Cataract is a painless eye disease, involving the progressive lens opacification. The only symptom of cataract is a gradual deterioration in vision. The lens has the size of an aspirin tablet and is located behind the iris. In the normal eye the lens is completely transparent and light rays entering the eye, without encountering any obstacle, reach the retina. This way a clear picture of the observed object is created. Emerging lens opacities constitute an obstacle to the correct vision. Such a situation may be compared to looking through a heavily soiled windshield.
Cause of cataract
Cataract may be congenital in nature and then it is observed in young children or even directly after birth. This type of cataract may be a result of diseases that mother had during pregnancy, it may also have a genetic background. Cataract is also sometimes a complication of some general diseases (e.g. diabetes, tetany) or eye diseases (e.g. uveitis). Similarly, eye injuries – can lead to the development of cataract – then we are talking about the traumatic cataract. It was also found that some medications (e.g. steroids) can cause the development of cataract. It is also known that persons living within the range of ionizing or infrared radiation (high temperatures) are exposed to the development of cataract. However, in most cases cataract develops with age, without any apparent reason. Then we are talking about the so-called senile cataract.
Symptoms of cataract
The first symptom of cataract may be blurred vision. Then some people begin frequently wipe their eye glasses, thinking that the cause is a dirty glass. There occurs the phenomenon of glare when looking at the light source, caused by splitting of light rays on the lens opacities. A signal of the beginning of the cataract may also be a need for frequent change of eye glasses and a problem with selecting a suitable correction. As cataract progresses, visual acuity is deteriorating and colours are faded. In extreme cases, when the lens becomes totally opaque, a significant vision impairment occurs. There are seen only the outlines of large objects. Cataract do not hurt, does not itch, does not cause reddening or tearing.
Cataract treatment is only surgical. Currently, the most used method of cataract removal is phacoemulsification, or ultrasonic fragmentation of the opaque lens. It gets fragmented and flushed from the eye with a special apparatus – phacoemulsifier. Only a thin posterior capsule remains. Its presence allows the implantation of an artificial lens. This ensures good visual acuity after the procedure, without the need for the use of strong corrective lenses. Phacoemulsification requires only the performance of a small incision in the cornea, only under a local anaesthesia. The operation takes about 15 minutes and is painless. The eye heals quickly. After a few days you can return to your daily duties.
Phacoemulsification, in comparison with the classical extracapsular cataract extraction, means:
- faster healing of the wound (small incision, not requiring stitching)
- shorter convalescence
- early stabilisation of vision with less possibility of post-operative astigmatism.
The following examinations are required:
- blood test (complete blood count, glucose, electrolytes, APTT)
The following examinations and consultations are performed during qualification:
- disease diagnosis
- USG of the eye ball (the calculation of the power of artificial lens)
- anaesthetic consultation.
Following the qualification performed, there is scheduled the term of the procedure, which is performed in the operating theatre under a local topical anaesthesia assisted with analgesics and sedatives – it takes about 10–30 minutes.
After the procedure, the patient remains in the Centre until the physician makes a decision that the patient can safely leave the hospital. It is necessary to perform a checkup a day after the procedure. An operated person can independently walk and perform basic activities. A few days after the operation a return to an earlier mode of life, with limiting heavy physical effort, is possible.
Modern surgical equipment
At MAVIT Medical Centre Specialised Hospital in Warsaw during the planning and performing cataract surgery we using two modern Alcon systems: Verion ™ Image Guided System and Centurion® Vision System.
CUSTOM-Pak® surgical kits produced by Alcon
MAVIT Medical Centre is one of the first ophthalmic centres in Poland, which during the performance of cataract removal procedures introduced CUSTOM-Pak® disposable surgical kits produced by Alcon. These kits were designed specifically for ophthalmic surgery, in particular for cataract removal.
They contain all the prepared (unpacked) disposable sterile medical materials and hardware accessories necessary for cataract removal, set together in an agreed order in a unit package.
Their use provides the highest standard of realisation of the procedure and guarantees the highest safety of its performance.
The decision on the procedure
Patient decides together with a physician on when cataract is going to be operated. The decision must be made when cataract leads to a disturbance of the current lifestyle, interferes with daily activities or work. One should not wait until the cataract completely develops.
Contraindications for the cataract removal procedure
There are rarely contraindications associated with the general health condition. The procedure does not require a general anaesthesia and a long convalescence. It is short and safe. Each patient before elective surgery is asked to perform certain additional examinations and consultations, is subjected to a detailed eye examination. This procedure allows to prepare the patient for surgery and ensure safety during the procedure. The patient already in 2–3 hours after the operation may return home.
At MAVIT MC we implant the most modern intraocular lenses.
All lenses implanted by us are one-piece, thin, flexible – they are characterised by a high degree of foldability, so that they can be introduced into the eye ball through a small opening. Lens implants are made of a variety of biologically inert materials: polymethylmethacrylate (PMMA), silicone or acrylic.
We offer to our patients:
Monofocal lenses – with yellow filter, imitating the function of natural lens, which protects the retina against phototoxic effects of blue light. These lenses provide good far and near vision, but do not correct astigmatism.
Monofocal lenses provide a single fixed focus, usually to perceive distant objects. As a result, patients after cataract removal can see clearly from a distance, but to perform activities using near vision, e.g. reading, work on computer, it is necessary to use eye glasses.
Toric lenses – provide good far and near vision, correct astigmatism.
Multifocal lenses – provide a full range of far and near vision, significantly reduce or completely eliminate the need for using eye glasses after the procedure.
At MAVIT Medical Centre Specialised Hospital in Warsaw we implan:
- monofocal lenses: ALCON AcrySof®, ALCON AcrySof® IQ Natural, ALCON SA60AT
- toric lenses: ALCON AcrySof® IQ Toric, ALCON AcrySof® IQ ReSTOR Toric
- multifocal lenses: ALCON AcrySof® Restor Natural, ALCON AcrySof® Restor Toric Natural, ALCON AcrySof® IQ PanOptix®.
At MAVIT Medical Centre Specialised Hospital in Katowice we implan:
- monofocal lenses: ALCON AcrySof® IQ Natural, ZEISS CT LUCIA®
- toric lenses: ALCON AcrySof® IQ Toric, ALCON AcrySof® IQ ReSTOR Toric, OCULENTIS Lentis Mplus Toric
- multifocal lenses: ALCON AcrySof® Restor Natural, ALCON AcrySof® Restor Toric Natural, ALCON AcrySof® IQ PanOptix®, ZEISS LISA, ZEISS LISA tri, OCULENTIS Lentis Comfort, Toric OCULENTIS Lentis Mplus, Human Optics – diffractiva.
All lenses used in the MAVIT Medical Centre provide (according to clinical studies):
- the possibility of implantation through a small opening in the cornea
- long-term centration and stability
- reduction of opacities of the lens posterior capsule.
- prof. dr hab. n. med. Marek Rękas
- dr n. med. Adam Kluś
- dr n. med. Mariusz Kosatka
- lek. Rafał Pawlik
- dr n. med. Radosław Różycki
- lek. Jacek Rudowicz
- lek. Mateusz Tłustochowicz