Cataract Surgery

What is cataract? Cataract is a blurring of the natural lens of the eye behind the iris and pupil. The retina is the light-sensitive layer in the eye that receives visual messages. In a healthy and normal eye, light passes through the lens and focuses on the retina, which must be clear and away from opacity to create an accurate lens image. When the lens loses its clarity, it causes vision impairment, which is called cataracts. Cataracts are not a problem in the early stages when only a small part of the lens becomes cloudy, but in most cases a larger part of the lens becomes involved and causes vision problems. The rate of cataract progression can vary from person to person and can progress over several years. But the rate of cataract progression is very high in people with diabetes. The important thing is that cataracts do not spread from one eye to another. Cataracts or darkening of the lens of the eye (the lens of the eye is located in the middle of the eyeball and its function is to focus light on the retina), which may cause blurred vision while studying and driving. Cataracts are the most common cause of vision loss in people over 40 and the leading cause of blindness in the world. The most common type of cataract can be considered age-related, most of which are over 65 years old. The eye lens is a part of the eye structure that is very clear and without any veins and is approximately 9 mm in diameter and 4 mm thick. Cataracts are small at first and have little effect on vision. The patient notices that his vision is slightly blurred and that he looks as if he is looking at the world through opaque glasses. Cataracts make sunlight or light bulbs very bright. The patient finds the headlights of the car lights more dazzling than before, and these lights make his eyes glaze over. On the other hand, the colors are not as bright as before.

Cataracts have several causes:

1-blood pressure

2- Obesity

3- Smoking Long-term use of corticosteroid drugs

4- Take statins to lower cholesterol

5- A history of inflammation or injury to the eye

6- History of eye surgery

7- Hormone replacement therapy

8- Excessive consumption of alcoholic beverages

9- Severe myopia • Family history of cataracts

10- The sun’s ultraviolet rays and other light sources

11- Diabetes

12- Age increasing

13- Congenital cataract

The types of cataracts are as follows:

Nuclear cataract: This complication occurs in the central region (nucleus) of the lens. Nuclear cataract is usually the result of aging.

Subcapsular cataract: This complication occurs behind the lens of the eye. Patients with diabetes or people taking high doses of steroids are more likely to develop subcapsular cataracts.

Cortical cataract: This complication is characterized by dark white and triangular spots that start around the lens of the eye and extend to the center of the lens. This type of cataract involves the lens cortex, the part of it that surrounds the central nucleus.

 Cataract symptoms: The most common and important symptoms of cataract disease are:

• Blurring vision
• Extreme sensitivity to light and brightness, including excessive brightness of cars at night, scattering of sunlight and headlights, as well as seeing the halo around the headlights.
• Fade colors.
• Low or blind vision at night.
• Symptoms mentioned above can also be caused by other eye diseases.

 If you encounter any of the above, be sure to see an ophthalmologist. The best time to have an eye cataract depends on your eye doctor’s diagnosis, but do not worry! Ryan’s specialized team will give you a free consultation 24 hours a day and will answer your questions.

Cause of cataracts

The structure of the eye is such that the iris and pupil and behind them is a lens, and naturally after passing light and reaching the lens, light is concentrated and an accurate and clear image is formed in the retina. The presence of any spots on the lens, as well as the darkening of the lens, causes the light not to be focused and scattered, and does not create a clear and accurate image on the retina, and ultimately causes vision impairment. The lens of the eye is made of water and protein, and the proteins of the lens of the eye are precisely and neatly located, and this makes the lens more transparent and allows light to pass through it accurately. Cataracts usually develop slowly over time. This complication is not associated with pain. However, the dark spots on the lens of the eye may be very small and the sufferer may have no knowledge of their vision loss, eventually leading to cataracts.

Cataract treatment

 In the early stages of cataract treatment, the patient’s vision improves with the use of glasses, magnifying lenses, and bright lights, but sometimes such measures may not help. Fico (eye cataract surgery) can be the only treatment. It is only by removing the opaque lens that can be a good alternative to the synthetic lens. Fico is another name for cataract medicine. Cataracts or cataracts require cataract or eye cataract (Fico) surgery that interferes with vision, work, or daily activities such as driving, reading, and watching television.

How to diagnose cataracts When the patient’s eye is carefully examined by an ophthalmologist, it examines the presence and extent of cataracts, as well as any other problems, including retinal or optic nerve problems that reduce vision, and finally, if the patient needs If you have cataract surgery, the surgeon and ophthalmologist will diagnose and treat the patient. When the patient has a disease other than cataracts, such as retinal or optic nerve problems, despite cataract surgery, it is possible that complete vision is not achieved. The ophthalmologist can diagnose a person with cataracts by carefully examining the lenses with ophthalmic devices and observing the blurred lens. It is no longer acceptable to detect cataracts using a flashlight because many diseases, including glaucoma, cannot be detected using a flashlight.

The examinations performed by an ophthalmologist are the following:

Visual recognition test: The patient’s visual acuity is measured at different distances using a special chart.

Examination of the dilated pupil: A drop is poured into the pupil to dilate or open it.

An ophthalmologist examines the retina and optic nerve with a magnifying glass to look for signs of eye damage or other problems. Vision will be blurred for up to a few hours after the examination. Tonometry (measuring intraocular pressure): An ophthalmologist measures intraocular pressure with a special device. Anesthetic drops are injected into the eye before the test. The ophthalmologist may perform other tests to check the structure and health of the eye. However, this procedure is usually done between 15 and 30 minutes.

How long does surgery take?

30 minutes to 2-3 hours. Complications during surgery, along with the preparation steps, may increase this time.

What to expect during surgery?

Prior to surgery, Ryan’s specialist team provides all the final information about the individual’s medical history and the surgery itself, and once the patient is ready, the surgeon begins surgery.

During surgery, one should expect the following:

The doctor usually gives the patient medicine to calm him down. Your doctor may use anesthetic eye drops or injections of anesthetic to numb the patient’s eye. The person stays awake during the operation and may see light and other movements, yet is unable to see what the surgeon is doing.

The surgeon makes small incisions so that he can reach the lens of the eye. He then removes the lenses and replaces them with synthetic lenses. Usually, stitches are not needed because the wounds heal on their own. The surgeon then places a protector over the eye or eyes and sends the patient to the recovery room.

Cataract Preoperative Care: What is the Basic Preoperative Solution?

1- Patients are usually instructed not to drink or eat for 12 hours before surgery.

2- Be sure to take a bath before cataract surgery.

3- Use clean clothes and do not make up before the operation.

4-Aspirin tablets should be discontinued with the permission of an ophthalmologist one week before the operation, as it may increase the risk of bleeding during the operation. . In this regard, you should thoroughly inform your doctor about your medical history and medications before surgery.

Cataract postoperative care:

1- The day after eye cataract surgery, when the doctor or colleague visits, the dressing is removed from the eye.

2- After the operation, you should avoid washing the area around the operated eye because it increases the risk of infection.

3- If you have to lift something from the ground, you should not bend at the waist, you should sit and lift the body.

4- You should use plastic eye protection for 5-6 days while sleeping or when leaving the house.

5. For a few days, you may experience blurred vision after cataract surgery, which gradually disappears.

6- After cataract surgery, avoid rubbing the eye for a week and do not sleep on the operated eye.

7- If your eyes need to be washed, you must use mild boiled water and sterile gas.

8- If your eyes become red or have severe pain after cataract surgery, be sure to contact or see your ophthalmologist as soon as possible.

9- One week after cataract surgery, driving will be possible.

10 – Lack of intense activity and heavy weight lifting (more than 25 pounds).

11- Avoid bending, exercising and similar activities that may affect your eyes while healing.

12- Keep your eyes closed when taking a shower or bath and also avoid bathing or hot bath for at least two weeks.

13- Avoid any activity that exposes your eyes to dust, dirt or other infectious contaminants.

Recovery:

The person usually waits in the recovery room for one hour after surgery. The surgeon may bandage the patient’s eye to aid in the healing process. When the patient returns home, he or she should focus on preventing eye infections. The patient should prevent water from entering the eye and use any eye drops only with the prescription of their doctor or surgeon. The person can continue most of their daily activities, including reading and watching TV. However, you should avoid lifting heavy objects and activities that can put pressure on the eye, such as jogging or basketball. The surgeon usually asks the person to come back for a checkup after surgery. Postoperative examination and check-up assures the physician that recovery is as expected. Checkups are usually done one day after surgery, one week later, and several weeks after surgery.

Contact your doctor immediately if you experience the following signs and symptoms after cataract surgery:

1- Decreased vision

2- Exacerbation of pain

3- Increased redness

4- Swelling around the eyes

5- Eye discharge

6- Wavy vision

7- Blurred vision or changes in vision.

Benefits of Cataract Surgery

Surgery is the only effective way to treat cataracts. Most doctors recommend cataract surgery when it affects the patient’s quality of life or impairs the patient’s ability to perform daily activities such as reading and driving.

Cataract surgery involves replacing dark eye lenses with implant and plastic lenses. Replaced lenses, like contact lenses, become part of the eye. In some people, other eye problems prevent the lens from being replaced. In such cases, vision can be improved by using glasses or medical lenses. Cataract surgery is usually included in outpatient surgery, which means that the patient will no longer need to be hospitalized after cataract surgery. During cataract surgery, the surgeon uses local anesthesia around the eye. It is generally safe, but the patient may have problems such as infection and bleeding.

Lack of cataract treatment

If cataract treatment is delayed, a person’s vision will be reduced to the point of counting fingers or just perceiving light, at which point a small number of patients may experience increased intraocular pressure (glaucoma) and As a result, they need emergency surgery, in which case the complications and risks are greater than conventional surgery.

What is the cost of cataract surgery in Iran compared to the cost of cataract surgery in other countries?

Today, medicine has become global and most cases such as cataract surgery can be treated in different parts of the world. However, many people travel to Iran every year to undergo cataract surgery here. Some of the important reasons for most patients are the high quality of treatment and the significant role of costs compared to other countries. In general, the cost of cataract surgery in Iran is one third of the cost of cataract surgery in other countries, while the quality is equal to countries such as the United States and Germany.