2024-08-13 09:36:03
Cataract surgery is one of the most commonly performed surgeries worldwide. In the vast majority of cases, results are excellent and complications are rare.
as an ophthalmologist Thousands of such interventions have been carried outWe know that many patients have misunderstandings about this surgery and the causes of cataracts (for example, some patients think they are growths on the surface of the eye). Let’s evaluate this very common pathology, but in most cases its treatment does not present any special difficulties.
What are cataracts?
To understand what this situation actually is, you have to imagine a window with a frosted surface: light is still transmitted, but detail is lost. Another image we can use is that of the transparent surface of a tropical ocean, which finds itself disturbed by storm turbulence. Likewise, when the lens (lens) The eye’s “natural” converging lens), which was previously transparent, becomes opaque.
This condition is not uncommon, as cataracts are estimated to affect people over the age of 80 more than half of americans (In France it involves more than just Editor’s note: 20% of people over 65 years old, more than 60% of people over 85 years old). Every year in the United States, Performed nearly 4 million cataract surgeries (2017, France conducted 830,000 interventionseditor’s note).
After intervention, more than 90% of patients recover Vision is 10/10 with glasses. However, this is not the case for people with other eye conditions, especially those with: glaucoma (a progressive disease characterized by high intraocular pressure), diabetic retinopathy (This may result in damage to retinal tissue) or age-related macular degeneration. at last, Infection rate after endophthalmitis surgery Less than 0.1%.
What does cataract surgery involve?
During cataract surgery, the defective lens is removed and replaced with a synthetic lens to restore vision. Most patients report that the procedure is painless.
This operation is Usually performed on an outpatient basis. It’s usually done under local anesthesia, using sedation similar to that used for dental surgery (we like to tell our patients they’ll be receiving the equivalent of three margaritas intravenously…). However, some surgical candidates must undergo surgery under general anesthesia. This is the case, for example, in patients with claustrophobia or in patients with movement disorders such as those caused by Parkinson’s disease.
Before surgery, the patient will be given drops to dilate the pupil to make it as wide as possible. Anesthetic is used on both the surface and inside of the eye. The surgeon then makes an incision between the clear and white parts of the eye, usually using the tip of a small, sharp scalpel. This gives him access to crystal capsulea film with a thickness similar to the wall of a plastic bag.
The crystal capsule is Suspended by small fibers called zonulesarranged like springs suspending a trampoline from the frame. To gain access to the lens, the surgeon performs a capsulotomy: an incision in the capsule. In order to be able to remove it through the small hole thus created, ultrasound is then used to break the crystal into pieces. These emulsify the lens, and the resulting debris is removed by suction. It may sound scary to describe it this way, but the process is painless.
Please note that laser-assisted cataract surgery Similar results were also obtained Compared with traditional surgery.
rare complications
Serious postoperative complications, such as infection, eye bleeding, or retinal detachment, are rare. They occur in about 1 in 1,000 people and, even when they do occur, require appropriate management Helps protect vision in many situations.
However, there is one complication that deserves attention. These are capsular complications. This occurs when a tear occurs on the posterior surface of the sac during surgery. In this case, the clear gel-like substance (lentus) behind the lens that fills the cavity of the eye Vitreous body) can be found at the front of the eye. According to some studies, such complications may occur Up to 2% of cases.
If this happens, the offending gel must be removed during surgery (this is called vitrectomy). By doing this, the likelihood of postoperative complications is reduced. On the other hand, patients who undergo vitrectomy are at increased risk for certain complications, including postoperative swelling (edema).
after surgery
Patients usually go home immediately after surgery. Most hospitals and clinics require an escort, but this precaution has more to do with the potential consequences of anesthesia than with the procedure itself.
Postoperative treatment begins the same day. It involves applying eye drops and wearing an eye patch without touching the eyes. You don’t need this protective case during the day, but Must be installed before going to bed.
Patients should keep their eyes clean and avoid contact with dust, debris, and water. For at least the first week after surgery, they should try not to bend over and avoid any exertion or heavy lifting. There is a risk if this instruction is not followed choroidal hemorrhagein other words, bleeding into the eye wall, which can be devastating to vision. The problem is that straining and lifting heavy objects can cause a sudden increase in blood pressure in the face and eyes.
Activities that only moderately increase your heart rate, such as walking, are allowed. Routine post-op checkups are usually done the day after surgery, then about a week after surgery, and finally a month after surgery.
Which new lens to choose?
For best results, plastic lenses used to replace cataracts are also called intraocular lensmust be accurately dimensioned. The first artificial lens was successfully developed is monofocal : They offer a single focusing distance, and the person undergoing surgery must choose whether they prefer to see clearly from a distance or up close. Most of the time, distant vision is favored, and people who have the surgery use glasses for near tasks, such as reading. This approach is still relevantas it still plagues approximately 90% of patients today.
However, recent developments have resulted in multifocal intraocular lenswhich offers the possibility to see both near and far, making it possible to operate without glasses. Some of these lenses are even trifocal: they allow you to see near, far, and at intermediate distances, which is important due to the democratization of screen use.
Most patients with multifocal lenses Very satisfied. However, a small percentage of them report suffering from a variety of visual disturbances, including nighttime glare and halos that form around light sources in dim light. Some patients who are troubled by these disturbances sometimes require removal of the multifocal lens to replace it with a standard intraocular lens. When the discomfort is too great, this approach helps alleviate discomfort for most everyone involved.
Research is currently underway to determine for whom multifocal lenses are best suited and for whom they are not. Most clinicians advise against the use of these lenses by people who are detail-oriented because these people face the following risks: Focus on the flaws of this type of lens rather than the benefits they provide.
Like most technologies, intraocular lenses have continued to improve over the years. Those currently available are much better than those that came before, and their successors may further improve vision in patients who receive them while further limiting side effects, such as the aforementioned halo.
However, it should be noted that new lenses are usually not fully reimbursed, which often results in Significant costs are borne by the patient.
Deciding which type of lens is best can be complicated. Fortunately, except in certain cases (such as cataracts following eye trauma), emergency surgery is usually not required when a diagnosis is made. Therefore, you can make your choice with complete confidence.
1724113243
#worried #surgery #Heres
