This article has been provided by Dr. Huseyin ACAR to give information about ‘Cataract Disease and Its Treatment’ in general terms.
WHAT IS THE STRUCTURE OF THE EYE ?
Function of our eyes is to sense the incoming light and to transmit it into the visual cortex at the brain. This has been done by focusing the light into the nerve layers with the help of lens system existing inside of the eyes. Our natural intraocular lens is one of the elements forming the focus system of the eye and it is that tissue affected by cataract disease. When studying structure of the natural intraocular lens, it is seen that it has been covered by an outer transparent membrane layer. At the inside of this membrane layer, there are transparent fibers rowed in a regular manner.
WHAT IS CATARACT AND WHAT ARE THE CASUSES ?
Cataract disease happens when fibers located inside of the natural intraocular lens loss their transparency. Decay in the structure of the fibers inside of the natural intraocular lens occurs usually due to the ageing. This process can be speed up by some factors such as diabetes, glaucoma, and traumas. The fibers losing their transparency causes decrease in vision.
Image 2: Cataract disease happens when fibers located inside of the natural intraocular lens loss their transparency
DIAGNOSE OF CATARACT DISEASE AND HOW TO TREAT IT ?
Diagnose of a cataract disease can be established in routine eye examinations. Generally there is no difficulty in making diagnose. The most important issue is to plan timing of the surgery and to determine whether the individual may obtain benefit or not from the surgery. Timing of surgery is decided as per the level of vision the patient needs and stiffness of cataract. Nowadays golden standard in the treatment of cataract disorder is PHACO method. Surgery is mostly done with drop anesthesia and the surgery lasts approximately 20 minutes. Patients are discharged from the hospital within 30 minutes or one hour later.
Recently small modifications have also been made to PHACO method as the laser systems develop. The most noticeable development in this area is the addition of femtosecond laser into the surgery. In this method, some of the applications are done with the laser. Yet, cleaning of the fibers within the membrane is realized by the help of PHACO device. There is no difference at the other stages of the surgery. Generally advantages of the PHACO method together with femtosecond laser are for decreasing the risk of complication and for easing towards the works of the surgeon. As for the disadvantages, it is an expensive one, gives uneasiness for the patient, and prolongs the surgery time.
Image 3: Cataract causes vision loss
WHAT ARE THE TYPES OF THE ARTIFICIAL INTRAOCULAR LENSES USED IN THE CATARACT SURGERY ?
In cataract surgery, natural intraocular lens with the deformed structure are removed by means of surgery and instead, an artificial intraocular lens are installed. The power of artificial intraocular lens to be used in the surgery has been calculated according to the vision need of the patient by implementing various devices and formulas prior to the surgery. Within these calculations, the aim is to minimize the eyeglasses need of the patient after the surgery. Our success rate is over 90% thanks to the contemporary devices and formulations.
Types of artificial lens to be installed into intraocular location are another important issue. Mainly there are two types of artificial intraocular lens.
One of them is called monofocal lens that can be tuned only focusing onto one point. These lenses can be arranged for focusing either long sight or short sight as per the need of the patient for eye disorder. If arrangement is made for short sight, then the patient would be required to use eyeglasses for long sight, after the surgery. Again if arrangement is made for long sight, this time the patient needs to wear eyeglasses for short sight. For some patients, eyeglasses requirements of the patients can be eliminated by making arrangements for one eye having short sight and for other eye having long sight. This method has own advantages and disadvantages.
The other type of artificial intraocular lens is multifocal and trifocal lenses. Relatively multifocal lenses are an old dated technology and they enable the patients to see the long sight and the reading distance. However their performances on intermediary sight are not that good. Trifocal lenses have been developed in order to overcome this problem. By these lenses it is possible to carry out daily life routine, without glasses, in short, intermediate and long sight. The research made with patients using these lenses has revealed that these people can carry out 80 – 90 % of their daily activities without eye glasses.
Cataract disorder occurs as a result of loss of transparent structure of the natural intraocular lens. This leads to decrease in sight for the patients. Today the only treatment of cataract disorder is surgery. The natural intraocular lenses having lost its properties are removed by means of surgery and instead an artificial intraocular lens is installed. There are two types of artificial intraocular lenses. First one within these types is the lenses showing either short or long sight. The second one is the lenses showing distances of both short and intermediate and long sight. Any of these types can be chosen according to the sight/vision requirement of the patient.