Cataract is a clouding of the eye lens and is a common disease of the elderly. However, the cataract can occur in individual cases in younger people or even innate. Usually, the lens opacity is noticeable by a decrease in visual acuity or increased photosensitivity or glare. In an advanced lens opacification, one can occasionally detect a whitish discoloration of the pupil. The chances of recovery from surgery are excellent. This procedure is less stressful and can be performed on an outpatient basis under local anesthesia. We are happy to inform you personally about our modern options for cataract surgery. We are happy to provide you with extensive information material for this purpose. In most cases, the cataract can be successfully treated, but the cloudy lens is removed and replaced with an artificial lens. See the following article for details about the Gray Star operation.
The main symptom of cataracts is the gradual opacity of the eye lens, combined with a loss of visual acuity. The process can last for years and is initially barely noticed by the patients. In addition, the cataract leads to glare effects, since the turbidity changes the refraction of light in the lens. It may also interfere with spatial vision or provide temporary vision enhancement if patients are farsighted. The reason for this is the thickening of the lens and a compression of the lens core. Due to the progressive turbidity of the lens, the visual acuity also decreases when looking into the distance.
The cataract is usually caused by age. About half of the 52- to 64-year-olds in Germany have a cataract, many without a visual disturbance to notice. But even younger adults and children can contract the cataract. Causes can be for example the intake of certain medications, smoking or alcohol consumption as well as previous eye diseases.
To detect the cataract, usually only a slit lamp microscope is needed. It has a 40x magnification and allows the ophthalmologist a detailed view of the lens. It can also detect weak opacities of the lens and examine other areas of the eye - such as the cornea or the anterior chamber of the eyes.
First, careful ophthalmological examinations are necessary to prepare the operation. For this we use the most modern equipment. To calculate the artificial lens, which is implanted into the eye as a replacement for the clouded lens, special measurements of eye length and corneal curvature are required, which we can perform with a modern device (IOl-Master 500) without contact. The examination with the Pentacam HR provides us with important information about the anterior segment of the eye, the corneal endothelial microscopy allows a statement about the condition of the cornea. On request, a retinometer examination can also be performed to estimate the expected visual improvement after an operation. Optical coherence tomography (OCT) allows safe exclusion of mid-retinal disease. During the discussion, we will advise you about the different types of lenses that are suitable for your operation. As a rule, we put a posterior chamber lens in the capsular bag of the eye. This artificial lens consists of an extremely compatible plastic (acrylic) and remains permanently in the eye. Of course, we also offer special lenses (premium lenses) with special features such as blue light filter lenses, aspheric lenses, Toric lenses, multifocal lenses or combinations of these lens types.
On the day of catarct surgery we expect you at the agreed time in our operating room waiting area. You stay sober on this day, you can take your medication as usual with a sip of water. Our anesthesia team will receive you and make preparations for the operation. This includes the administration of drops for pupil dilation, germ reduction and surface stunning of the eye. In our anesthetic preparation room, we will talk to the anesthetist, who will then connect you to modern monitoring equipment and initiate local anesthetic measures. The cataract surgery can be done in a local anesthetic by drops or a small syringe next to the eye. You will not feel anything of the syringe, as you will for a moment be put in a short Rauschnarkose.
In our state-of-the-art operating room you will be looked after by our surgical nurses. In addition, the monitoring of the ECG and the oxygen saturation of the blood by a measuring device on the finger will be carried out by the anesthesia team. There is always the possibility of administering medication via a small access to the arm vein. The cataract operation takes only about fifteen minutes. First, you can make it comfortable lying on our operating table, you get a knee roll to relieve the spine and, if necessary, a small pillow under the head. After the conjunctiva and the surrounding area of the eye have been thoroughly disinfected, they are covered with a germ-free cloth. In addition, if necessary, you will receive oxygen via a small tube, which we attach to your cheek with a band of plaster. A small lid lock keeps your eye open, so you can not accidentally close it during the operation. After the surgical microscope has been swiveled over your head, the procedure can begin. They support our work by looking directly into the light of the microscope above you.
With us you will be operated according to the latest scientific findings with the latest technology. We work with an innovative phaco device (device for liquefaction and suction of the lens) latest design. For this, only a microscopic cut of 2.2 millimeters at the edge of the clear cornea (Clear Cornea Incision) is required. Two more small slices of 1.0 millimeter allow us to operate on both sides with the smallest microsurgical instruments. Due to the cutting in the cornea, we work virtually bloodless. After opening the anterior lens capsule, the lens material is liquefied and aspirated using a special probe (Phakotip). Our device works very gently, because it has an oscillating probe and therefore requires very little ultrasound energy. The art lenses we use are extremely well-tolerated products of well-known manufacturers. These lenses made of acrylic (folding lenses) are rolled into the eye through a small tube through the 2.2 millimeter incision and then placed securely in the capsular bag; The capsular bag is the natural location of the lens in the eye. A suture is no longer necessary with our self-sealing cut. At the end of the operation, the eye is covered with an ointment dressing and the patient can return home after a short monitoring period. Many patients report that the procedure was painless and less stressful for them.
Already on the day after the procedure, all patients are re-examined by us. The bandage is removed, visual acuity and intraocular pressure are checked and the slit lamp is examined. Already at this time many patients can already see much better than before the operation. We prescribe eye drops and eye ointment, which must be applied about 5 times daily. Our patients receive a lens card, a leaflet with important information as well as a report for the general practitioner and the continuing ophthalmologist for assigned patients. Our follow-up checks are routinely done after a further 2, 7 and 14 days. After about 4 weeks, usually a new lens can be prescribed.
Because cataract surgery is a routine procedure for many surgeons, problems and complications are rare. The rate is less than one percent, which minimizes the risk of cataract surgery for patients.
Possible complications and risks of cataract surgery:
Another problem can be the so-called after-star. In the process, after a cataract operation, the posterior lens capsule becomes cloudy, which also leads to a reduction in vision. The risk of a follower is given as around 4 percent. The posterior can usually be easily corrected with a so-called YAG laser, whereby the complication is corrected.
A disadvantage of the lens exchange is that the eye with the standard artificial lens is no longer able to adjust to different distances when looking at it. For this reason, patients sometimes need glasses after surgery to read a book or drive a car, depending on the type of lens they have chosen. A balance can create multifocal lenses. They work in a similar way to progressive spectacles and are intended to enable vision at different distances. Even weak double vision and reduced vision of contrasts can be a consequence of cataract surgery, which affects vision in some way. Artificial lenses with special properties can also be a measure here to avoid these complications.
Depending on the type of treatment and lens choice, the prices for a lens operation amount to between € 1,800 and € 3,000 per eye. So before deciding on an operation, you should first discuss the cost of treating the cataract with various providers and, above all, compare the included services. Before and after the procedure usually several examinations as well as dates for the Nachsorge and control are necessary.
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