When should cataract surgery be performed? Surgery is recommended when the lens becomes slightly cloudy at first and the vision (as determined by an eye test) deteriorates significantly. Surgery is then the only treatment option for cataracts and, if cataracts are the only eye disease present, it usually leads to good success. The operation under local anesthesia is only a minor burden for the patient and usually painless. Today, cataract surgery is one of the most common operations and about 600,000 of these operations on the lens of the eye are performed in Germany every year.
Procedure of the treatment
The clouded lens is surgically removed from the eye and usually replaced by an “intraocular lens” made of plastic. The operating ophthalmologist will perform a thorough preliminary examination, and the refractive value for the new (artificial) lens is then calculated using ultrasound. The strength of this lens will be adjusted so that after the operation the patient can see better either near or far without glasses.
However, an exact prediction of the refractive conditions after the operation is impossible. Initially, only one side is operated on, even if cataracts are present on both sides. Together with the doctor in charge, it is determined when the operation on the second eye should follow.
Since the operation is usually performed under local anesthesia, the patient is allowed to eat light food on the same day after consultation with the surgeon. Because the eye is locally anesthetized, the patient notices very little, if at all, of the operation. However, the injection of the anesthetic next to or near the eye may temporarily restrict the mobility of the eye, the eyelids and also the image transmission.
What happens during the treatment?
The lens of the eye, which lies directly behind the pupil, consists of several parts. The core, located in the center of the lens, hardens over the course of life and carries the softer cortex around it. In its entirety, the lens is enclosed by the lens capsule, which is attached to the radiation body of the eye behind the iris with the so-called zonula fibers (elastic fibers).
Nowadays, during cataract surgery, the entire cloudy lens is no longer removed, but the posterior and lateral lens chamber is left in the eye if possible. The most common form of surgery is phacoemulsification, in which the lens capsule is opened at the front in the form of a disc through an incision only a few millimeters in size. The harder lens core is then liquefied with ultrasound and aspirated together with the soft cortex of the lens.
The lens capsule emptied in this way is then filled with a small folded soft artificial lens (so-called folded lens) via the small incision. Alternatively, the previously small incision is enlarged and the unfolded lens is inserted into the lens capsule. After the operation, an ointment bandage is applied and the patient can get up immediately and eat light food.
Depending on the time and progress of the treatment, the bandage is changed in the afternoon or waited until the next morning. A complete healing of the operation can only be expected 4-6 weeks after the treatment, even though most patients already have a significantly better vision directly after the operation than before. For this reason, it only makes sense to adjust a visual aid (glasses or similar) from this point on, because before this time, vision would still be subject to excessive fluctuations.
