Cataracts or cataracts are clouding of the natural lens that can only be remedied by surgical removal.
During cataract surgery, the clouded natural lens is removed and replaced by an artificial lens (intraocular lens). Cataract surgery is one of the most common procedures performed on humans and is normally a routine procedure.
During cataract or cataract surgery, the natural clouded lens is shattered with ultrasound and suctioned through a hollow needle (phacoemulsification). In individual, very advanced cases, the lens cannot be shattered and must be carefully pushed out of the eye (extracapsular lens removal). In both methods, the lens capsule should remain intact so that the artificial lens can later be inserted stably and correctly centered.
Femtosecond laser-assisted cataract surgery (femto-cataract surgery) shines with its precision. Blades are generally not used. The lens capsule is opened with a laser beam with micrometer accuracy, circular and exactly centered on the pupil. This improves the stability of the lens capsule, which later serves as a suspension for the artificial lens. Furthermore, the clouded lens is crushed with great precision, which facilitates suction and thus protects the cornea. This technique is generally more accurate and gentler than manual gray star surgery.
> learn more about Femtosecond laser-assisted cataract surgery
The procedure is performed under local anesthesia (local anesthesia). Anesthetic eye drops are administered 30 minutes before the operation and anesthetic is applied to the eye during the operation itself. The anesthetist provides access to your bloodstream so that you can give sedatives or painkillers when needed.
Despite all care taken, complications can occur during cataract surgery. These are very rare as this is a routine procedure and we perform between 10 and 25 such procedures every week.
> learn more about Risks and prospects of success in cataract surgery
Cataract surgery is primarily used to replace the clouded lens with a clear artificial lens so that light can reach the eye unhindered again.
The old glasses usually have to be adjusted after this operation, as the refractive properties of the artificial lens do not exactly match the natural lens.
Thanks to the latest lens calculations, specially designed lens implants can compensate for existing vision defects such as astigmatism, farsightedness, nearsightedness and presbyopia. These so-called value-added lenses enable patients to see sharply at one or more distances without glasses. Unfortunately, the additional costs for this are not covered by health insurance and must therefore be charged to the patient.
Before a cataract operation, it is useful to estimate what is the best solution for you. During the preliminary examination for cataract surgery, this exact question is discussed in an overview of the condition of your eyes.
Both eyes are corrected so that the patient can see sharply into the distance after surgery. Glasses are still required for medium and close distances.
Both eyes are corrected so that you can see sharply in the middle range (newspaper/computer). Glasses are necessary for viewing in the distance (watching TV/driving).
Both eyes are corrected so that you can see clearly in the vicinity (newspaper/book). You may need glasses to work at a computer. In the distance (watching TV/driving) can only be seen with glasses.
Your guide eye is corrected so that you can see sharply into the distance. The other, non-dominant eye covers mid-distance vision. You have the advantage that you no longer need glasses for most daily activities after the procedure. Conventional single-vision glasses can help you read newspapers in a relaxed way. Monovision can be simulated with glasses or with a contact lens test and provide information about compatibility.
Looking at a distance and close without glasses, as at a young age does not have to remain a dream. There are special artificial lenses that allow both eyes to see near and far at the same time.
These special multifocal lenses do not focus light to a single point, like monofocal lenses, but to several points, which enables so-called “pseudo-accommodation.”
Unfortunately, not all patients are suitable for implanting multifocal lenses; this is evaluated during the preliminary examination for cataract surgery (link).
The development of lens opacity can be slowed down by wearing glasses with UV protection and eating a healthy diet. Existing turbidity can only be treated with cataract surgery.
Most people develop lens opacity sooner or later, which is part of the natural aging process. Cataracts affect 50% at the age of 65 and almost 100% from 75 years of age. Cataracts can occur much earlier in people who suffer from blood sugar disorders (diabetes mellitus) or take cortisone supplements.
There are various reasons for cataract surgery:
Choosing the right ophthalmologist is decisive for the success of cataract surgery
Possible criteria are:
It is not possible for cataracts to come back again. After cataract surgery, around 50% of patients experience a cataract, with individual cells accumulating and clouding on the back of the artificial lens. A short and painless laser procedure can make the lens clear again (link: YAG capsulotomy).
Due to the immense progress made in the safety of cataract surgery, it is now possible to consider operating both eyes at the same time. Benefits include patient comfort. There are fewer follow-up checks and the patient is quickly able to return to work.
In principle, from our point of view, it makes more sense to operate on one eye first and only a week later on the second eye. This makes it possible to adjust the choice of artificial lens on the second eye if necessary and to address postoperative inflammation preventively.
No, there may only be a slight feeling of pressure for a few seconds, e.g. when the IOL is implanted or when the femtosecond laser is applied.
The eye that is not being operated on is covered and therefore only sees the dark cover. The eye that is being operated on sees the light from the microscope. As a result, glare can occur for a short time. Patients often perceive the twinkling of microscope light as a kind of kaleidoscope.
Between 10 and 20 minutes, depending on how far the cataract has progressed.
As a rule, work can be resumed just a few days after the operation. To be on the safe side, we issue a work reference for one week after cataract surgery. After the implantation of multifocal lenses, it usually takes several weeks to months until patients become accustomed to the new visual experience and get by without glasses.
Depending on the type of operation and the IOL used, the vast majority of everyday situations can be handled without glasses after cataract surgery. If simple IOLs are used, the progressive glasses must be adjusted.
