Modern ophthalmology practices low-traumatic operations that allow you to quickly, under local anesthesia, with minimal damage, replace the lens with an artificial lens. Almost immediately the person regains the ability to see, he can return home and spend the rehabilitation period with his family. As after any surgical intervention, discomfort is possible after phacoemulsification. They are individual and cannot be classified; patients describe them differently.
- After cataract surgery, a foreign object (mote, grain of sand) interferes with the eye.
- There is pain, lacrimation, swelling of the cornea or eyelids.
- Increased sensitivity to light and eye fatigue.
- Blurred vision is noticeable.
- There is a feeling of tingling and itching.
After discharge, the doctor prescribes a schedule of examinations for the patient. The specialist will assess whether the symptoms require medication correction or are normal.
Why does a foreign body interfere with the eye after cataract surgery?
Sometimes it is quite difficult for the patient to believe that there is no foreign object under the eyelid. Thoughts arise that fluff, a speck of dust, or sand got there. You cannot rub your eyes or try to remove a grain of sand yourself - there is a high risk of infection and complications.
The sensations are caused by the so-called dry eye syndrome. The cornea, recovering after surgery, remains insufficiently moisturized. To compensate for this, your doctor may recommend using artificial tear drops. At such moments the patient feels that the sensation foreign body disappears for a while.
How long after cataract surgery does a foreign body interfere with the eye?
Recovery takes a month, after which the discomfort goes away. There are individual situations when dry eye syndrome is completely compensated within 60-90 days. This is not a cause for concern unless the doctor finds other problems or complications.
Over the course of 2-4 months, the brain continues to adapt to the new lens. Engaging in a variety of activities will be beneficial - the more new things a person tries, the faster nervous system adapts to change. After six months, vision will become optimal.
If the discomfort does not go away, it is quite possible that the problem is not related to the eyes, but to neurological disorders. In this case, the ophthalmologist will recommend contacting a neurologist for examination. Such cases are rare - up to 1% of all operations performed.
You can ask questions regarding the patient’s feelings after surgery during a consultation with an ophthalmologist at the Eye Surgery Center in Moscow.
Once installed, the artificial lens of the eye improves vision. If a person has healthy visual organs, then they freely transmit light rays and project them on the retina. In this case, the natural lens is capable of performing the function of a lens.
How to choose an artificial lens
However, in many patients, the natural lens may lose its transparency over time and the quality of perception of the surrounding world will significantly deteriorate. To solve such problems, an intraocular lens is implanted.
Varieties
If we consider the artificial lens in more detail, then according to its structure it can be divided into two parts. The main thing is the optics, since this part has a diffraction zone. In the future, it will guarantee a clearer image. With its help, the lens will improve your vision. However, doctors warn that not every lens can restore 100% vision.
The second part is called haptic. It is necessary to ensure reliable fixation of the lens to the eye. Modern ophthalmologists distinguish the following types of intraocular lenses:
- Tough. These lenses are made from special plexiglass that does not bend. After their installation, the eyes require a longer rehabilitation period. The incision after the operation will be large, so stitches will be necessary.
- Soft. This type of lens is considered more common today. Polymer materials are used in their production. Installation involves a small incision, so no stitches are required. However, special tools must be used to perform the operation.
Popular types of IOLs
Now it's time to understand another classification that soft intraocular lenses have. According to it, the following subtypes can be distinguished:
- monoblock;
- lenses that have an aspherical shape;
- with the “yellow filter” function - such products allow you to provide reliable protection from ultraviolet radiation;
- accommodating lenses – capable of independently changing further structure;
- toric lenses - intended for patients with astigmatism;
- multifocal IOLs.
Benefits of soft IOLs
If you decide to give your preference to soft lenses, then you can get the following advantages:
- During the operation, the eye will receive minimal trauma. For more precise installation doctors use a microscope.
- The risk of postoperative astigmatism is significantly reduced.
- This eye therapy does not require a long rehabilitation period. Already on this day the patient can go home.
- The occurrence of secondary cataracts is minimized.
- Soft intraocular lenses can be used to solve a variety of ophthalmic problems.
- Installation of such lenses is allowed for people with diabetes.
Organ of vision after installation of a phakic IOL
Lens requirements
Today, artificial eye lenses are of high quality. The material used in the manufacture of the lens must be of high quality and meet certain characteristics. This will ensure:
- comfort;
- safety;
- no negative consequences;
- reduction of the postoperative period.
First of all, the IOL must show sufficiently high resistance to chemical and biological reactions. If the indicators are high, then the wound healing period will be significantly accelerated.
It is important to know! The first artificial lenses were of impressive size. Therefore, their installation was too traumatic for the eye.
Now you need to pay attention to the transparency of the eye lens. This ability will guarantee the passage of light rays and form a clear image. When choosing, the following characteristics can also be considered important:
- refractive index;
- flexibility;
- service life of the artificial eye lens.
This is enough important points, which will further help make IOL implantation more comfortable and painless.
Implantation stages
An artificial lens allows you to quickly get rid of cataracts. Many statistics indicate that cataracts are now congenital. Cataracts can also be considered a complication that occurs in diabetics. Now it’s time to take a closer look at IOL implantation surgery.
First, specialists remove the natural lens, which has become unusable. Doctors then place an artificial lens in the freed space. The artificial lens is inserted in a folded state. After melting it will be fixed. The healing period of a postoperative wound does not take much time.
Implantation of artificial lens
Usually the duration of the procedure does not exceed 60 minutes. The patient will observe improvement in vision within the first hours after the procedure. Modern ophthalmology now also uses lenses that will solve accommodation problems. This lens contains several focal points that provide a clear image of objects far and near. Sometimes complications may occur after surgery, which include:
- Infection.
- Intraocular inflammatory processes.
- Displacement of the installed lens.
- Problems with intraocular pressure.
IN Lately Doctors also began to use a seamless lens installation technique called phacoemulsification.
Which lenses to choose
Only a doctor should determine which lens is suitable for a patient. When choosing, he will independently tell you the advantages and disadvantages of each option.
It is important to know! An artificial lens will help get rid of cataracts. Nowadays, cataract disease affects half of the older population.
Domestic lenses are significantly inferior to imported models. However, their cost will be low. The patient must pay not only for the implant, but for all consumables.
The development of intraocular lenses never stands still and is constantly evolving. Almost every year, the industry releases improved lenses that can correct multiple deficiencies at the same time. Remember that multifunctional artificial lenses are more expensive than other models. Now you know how to choose an artificial lens. We hope this information was useful and interesting.
To preserve vision after surgery, it is necessary to adhere to certain rules recommended by an ophthalmologist for quite a long time. During this period, you should strictly follow the instructions regarding rehabilitation, as they will help to avoid possible complications.
- Lasts for a week after lens removal. Patients may experience pain in the orbit, irritation of capillaries and mucous membranes. During this period, the body gets used to new circumstances. Patients' vision improves noticeably.
- Lasts up to a month. Over the entire period of time, visual abilities may change, depending on the stress to which the eyes are subjected. In some cases, glasses may be required to read or view the monitor. For up to 30 days, a person must create the most gentle regime for the eyeballs.
- Lasts up to six months. During this period, vision reaches full acuity, so patients can be fitted with lenses or glasses.
Rehabilitation after cataract surgery does not always last 180 days. The exact recovery time depends on the patient's health and the type of surgery. If the patient has undergone phacoemulsification, the rehabilitation period is reduced. With capsular extraction, recovery occurs after the sutures are removed.
Postoperative restrictions: what to avoid?
Modern ophthalmological methods of cataract surgery allow you to very quickly return to a normal lifestyle. It is worth noting that surgical intervention does not require subsequent hospital treatment of the patient. He can go home within a couple of hours after the insertion of the intraocular lens.
The restrictions are simple, so they are very easy to implement. It is important to say that the rules of daily behavior of the patient must be followed until complete recovery. Here are the basic post-operative obligations to help reduce the risk of complications:
It is also important to monitor the safety of the operated organ of vision. On sunny days, wear safety glasses, do not insert contact lenses, and do not touch your eyes with your hands.
Using eye drops after cataract removal
A prerequisite for restoring the operated lens is the introduction of special solutions. Intraocular drops help prevent infection of the mucous membrane and speed up the healing process of the cornea. Eye drops are carried out according to the following scheme:
- The first week, medications are administered 4 times a day;
- For the second 7 days, the multiplicity is reduced by instillation three times a day, etc.;
- After a month of therapy, the drugs are discontinued if the patient has no complications.
Usually, the ophthalmologist prescribes antibacterial drops (Tobrex, Vitabakt) to disinfect the eye and anti-inflammatory drugs (Indocollir, Naklof) to prevent inflammation of the mucous membranes and adjacent tissues. In some cases, combined drugs (Maxitrol, Torbadex) are used if it is necessary to administer drugs with a pronounced effect.
Eye drops should be carried out according to the following rules:
- The patient lies on his back and tilts his head back.
- Uncorks the bottle with the solution and turns it over with the dropper down.
- Using your fingers, you retract the lower eyelid to form a conjunctival sac.
- Drops are injected into the cavity under the eyelid and the eye is closed.
- To prevent the medicine from leaking out, you can lightly press the inner corner of the eyeball with a finger wrapped in a sterile scarf.
If the patient is prescribed several types of drugs at once, then a break of 10 minutes should be taken between their administration. You should avoid touching your eyes with the drug dropper to avoid infection.
During the rehabilitation period at the first stage, the doctor may recommend wearing an eye patch to protect the organ of vision. To do this, use regular gauze folded in half. There is no need to bandage the eye across the entire head; you can glue the bandage with an adhesive plaster to the forehead to create a “canopy” that is not adjacent to the eye socket. This dressing will protect the patient from dust, drafts, bright light and other potentially irritating factors.
You need to adhere to the restrictions until the surgeon says you can stop performing mandatory requirements. From time to time you should see a specialist to prevent the development of unexpected inflammations or pathologies.
Complications after surgery
Pain in the eyeball due to cataract removal is a completely normal phenomenon, which will stop after a few days. But in case of severe inflammatory processes and pain, you need to consult a surgeon so as not to miss the appearance of such pathologies:
As you can see, it is very important to comply with the mandatory restrictions in order to protect the eyes from the development of severe complications.
Cataract removal and lens replacement is a very serious medical procedure, followed by a long rehabilitation period. It is imperative to follow all the rules and recommendations of doctors to prevent the development of complications.
First, let's figure out what a cataract is.
Note! "Before you start reading the article, find out how Albina Guryeva was able to overcome problems with her vision by using...
It is important to understand that a cataract is a partial or complete clouding of the lens located between the iris and the vitreous body. The lens serves as a kind of lens through which light passes and refracts. A clouded lens is not able to perform this function, and a patient with cataracts experiences deterioration in vision, even to the point of loss.
Treatment is carried out surgically, ultrasound or laser phacoemulsification with the introduction of a false lens. The operation is practically the safest of all surgical interventions, but it is very important to properly withstand the recovery of the eye.
Restoring the body after cataract removal
Rehabilitation after surgery takes a long time (can last up to six months). Conventionally, it can be divided into three stages:
- The first stage is the most difficult, taking the first week after surgery. During this period, pain and swelling in the eye area may be observed. Such manifestations are a normal response of the body to intervention. During the first week, the patient notices improvement in vision
- The second stage is from the eighth day to the thirtieth. During this period, the quality of vision is not stable. It is necessary not to overload your eyes. You should limit watching TV, reading books, and working on the computer. You may need glasses for this.
- The third stage is the next 4-5 months.
Features of the postoperative period
The postoperative period has its own characteristics. Let's look at them:
- After the operation, a bandage is usually put on, which is not advisable to remove for half a day after the operation. This blindfold protects your eyes from dust, smoke and other aggressive substances, as well as from bright light.
- After removing the bandage, the eyes should be treated with an antiseptic solution (furacillin, chlorhexedine).
- In the first few weeks, you need to put anti-inflammatory drops in your eyes. To prevent secondary infection from occurring.
- During the first week, doctors do not advise leaving the house unless absolutely necessary.
- After the painful sensations in the eyes pass (usually they last three to four days), you can read or watch TV, but still the time for such activities should be limited to a minimum.
What determines the duration of the rehabilitation period?
Patients are often concerned about how long the recovery period will take. And why it lasts longer for some than others. So let's find out what the recovery period depends on.
- First of all, of course, from the patient’s condition before the operation. The rule is simple: the worse the patient’s condition, the longer it will take to recover.
- Also, the rehabilitation period depends on the type of intervention. A big role is played by how exactly your cataract was removed: ultrasound or laser.
After replacing the lens, you need to take special care of your condition. General recommendations:
- Avoid eye strain. This is perhaps the most important rule. Eye strain should be avoided throughout the rehabilitation period. If you wish, you can read a book, watch TV, or work on the computer for a while one or two days after discharge. But if your eyes get tired, you need to stop the load immediately.
- You should not drive a car for the first month. Since this overloads the eyes and can provoke the development of complications.
- Maintain a sleep schedule. In the first month, you should not allow yourself to get enough sleep. Specialists in postoperative period Ten hours of sleep is recommended. There are also restrictions on sleeping position. It is unacceptable to sleep on your stomach and on the side on which the eye was operated on. The best position is lying on your back.
- Observe hygiene rules. After the intervention, the body’s local defenses are weakened, so you should be especially careful with hygiene procedures. During the first two weeks, doctors advise avoiding the use of cosmetics, as well as getting water, soap suds, and dust into the eyes. You should wash your hair by tilting it back, not forward.
- It is recommended to avoid physical activity for the first month. Avoid all types of sports: gym, gymnastics, yoga, horse riding, jumping, swimming. Lifting heavy objects should also be limited; lifting more than three kilograms is not recommended. It is also strictly forbidden to be in a head down position. Excessive physical activity threatens you with serious complications: pressure increases, including intraocular pressure, and the vessels may not be able to withstand it and hemorrhages form.
- Prohibited use high temperatures. This can also lead to the development of eye bleeding. In the first month it is forbidden to go to the bathhouse, sauna or be under direct influence sun rays, you should also postpone trips to the solarium.
- Avoid drinking alcohol and nicotine. They have a detrimental effect on the condition of blood vessels. This is especially true for alcohol; its use should be avoided in the first month. Try to limit smoking to a minimum.
What complications can occur after cataract surgery?
Despite the fact that this operation is considered one of the safest, it may have its own complications. In most cases, complications arise due to non-compliance with medical recommendations.
- Secondary cataract. It can appear at any time - in a few months, or maybe in a few years. The reason for this is that it is often difficult to remove all the cells of the affected lens.
- Retinal disinsertion
- Increased intraocular pressure. Common cause The appearance of this complication is failure to follow the recommendations during the rehabilitation period, namely: heavy lifting, excessive physical activity, etc. Sometimes increased intraocular pressure is due to existing diseases and genetic predisposition.
- Displacement of the lens. In most cases, it occurs as a result of an incorrectly performed operation. In this case, repeated surgery is necessary.
- Retinal swelling. Develops as a complication in the presence of concomitant diseases.
- Hemorrhage into the anterior chamber. Appears as a result of medical error or excessive physical exertion. Treatment is carried out with medication; in rare cases, surgery is used.
It is worth noting that discomfort in the eye area after cataract surgery is normal, this is how your body reacts to outside interference. But if you experience severe discomfort, you should consult a doctor.
Surgical treatment of cataracts is one of the most common eye interventions today. The technique of its implementation has been thoroughly tested and does not cause difficulties in execution by experienced ophthalmological surgeons. However, like any other operation, it carries certain risks of complications. In this article we will reveal the details of adverse consequences and find out how to minimize the chance of their occurrence.
Lens replacement is the only proven treatment for cataracts.
Translated from ancient Greek it means “waterfall”; most likely the disease is so named due to the distortion of the perceived picture of the surrounding world as if through a flowing stream of water.
The risk of developing the disease occurs after 45 years, when the body becomes unable to maintain metabolism in the lens tissue at the proper level and the content of free radicals in it increases. They are capable of causing irreversible processes in proteins, which is externally manifested by clouding of the lens tissue.
The most significant additional factor provoking the development of the disease is exposure to direct sunlight.
The causes of the onset of the disease may include:
- old age;
- ionizing radiation;
- violation intrauterine development(congenital);
- metabolic failure;
- insufficient intake of vitamins into the body;
- toxic effects of poisons or drugs;
- ophthalmological diseases (, etc.)
- smoking.
Cataracts are considered the most common disease among older people. According to WHO, after 70 years, about 70-80% of the population suffers from it. Its course is characterized by steady progression. If during manifestation areas of opacification may not affect the light-transmitting area of the lens at all, or appear as separate “drops” in the image, then later it covers the structure of the biological lens completely.
Let us turn to the classification of pathology by localization. There are cataracts:
- anterior polar;
- posterior polar;
- fusiform;
- layered;
- nuclear;
- cortical;
- posterior subcapsular;
- total.
Cataract treatment
The picture clearly shows the stages of the lens removal operation If we understand the term “treatment” as complete elimination of pathology, then only surgery can contribute to this. Some people are afraid to undergo surgery and resort to drug therapy.
Today, the following drugs help with this: Oftan-Katachrome, Senkatalin, Vitaiodurol, Vicein, Taufon,. However, you should be aware that this method is not capable of restoring vision and returning the lens to its former transparency.
There is evidence that only Quinax is capable of slightly resolving areas of opacities. But with any means of conservative therapy, the disease worsens in one way or another.
Before analyzing methods of surgical elimination, it is worth determining the stages of the disease. Cataracts are classified as:
- initial;
- immature;
- mature;
- overripe.
Old methods assumed a wait-and-see approach, in which intervention was possible only with mature cataracts, when a person would almost completely lose vision. The latest techniques involve manipulation at any stage of the disease with high efficiency. Let's find out the features of types of surgical treatment.
Extracapsular cataract extraction
Proposed back in 1738. Its peculiarity involves waiting for the maturation of cataracts.
Currently, it is practically not used due to its high invasiveness and greater likelihood of complications.
Phacoemulsification
A more popular method than femtolaser. Can be used on different stages development of cataracts. The manipulation technique involves:
- installation of anesthetic drops;
- making a micro-incision of the cornea measuring about 2 mm;
- introduction of a phacoemulsifier through the incision;
- emulsification of lens tissue with ultrasonic waves;
- removal of parts of the destroyed biological lens;
- insertion of an intraocular foldable lens (IOL).
The incision is made and closes automatically, without suturing.
The operation takes about 15 minutes, and the patient can be sent home on the first day after the operation.
The disadvantage of using ultrasound for overripe cataracts is the increased damage to adjacent structures of the eye by ultrasound, since at this stage the lens becomes very dense, which improves the propagation of ultrasonic vibrations.
Femtosurgery
Lens replacement surgery performed using a femtolaser is considered the “gold standard” today. Most modern method elimination of cataracts. Its low popularity is due to the higher cost of the operation and the complexity of the equipment. The course of the operation is fundamentally the same as phacoemulsification, but the main difference is that the femtolaser is completely controlled by automation, and not by the hands of the surgeon.
The incision of the cornea, as well as the destruction of the lens, is performed with a high-precision laser.
When performing a femtosurgical operation, the eye tissues are not exposed to heat and the negative effects of ultrasound, therefore there are fewer complications after the intervention.
Complications after surgery
Regardless of the method of performing the operation, complications occur one way or another, their frequency varies from 0.5 to 1.5%. The degree of risk is influenced by gender, age, stage of the disease, method of surgical treatment, and concomitant diseases.
Complications are divided into those that occurred during the operation (for example, due to the fault of the surgeon) and postoperative, which in turn are divided into early and late.
Early postoperative complications
After surgery, the intraocular eye lens begins to perform the function of the lens These include:
- Development of inflammation. In response to the intervention, the body adequately responds with inflammation. To prevent it, the administration of steroidal anti-inflammatory drugs in combination with broad-spectrum antibiotics under the conjunctiva is actively used. If the course is favorable, all the main functions of the eye structures are restored within 2-3 days.
- Hemorrhage into the anterior chamber. Occurs when the iris is injured either during the lens replacement procedure or after installation of intraocular lens elements. When the amount of blood shed is insignificant, the complication can be eliminated conservatively, with absorbable drugs. If this does not help, you will have to rinse the anterior chamber.
- Height . This is due to clogging of the intraocular fluid drainage system with viscoelastic. In the absence of proper drainage, the amount of fluid increases and this contributes to compression of the intraocular structures and disruption of their trophism. Instillation of antiglaucoma drops usually helps. Sometimes it becomes necessary to puncture the anterior chamber and perform drainage.
- Displacement of the implanted ocular lens. Depending on the degree of displacement, patients may experience increased eye fatigue, which goes away after rest, or constant discomfort. When diagnosing this condition, repeated surgical intervention is indicated to correct the position of the artificial lens.
- . A terrible, but at the same time quite rare complication. It occurs as a consequence of concomitant severe myopia, an error during surgery or trauma after it. Minor detachment can be treated with laser coagulation; in case of massive detachment, vitrectomy or scleral filling with a silicone sponge is performed.
Late postoperative complications
After the operation, it is recommended to refrain from visual strain for the time specified by the ophthalmologist. There are fewer of them than the early ones, but you should not pay less attention to them. Highlight:
- Irvine-Gass syndrome. It detects swelling of the central region of the retina. Develops 4-12 weeks after the intervention. The condition can be treated with laser, conservative or surgical methods.
- Secondary cataract. A frequent complication, usually detected between 2-3 months and several years after manipulation. The reason is the incomplete removal of natural lens cells, which proliferate and later move into the optical region of the implanted lens, thereby interfering with the passage of light rays. The incidence of secondary cataract development correlates with the material of the artificial lens: polyacrylic - 10%, silicone - 40%, PMMA - 50%.
Prevention of complications
Following some simple rules will significantly reduce the risk of developing both early and late postoperative complications.
- do not tilt your head until the doctor’s permission;
- sleep on the good eye at night;
- do not drive;
- refrain from lifting loads weighing more than 10 kg;
- try to avoid getting water into the operated eye;
- maintain a daily routine and rest schedule;
- eat rationally;
- to refuse from bad habits.
These measures should be followed impeccably, then the chance of restoring good clarity of vision will be as high as possible.
Thus, modern eye microsurgery can offer effective elimination of cataracts with a minimum of complications. When choosing a method of surgical intervention, it is important to take into account all their features and listen to the opinion of an experienced ophthalmologist.
In the video you will find information about the mechanism of cataract development, as well as a visual display of ways to eliminate it:
