The main function of the eyepiece is to collect light from the cornea and transmit it to the retina. Cataracts occur with the deterioration of the transparency of the eyepiece. Cataract is the most common eye disease that causes vision loss in people over the age of 40.
Cataracts can occur from birth or over the years. It is possible to talk about different types of cataracts according to the region where transparency is lost in the eye lens. When a cataract occurs at the back of the lens, it is called a “subcapsular cataract”, a “nuclear cataract” when it occurs in the center of the lens, and a “cortical cataract” when it starts outside the lens.
Cataract, which does not cause any obvious complaints at the beginning, but causes complaints such as blurring of vision, light sensitivity, decrease in night vision and double vision over time, can seriously reduce the quality of life of patients over time. Therefore, cataract treatment should not be ignored. Cataract treatment can only be done with surgical methods. Today, developing medical technologies have greatly increased the success and comfort of the treatment process of cataract surgery.
What is Cataract?
Cataract is the opacity of the natural lens of the eye, which is one of the important tissues in the eye that allows us to see, by losing its transparency. Its normally transparent structure deteriorates and becomes like frosted glass.
Although cataract is an eye disease that gets worse, patients do not have serious complaints due to the clouding of a small part of the lens in the initial stage, while it causes further deterioration and decrease in vision over time.
As I just mentioned, cataracts can occur from birth or with age. This disease, which can be felt in one or both eyes, is considered to increase by 90 percent depending on age. However, it is not a correct approach to reduce the causes of cataract to congenital anomalies or growing age. Nutritional habits, genetic predisposition, past eye diseases, systemic disorders and traumas to the eye are also among the risk factors that cause cataract formation.
What are the Causes of Cataract?
The main cause of cataract disease is the loss of flexibility and transparency of the natural lens of the eye. These structural changes that occur in the lens of the eye and cause vision problems can start for various reasons.
The most important risk factor for cataract formation is increasing age. However, regardless of age;
- Congenital anomalies,
- Eye traumas,
- Various systemic diseases such as diabetes,
- Long-term use of cortisone drugs,
- Recurrent intraocular infections such as uveitis,
- Factors such as undergoing vitrectomy (back of eye surgery) may also lead to cataract formation.
What Are the Symptoms of Cataract?
Cataract symptoms can vary depending on how the disease deteriorate and the type of disease. Not all cataract symptoms are seen in every patient, but we can list the most common cataract symptoms as follows;
- First of all, declining steadily in farsightedness,
- Temporarily better nearsightedness without glasses,
- More deterioration of vision in sunny environments,
- Scattering in illuminated environments,
- Color matting,
- double vision
How Is Cataract Treatment Done?
Cataract treatment can only be performed with cataract surgery. Currently, no effective method has been found in the treatment of cataracts other than surgery. In order to decide on cataract surgery, the patient should be examined in detail, the progression level of the cataract should be determined and the complaints of the patients should intensify. Since cataracts in the initial stage may not cause complaints, they may not require surgery.
Cataract Surgery
Cataract surgery is performed very comfortably with developing medical technologies. During cataract surgery, which can be performed with different techniques, the patient’s clouded eye lens is removed and an artificial intraocular lens is placed in its place. The choice of artificial lens placed in the eye during cataract surgery depends on the patient. In line with the eye tissues, preferences, wishes and needs of the patients, a choice is made between monofocal lenses, multifocal lenses, toric lenses and trifocal lenses called smart lenses.
How Is Cataract Surgery Performed?
Cataract surgery is performed in two ways;
Classic PHACO (Phacoemulsification) Method, which has been applied for many years
Femtosecond Laser Method (Femtocataract)
In both cataract surgery methods, no needles are used and no stitches are used. Therefore, patients’ recovery in the post-operative period is fast and comfortable. Patients can return to their daily lives the day after cataract surgery.
How is Cataract Surgery Performed with the FAKO Method?
- The duration of the operation is 10-15 minutes.
- The eye is anesthetized with drops (no injections),
- A very small incision of 2 mm is made.
- A round aperture is provided from the front of the lens with the cataract.
- By entering the eye with an ultrasonic device called phaco, the lens with cataracts is first divided into small pieces and these pieces are cleaned by suction one by one with the same phaco device.
- The artificial intraocular lens is then injected into the eye with an injector. This artificial lens is opened in the eye and placed where the cataract lens was removed.
- Finally, an antibiotic drug is injected into the eye and the wound is inflated with liquid and the operation is terminated.
- No stitches are placed.
How is Cataract Surgery Performed with Femtosecond Laser Method?
- The duration of the operation is 10-15 minutes.
- The eye is anesthetized with drops (no injections),
- The patient is first placed under the Femtosecond Laser device. Here, under computer control, before even opening the eye, a circular opening of desired dimensions is created in front of the membrane surrounding the cataract lens with the laser. Then, the cataract lens is divided into pieces of the desired number and size, and finally, a 2.2 mm incision is prepared to enter the eye. All these stages are done in a short time like 30-40 seconds and safely without the patient feeling anything.
- After the laser phase is completed, the patient is placed under the operating microscope. Here, the eye is entered through the incision created by the laser (without using a knife), and the cataract lens that is broken by the laser is suctioned out with the phaco device.
- The artificial intraocular lens is then injected into the eye with an injector. This artificial lens is opened in the eye and placed where the cataract lens was removed.
- Finally, an antibiotic drug is injected into the eye and the wound is inflated with liquid and the operation is terminated. No stitches are placed.
What are the Factors Affecting Success in Cataract Surgery?
Cataract surgery, which is one of the most frequently performed surgeries in the world and in our country, is a very specific and detailed surgery. Both surgical methods and preoperative examination devices and artificial intraocular lens technology are constantly developing. It is very important for the success of cataract surgery that the surgeon performing the operation follows and applies all these developments.
Therefore, the success of the surgery;
the surgeon has up-to-date knowledge and experience,
the surgical method to be performed,
the device and material to be used,
the quality of the lens to be put into the eye,
It depends on the suitability of the patient.
FEMTOSECOND LASER CATARACT SURGERY
Safe and comfortable surgery, fast recovery, high success…
The main difference between femtosecond laser cataract surgery and Phacoemulsification is the technology used to access the lens of the eye. In the phaco method, a slit knife is used for incision in the cornea, while the incision is made entirely with laser technology during cataract surgery with Femtosecond. Therefore, in the femtosecond technique, the incision can be made more smoothly and in a planned manner, the post-operative risk factors can be minimized, and the postoperative visual quality of the patients can be improved.
What is Femtosecond Laser?
Femtosecond lasers are laser systems that can shoot at time intervals as short as one quadrillionth of a second, do not harm the tissues outside the targeted tissue, and make the desired incisions smoothly and very accurately.
How Many Years Has Femtosecond Laser Been Used in Cataract Surgery?
Femtosecond laser technology has been used in cataract surgeries since 2010. Since the incision in the eye is opened carefully and does not damage the surrounding tissues, better results are obtained compared to the classical FACO method, and cataract surgeries with Femtosecond are becoming increasingly common.
What are the advantages of Femtosecond Laser Cataract Surgery over the Classical Phaco Method?
The most important steps performed by the surgeon’s hand in the phaco method can be performed flawlessly under computer control and untouched by human hands in Femtosecond laser cataract surgery.
In the laser method, the time spent in the eye and using the ultrasonic phaco device is very short.
The rate of intraocular tissues being affected by surgery is greatly reduced. This accelerates the healing process and provides a safe surgical opportunity.
It also positively affects the long-term performance of the artificial intraocular lens, which directly affects our post-operative vision by ensuring that all stages of the surgery are performed very smoothly.
At the same time, it provides the opportunity to correct mild to moderate astigmatism with incisions called Arcuat during cataract surgery. However, the success of this procedure is depend on the surgeon’s experience in this area.
Who Should Prefer Femtosecond Laser Cataract Surgery?
Cataract surgery with femtosecond laser can be applied to all patients who want to have cataract surgery. However, for some patients, cataract surgery with a femtosecond laser may become the only choice.
Femtosecond laser cataract surgery is the surgical method we prefer especially in patients with high risk of complications and/or in patients who are planned to wear smart lenses to get rid of glasses after cataract surgery.
Who Cannot Have Femtosecond Laser Cataract Surgery?
Femtosecond laser cataract surgery is not applied to patients who have spots or lesions on their corneas that prevent the passage of laser beams, or whose pupils are not dilated enough. Femtosecond laser cataract surgery can be applied to all other cataract patients who do not have the problems we have mentioned. It should not be forgotten that the surgeon’s experience and the quality of the laser device are very important determinants in increasing the success of laser cataract surgery, in addition to the correct evaluation of the general health status of the patients and comprehensive eye examinations.
CATARACT SURGERY SUMMARY INFORMATION
The operation takes 10-15 minutes. It lasts, needle-free, seamless, painless.
You can go home at the end of the operation on the same day.
The next day comes for control.
It is appropriate to take a break from working life for at least 1 week.
It is necessary not to do heavy work for at least 2 weeks and not to rub the eyes.
Drops are used for 1 month.
Visual clarity increases gradually from the first day until the end of the first month.
Glasses examination is done at the earliest 2 weeks later, preferably at the end of the 1st month.
The need for glasses varies according to the characteristics of the lens put into the eye.
If there are cataracts in both eyes, it is appropriate to perform the operation 2-3 days apart, not on the same day.
Cataract does not occur again.