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Cataract Unit and Phako Operation

What is Cataract?

Cataract is the opacification of lens, which is one of the refractive ambients in human eye and focuses the rays entering the eye on the vision point, losing its transparency and having the appearance of mat glass.

What are the Causes of Cataract?

Cataract is generally depend on age and seen mostly over the age of 50. Cataract possibility increases with advancing age. Natural lens comprises of water and protein. Proteins degenerate with aging. This causes opacification of the lens and decrease of vision. Moreover, it may occur in diabetes, calcium disorders, following long-term steroid use, as a result of impacts to eye or innately.

What are the Symptoms of Cataract?

Impairment of visual clearness, eye-glasses numbers to be insufficient, frequent changes in near and distance acuity prescriptions, sudden recovery in near acuity disorders of some patients, having troubles under brilliant light, shaded vision of colours, decrease in vision at night are the most frequent symptoms of cataract.

How is Cataract Treated?

Surgical operation is the only way of treatment of cataract. Despite the presence of many surgical methods implemented in the past, the operation technique used successfully and frequently in our day is the Phacoemulsification method, which is known to be a sutureless technique. This method is known colloquially as “PHACO” in brief.

When should Cataract Operation be performed?

Today, cataract operations should be performed when it gets to the level where humans cannot carry out their daily life and social activities. While cataract used to be expected to develop and vision to close almost completely in the past, cataract to develop at an advanced level affects both surgeon and patient comfort negatively in our day. Therefore, when cataract starts to affect person’s daily life, it should not be avoided from operation following the detailed examination under physician control.

How is Operation performed under Phacoemulsification Method?

It is entered inside the eye with approximately 3mm laceration in the phacoemulsification method. Cataract is divided into very small pieces through the sound waves propagated by the state of the art technology PHACO device. Then these pieces are absorbed and discharged. Following the cleaning of opaque cataract completely, a thin capsule is left behind. An artificial lens is placed to stay in the eye of the patient for life. No suture is needed due to the operation is performed through a very small laceration. The operation time is mostly 15-20 minutes.

Which type of Anaesthesia is used in Cataract Operations?

Drop anaesthesia is frequently used during the operations. Eye is ensured to be benumbed being poured eye lotion. General anaesthesia is sometimes preferred in children or in patients who are not capable of undergoing operation under local anaesthesia. Local anaesthesia can be applied through injection to supraorbital.

Are glasses needed after operation?

Private corrective lens is placed during the operation. This lens ensures distance acuity, glasses are necessary for near acuity. Some patients may need distance acuity prescription glasses. If multifocal lens (the lens that aims to correct both distance and near acuity) is used, then patients may continue their lives without using glasses. Glasses are prescribed 2 weeks after the operation at the earliest.

Does Cataract Recur?

Cataract ingenerates in the eye once and does not recur when natural lens is replaced by the new artificial lens with operation. However, the transparency of the membrane in which the lens is placed may decrease particularly in young patients. Therefore, patient’s clarity of vision may decrease. If sight decreases in these patients, a special laser (YAG laser) treatment is applied and the membrane which loses its transparency is cleaned and patient is ensured to reach to seeing level.

How is Congenital Cataract Treated?

If congenital cataract prevents seeing, then it must be operated at the earliest. Permanent amblyopia occurs if operation is not performed as soon as possible. The operation is applied through the phacoemulsification method again and a folding les is placed into eye if age is appropriate.

ABOUT CATARACT OPERATION

Things to Pay Attention before and after Cataract Operation

  • Aspirin and the like medications must be discontinued 3 days before the operation.

  • Patients may have breakfast on the operation morning but it should not be a heavy breakfast.

  • Medications used for systemic diseases such as diabetes, hypertension and asthma must not be discontinued on the operation day.

  • Insulin dosage, oral antidiabetic treatment, diet must continue normally.

  • It would be useful to bring your systemic medications on the day of operation.

  • Face should be washed thoroughly on the day of operation.

  • Please do not put on make-up, lotion and parfume.

  • Your cloths will be changed with the sterile cloths to be given to you during the operation.

  • You may return home after a short while following the completion of the operation. Your doctor may invite you to examination again within the first 36 hours.

  • You may have a bath 3 days after the operation.

  • You’d better not return home alone or drive car.

What about my Operation?

  • You may convey anything you want to say to your doctor during the operation because you will not be completely anaesthetized.

  • The operation will be performed through the phaco method which is known to be the sutureless technique. This method will ensure increase in your vision early and there will not be situations such as removing sutures.

  • You’d better not move your head or eye for a very short time during the operation.

How I should drop my eye lotion?

  • Hands must be washed thoroughly before dropping lotion.

  • If your physician recommended the use of 2 different lotions after the operation, both lotions must not be dropped simultaneously. There may be interaction between two medications. The second lotion must be dropped 15 minutes later than the first lotion.

  • You’d better shake the bottle before dropping the lotion.

  • Lotion must be dropped into the eyelid without touching the tip of the lotion to eye and looking upward and pulling the lower eyelid down.

  • Eye drops must continue during the day, there is no need for drops while sleeping at night.

  • Unless said otherwise, using lotions for 15 days in accordance with the time table given to you will be sufficient.

Recovery

The recovery time is short. Wide laceration applied with the old methods delays the postoperative recovery of sight. However, the small laceration applied with the phaco method accelerates the period of recovery.

1) You need to be checked one after the operation. The closed eye is opened. Sight can be blurred or very clear at first. There can be different healing processes for everyone.

2) Following a few weeks, clearness in sight increases more and more and a measurement can be performed for new glasses after one month. The 1st day, 1st week and 1st month checks are made after the operation. During this time, both healing of the eye and protection against infection are ensured with eye lotions.

3) You may feel the need for glasses following the operation. Because following the cataract operation, light passes through cornea and artificial lens and reaches to retina. For a good sight, the light should focus on retina and if your eye is not capable of doing this, then you may need glasses.

4) While young lenses change shape when looking near, the lens placed into your eye cannot do this. And while distant objects are clearly seen, you may need glasses when looking near.

Femtosecond Laser Cataract Surgery

The place of entrance to eye have been made through the “femtosecond laser cataract” method used in the cataract surgery, peeling the anterior membrane of cataract (capsule) and dividing the cataract into pieces have been performed with laser energy for the last 5 years. In the classical phaco method, entrance to eye is made through bistoury and the anterior membrane is peeled by a surgeon.

These processes in the laser cataract surgery are performed nonsurgically and with exact sizes. Besides, lesser energy is applied to eye due to cataract is divided into pieces with laser energy, thus the risk of cornea damage is reduced. Femtosecond laser cataract surgery minimizes the error margin for patients and the cataract surgery provides safer results.

Following the cleaning of cataract with the operation, lenses are placed into eye, which are permanent for life. It is aimed nonexistence of the need for glasses after the operation placing lenses with distant/near acuity and stigmator features. The astigmatism disorder can also be corrected during the same operation via Femtosecond laser surgery.

Consequently, cataract can be healed effectively, quickly and safely thanks to the state of the art technology devices and methods with “Femtosecond laser cataract surgery”.