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Cataract is caused by the loss of normal transparency of the crystalline lens (natural lens of the eye), which becomes progressively opaque and progressively reduces vision. Cataracts usually appear with age, although they may be congenital or caused by trauma. Its incidence is 50% in people between 65 and 75 years old and 75% above 75 years old.
Cataract formation is usually slow and progressive, so it can go unnoticed for quite some time.
The most common symptoms of the cataract patient are blurred vision that does not improve with glasses, loss of brightness of bright colors or difficulty in night vision. It can also manifest itself as a change of grade or the appearance of myopia that has never existed before. In these cases patients report that their near vision has improved but their far vision has worsened. This is because as the waterfall forms, the lens becomes thicker and therefore more powerful as a lens (more myopic).
Currently, the only effective treatment is surgery. The cataract cannot be corrected with glasses or eye drops and attempts to stop it from appearing have been unsuccessful.
The surgical technique currently used for cataract cases is phacoemulsification. This technique uses ultrasound to dissolve the cataract and aspirate it. When the lens is removed, its diopter power must be replaced with an intraocular lens.
There are currently multiple options in intraocular lenses. On the one hand we have “monofocal” lenses, which are those with which the eye would be graduated for distant vision and would only need glasses for near vision. “Multifocal” lenses, on the other hand, are those that allow us to have independence from glasses for both near and far vision. Not everyone is suitable for multifocal lenses, and a thorough in-office study is essential to determine the best option for each patient. For patients with elevated astigmatism, we now have “toric” lenses, which are able to eliminate astigmatism completely.
Cataract surgery is performed under “topical” anesthesia in most cases. This means that only drop-only anesthesia is used. An anesthesiologist is always present, so a light sedation will always be administered intravenously for the patient’s peace of mind. In complex cases or those in which the patient’s collaboration is difficult, the surgery can be performed under anesthesia, which is done by injecting anesthetic around the eye.
The surgery usually lasts between 10 and 15 minutes, and after this time the patient will stay about 45 minutes in the clinic.
Recovery after cataract surgery is quick and painless, as the minimally invasive techniques available mean minimal trauma to the eyeball. Full visual recovery usually occurs on the second or third day after surgery. The patient should avoid physical exertion for 1 week and water activities for 2 weeks.
Dr. Nieto is a reference in oculoplastic surgery. He combines his activity in reconstructive surgery in public medicine with his private reconstructive and cosmetic activity at the Clínica Corachán in Barcelonaand the Instituto Oftalmólogico Gabriel Simón in Madrid.
Clínica Corachán 2, bajos. Plaza Manuel Corachán 4, Despacho 8 Barcelona 08017
Instituto Oftalmológico Gabriel Simón Fuencarral, 7 28004-Madrid
