reacts sharply to the manipulation. The second stage lasts for a month. Patients are advised to use drops, wear glasses, and not strain their vision. And the final stage, lasting five months, is characterized by complete restoration of the functioning of the visual apparatus.
During rehabilitation, it is important to regularly visit the ophthalmologist and adhere to certain restrictions, namely:
- do not lift heavy objects;
- In the first days, it is important to control the amount of fluid consumed. You will have to give up soda and alcoholic drinks;
- exclude sports;
- refuse to visit the bathhouse and sauna;
- wearing a bandage in the first two weeks;
- use of antiseptic eye drops;
- daily rinsing of the eye with sterile water;
- refusal to drive a car;
- When taking a shower, you need to make sure that splashes of water do not get into your eyes;
- avoid bending over, especially in the first days after surgery;
- do not press or rub the operated eye;
- do not take hot baths;
- It is recommended to wear glasses during the first week. They will need to be washed with soap every day;
- exclude strength training, running, jumping, gymnastics, cycling;
- It's better to sleep on your back. It is strictly forbidden to sleep on the side on which the eye was operated on;
- try to limit your stay in smoky or dusty rooms;
- limit computer work and TV watching;
- In the first few days you should not wash your hair.
During the period while the eye is recovering, visiting baths and saunas is strictly prohibited.
Attention! Bed rest is optional. The main thing is to avoid intense physical activity.
Fast and proper rehabilitation includes the following areas:
- proper nutrition. The basis of the diet should be foods rich in vitamins and microelements. Try to eat more vegetables and fruits;
- use of eye drops. Patients may be prescribed disinfectants, anti-inflammatory agents, as well as drops of combined action;
- compliance with the regime;
- selection of corrective means – lenses or glasses;
- timely consultation with an ophthalmologist.
Possible consequences
Let us highlight the complications that may arise after surgery:
- secondary cataract, accompanied by deterioration of visual function;
- hemorrhage;
- infectious process;
- increased IOP;
- rupture of the posterior capsule;
- iris loss;
- uveitis, iridocyclitis;
- astigmatism;
- retinal detachment;
- corneal edema;
- diplopia – double vision;
- blurry vision.
Important! After lens replacement surgery, secondary cataracts may develop.
Sometimes patients complain that after surgery they have double vision and their eyes turn red
Separately, I would like to say about secondary cataracts, which can appear after surgery. What is this connected with? The fact is that during surgery, a specialist cannot completely remove all epithelial cells of the lens. As a result, they begin to affect the implanted lens, leading to its clouding. This complication may take several months or even years to develop.
The disease manifests itself in the form of decreased visual acuity, distortion and blurring. To correct this condition, direct surgery or laser treatment is performed.
In order to avoid the development of secondary cataracts, it is very important after surgery to use metabolic agents that slow down the process of lens opacification. Patients should undergo regular follow-up with an ophthalmologist.
In the early postoperative period, suprachoroidal hemorrhage may appear. Most often it occurs in older people who have been diagnosed with glaucoma, as well as cardiovascular diseases. When the posterior capsule ruptures, the vitreous body is lost, the lens is displaced, and bleeding also develops.
Lens replacement can also cause Irvine-Gass syndrome. The risk group for this complication includes people with uveitis, diabetes mellitus and wet AMD. To combat the complication, corticosteroids, angiogenesis inhibitors, and nonsteroidal anti-inflammatory drugs are used.
A procedure such as replacing the lens of the eye is an effective treatment for cataracts. Modern medicine allows the operation to be performed quickly and painlessly; the procedure does not take much time. Since any surgery is dangerous and has its own indications and contraindications, it is important for the patient to conduct a thorough assessment of his condition before undergoing surgery. In order for the recovery period to pass without complications, it is important for the patient to follow the recommendations of the treating doctor. It is advised to prepare very responsibly for lens replacement.
Indications for testing
An operation to replace the lens of the eye is indicated for cataracts, presbyopia, myopia and high-degree astigmatism, when irreversible pathological processes have occurred in the visual organ (turbidity, changes in structure). Treatment allows the patient to return to a normal lifestyle and fully restore visual function. Elderly people with degenerative changes in the cornea are at risk, and the procedure is also indicated for myopia and farsightedness. The effectiveness of treatment depends on timely detection of the disease and early surgical intervention.
A well-chosen posture during sleep after surgery promotes a speedy recovery. When patients lie on their stomach or side, the risk of postoperative complications increases significantly.
Preparation for the procedure
Laboratory diagnostics will help prevent the development of postoperative complications.
During eye surgery, hospitalization is not necessary; all procedures take little time and are completed in 1 day. Preparation for surgery includes a thorough examination. To reduce the risk of complications during surgery, the patient is recommended to consult a cardiologist and anesthesiologist. You should prepare for the procedure by passing all the necessary tests, such as:
- blood for sugar, hepatitis B, RW;
- general blood analysis.
Laser lens replacement for glaucoma requires prior consultation with a therapist and dentist, the latter will issue a certificate of oral cavity sanitation. It is necessary to prepare for cataract surgery. The patient needs to take a shower, wash his hair, and put on completely clean clothes (preferably made from natural fabrics). The day before, it is forbidden to drink alcohol, eliminate excessive physical activity, and replace it with gentle ones. If a person takes medications to treat diabetes, normalize blood pressure and blood sugar, he must inform his doctor.
Types of lens
Selection of an implant is a purely individual process.
In order for lens replacement for cataracts to give positive results, a suitable intraocular lens is selected individually by an ophthalmologist. There are the following types of artificial implants (IOLs) that successfully change the lens of the eye:
- accommodating monofocal lens;
- multifocal;
- monofocal;
- aspheric IOL.
Carrying out the procedure
Surgery to replace the lens for cataracts is called ultrasonic phacoemulsification. The technology helps correct cataract defects and lens clouding and restore vision. A specialized instrument is inserted through a small incision, and then, using ultrasound, the defective organ is turned into an emulsion. The broken particles are removed from the eye, and an IOL is implanted. After the lens is placed, it straightens and falls into place on its own. The time of the manipulation depends on the characteristics of the development of the pathology; the operation usually lasts 30 minutes. It is recommended to change the lens under local anesthesia.
Complications
The latest technologies reduce the risk of complications to a minimum.
Lens replacement, called refractive lensectomy, when performed correctly and following all the ophthalmologist's recommendations, rarely causes side effects. Possible complications in children and adults include the development of secondary cataracts. The deviation is expressed in clouding of the posterior capsule, a change in color from transparent to cloudy. The use of silicone and polymethylmethacrylate prostheses increases the chances of this side effect. Removing the lens of a child's eye can stimulate fluctuations in intraocular pressure; IOP increases in cases of poor washout of the viscoelastic or lens displacement. Refractive lens replacement can cause swelling of the optic organ; sometimes cataract removal provokes pseudofactual bullous keratopathy, rhegmatogenous retinal detachment, choroidal hemorrhage, astigmatism, and inflammation.
Any surgical intervention causes understandable fear and apprehension in the patient. Especially when it comes to such a delicate technique as replacing the lens of the eye.
After all, not only the quality of vision, but also the overall quality of life will depend on the outcome of the operation. Patients are primarily concerned with how the operation proceeds, what to do after the procedure, and how quickly vision is restored. This article contains the most comprehensive information that will be useful to everyone who is about to have an implant installed.
Why does a natural lens sometimes need to be replaced?
The lens is an element of the eyeball, shaped like a biconvex lens of high refractive power. It refracts light rays of different directions and sends them to the retina, where a clear focus of the image is created.
Depending on how close or far away the object being viewed is, the elastic lens changes its curvature. It refracts rays differently for good distance and near vision. Transparency is a key property of the lens, which allows rays to pass through and hit the retina.
REFERENCE: A natural lens is devoid of nerve endings, blood and lymphatic vessels. Nature itself made sure that no biological inclusions created obstacles to the penetration of light.
As a result of pathological processes, the lens becomes cloudy, its level of transparency changes, and the rays can no longer easily enter the internal media of the eye. If the lens completely loses its transparency, the person becomes blind in the corresponding eye.
Implantation surgery helps to radically change the situation. This is an artificial lens made from biocompatible tissues and serves as a replacement for a clouded lens. Internal environments become transparent again, and a person gets rid of the risks of remaining blind.
Indications for implantation
The main indication for replacing a lens with an implant is cataracts.. This is a degenerative disease caused by a violation of the biochemical composition of the lens with subsequent opacification.
In addition, the operation is indicated for:
- aphakia – congenital or post-traumatic absence of the lens;
- subluxation or displacement of the lens;
- severe refractive errors – , presbyopia, .
For astigmatism and high degrees of refractive error, the lens is replaced even when it remains transparent. The installed intraocular lens will compensate for anomalies of the refractive system and significantly improve visual acuity. If you cannot tolerate glasses, surgery to install an IOL may also be a reasonable solution.
Contraindications
Temporary contraindications to intervention are infectious and inflammatory diseases affecting the structures of the eye: conjunctivitis, blepharitis, iridocyclitis, scleritis, iritis, etc. The same applies to general infections - influenza, ARVI, syphilis, tuberculosis, mumps, rubella, etc. Intervention It is allowed to carry out only after complete recovery and relief of the inflammatory process.
Absolute contraindications:
IMPORTANT! The operation may be denied to persons with a complete lack of light perception. In this case, irreversible changes occur in the retina and installing an IOL will not help restore vision.
During pregnancy and lactation, intervention is also not performed. The operation is not complete without painkillers and antibacterial medications, which can harm the child.
Preoperative preparation
Before surgery to install an IOL, the patient will have to undergo a number of tests:
- clinical blood test;
- blood test for HIV, syphilis and two types of hepatitis (C and B);
- general urine analysis.
It will also be necessary to do fluorography and a cardiogram. If the patient suffers from general diseases (diabetes mellitus, hypertension, pathologies of the kidneys, blood vessels), consultation with related specialists - a therapist, endocrinologist, cardiologist, nephrologist - will be required.
A comprehensive ophthalmological examination is mandatory. It allows you to study the anatomy of the patient’s eyeball, refractive characteristics, and associated disorders.
The day before surgery, avoid heavy drinking, drinking alcohol, smoking, and physical activity. On the day of surgery, it is better to refuse breakfast, or try to have your last meal no later than 4 hours before the procedure.
How to choose an IOL
The choice of IOL is a key point in the preparatory stage. Many patients wonder which lens is best to install in order to achieve 100 percent vision. Only an experienced ophthalmologist can choose the right implant. To make an informed choice, it is necessary to take into account the characteristics of the visual apparatus, the age and occupation of the patient.
All IOLs that are installed in place of the removed lens are called aphakic. In terms of structure and functionality. Mainly used:
Often patients are limited in finances, so they have to make a choice in favor of a less functional, but cheaper IOL.
REFERENCE! Monofocal IOLs are the cheapest for patients. They restore good distance vision, but for close work the patient may need glasses.
Progress of the operation
Modern ophthalmology offers a number of high-tech techniques that make it possible to replace the lens quickly, accurately and with minimal trauma.
Extracapsular extraction
This is the most affordable operation. The disadvantage of the operation is the need to make a large incision in the cornea and apply sutures.
The intervention is carried out under local or general anesthesia according to a specific scheme:
Extracapsular extraction is considered traumatic and carries a high risk of complications. Recently, the technique has been abandoned in favor of more progressive techniques.
During cataract extraction, complex equipment and expensive instruments are not required, therefore its price is considered relatively low. The cost of the operation without IOL implantation is about 15 thousand rubles. To this amount you will need to add the price of the implant depending on the model.
Phacoemulsification
Phacoemulsification is one of the most progressive and effective methods of lens replacement. The advantages of phacoemulsification are low trauma, safety and short recovery period. The operation does not even require anesthesia. The patient is conscious, and pain relief is carried out only with the help of anesthetic eye drops.
How the operation works:
- After instilling the drops, an eyelid dilator is installed.
- A micro-incision is made on the surface of the eyeball.
- The anterior chamber of the eye is filled with viscoelastic - this substance protects the internal structures from injury.
- A probe is inserted into the microincision, through which the lens is liquefied to an emulsion using laser or ultrasound.
- Through the same incision, the emulsion is removed from the cavity, and a lens-implant is installed in its place.
- The remaining viscoelastic is washed away with an irrigation solution, and the incision is self-sealed without sutures.
The operation time without a preparatory period is 15-20 minutes. It is better to check with your ophthalmology clinic how much phacoemulsification surgery costs. As a rule, the price of the procedure without IOL implantation is about 20-25 thousand rubles.
REFERENCE: The intraocular lens remains in the lens capsule for life, successfully performing its functions.
Eye care during rehabilitation
After any intervention, a sterile bandage is applied to the operated eye. Depending on the level of trauma, it will be allowed to be removed on the same day or later. In the postoperative period, the patient will be prescribed drops with disinfectant and anti-inflammatory properties. They will need to be instilled according to a sterile scheme, gradually reducing the frequency of use.
In the first days, you should avoid contact of the mucous membrane of the eye with any irritants - soap solutions, water, dust, foreign particles. In some cases, the use of a special curtain and sunglasses is indicated. You should wash your face very carefully, without touching the operated area with your hands.
The effectiveness of artificial lens installation
Vision is restored most quickly after phacoemulsification surgery. Already on the same day, diagnostics are carried out in the doctor’s office, which shows an improvement in vision by approximately 70%. Visual perception is finally restored on the second or third day after the procedure. Theoretically, on the day of surgery, the patient can already read and watch TV, but doctors advise postponing these activities to a later date.
With extracapsular extraction, rehabilitation lasts longer - from several weeks to several months. The quality of vision is assessed after removal of the sutures.
The effectiveness of lens placement largely depends on the type of IOL chosen. Accommodating and multifocal lenses provide the best postoperative results because they completely imitate the work of the natural lens. They allow you to see well at any distance without glasses. Monofocal lenses are a budget option. After their installation, vision is restored either far or near. And to change focus you will have to use glasses.
Possible complications after the intervention
In the postoperative period, there is a risk of complications:
- increased intraocular pressure;
- macular edema;
- postoperative astigmatism;
- corneal edema;
- pseudophakic bullous keratopathy;
- IOL displacement;
- rhegmatogenous retinal detachment;
- endophthalmitis.
Statistics say that complications after phacoemulsification surgery are recorded in only 2% of cases. Moreover, most of them can be successfully treated and do not lead to loss of visual function.
IMPORTANT! You will have to visit the doctor on the 2nd, 7th and 14th day after the procedure. This is necessary to assess lens survival and early diagnosis of complications.
Living with New Vision
After modern ophthalmological operations, the patient can safely lead a normal lifestyle. Restrictions should be adhered to only in the first postoperative month so that the implant takes root and finally takes the desired position.
What restrictions does the introduction of IOLs imply in the first month after surgery:
- prolonged eye strain – reading, writing, watching TV, working at the computer, sewing;
- sleep on the side of the operated eye and on the stomach;
- physical activity over 5 kg;
- mechanical impact on the eye - friction, scratching, pressure;
- use of contact lenses;
- swimming in public reservoirs and pools.
Video review
Patient impressions of lens replacement surgery:
Lens replacement has long moved from the category of high-tech operations to the category of everyday ophthalmological practice. The most popular and effective technique is phacoemulsification. This is the treatment prescribed to patients with cataracts and serious refractive errors. If the operation is successful and a highly functional lens is selected, you can count on excellent vision without glasses at any distance.
