Cataract Surgery

About cataracts:

More than fifty percent of the people over the age of 60 and quite a few younger persons suffer from cataracts. In fact, cataracts are so usual that everyone will eventually develop one provided that they live long enough.

Some people (5%) have cataract younger, for different causes : diabetes, glaucoma, inflammatory diseases of the eye (as iritis…), traumatism of the eye, use of cortisone (for asthma, rheumatoid arthritis…)

A cataract is a progressive clouding of the eye's natural lens, which interferes with the light passing through to the retina, resulting in a gradual blurring or dimming of the vision.
Reading may become more difficult and driving a car might present dangers. Cataract sufferers may also be troubled by a bothersome glare, halos around lights or even double vision. As the cataract worsens, frequent changes in eyeglass prescriptions may become necessary.

Currently there is no medical or laser treatment to reverse or prevent the development of cataracts. Once they have formed, there is only one way to recover a clear vision; that is, to physically remove the cataract from the eye.

Before the operation:

During an eye examination, the doctor uses a slit lamp and an ophthalmoscope to look inside the eye. In most cases, eye drops are used to dilate (widen) the pupil.

The length of the eyeball is measured using a special instrument A-Scan or IOL-Master (laser interferometry). This helps the doctor to choose a new lens to replace the cloudy lens.

This has to be done one or, preferably, two days before the operation. At that time, the patient receives antibiotic drops during the two preoperative days.

The patient should bring along a medical, both ophthalmologic and general, report.
There is no need to stop any previously used medication.

Surgery:

Pre-operation of the eye includes dilatation of the pupil by drops starting 90' before the operation.

The surgical team includes an ophthalmologist, an anaesthesiologist and some nurses.
Anaesthesia is mostly provided by way of drops and an intravenous sedation. Sometimes, it is done by local injection or general anaesthesia.

The ophthalmologist uses delicate instruments and a special microscope that magnifies and lights the eye up. The cataract is removed with an advanced technique called phacoemusification, or small incision cataract surgery. An incision of about 2.5mm is made in the front part of the eye. The cataract is then broken into microscopic particles, using high energy sound waves, and gently suctioned from the eye. To compensate for the removal of the eye's natural lens, an intra-ocular lens (IOL) is implanted into the eye.

The operation's time is about 15 to 20 minutes.

After the surgery:

A patch or a transparent eye shield is placed over the operated eye; the blood pressure is monitored and the patient rests until s/he is ready to leave.
The patient is likely to feel sleepy and unable to drive; therefore, it is necessary to make arrangements for her/his transport home and accompaniment by another person.

Check ups are mandatory, both one day and one week after the operation. During the two post-operative weeks, the patient will need eye drops (antibiotic and steroids) first four times, and later two times a day.

In most cases (95%), the patient will stay in Belgium for a period of 10 days. Some difficult cases may require a longer period of time.

Surgical Risks:

Cataract surgery has a high rate of success. However, there are certain risks; including bleeding, infection, retinal detachment, droopy eyelid, and loss of vision.