What complications after cataract surgery are possible and how dangerous are they? Feeling a foreign body after cataract surgery - what to do? Why does the lens sparkle after eye surgery?
The most reliable, effective, safe and least traumatic method of treating the organs of the visual apparatus in case of cataract disease is phacoemulsification of cataract with IOL implantation.
Benefits of the operation
The reliability and advantages of the operation over other types of surgical intervention are represented by the following factors:
Phacoemulsification of cataracts is considered one of the most safe species surgical intervention.
General stages of the operation
Let's take a look at the operation process:
- The basis of the operation is the removal of a cloudy lens affected by cataract and replacement with an artificial analogue. To do this, the doctor makes the minimum incision that does not exceed a couple of millimeters.
- Further, the lens, complicated by pathology, is crushed using ultrasound or a laser without violating the integrity of the capsule, and after that all particles are removed, or rather sucked from eyeball.
- The next step in the operating process is the introduction of an intraocular lens, imitating the natural lens, in an unfolded form. It independently unfolds inside the eye and makes it possible to completely restore the health of the organs of vision. Each lens made of artificial materials is selected only after a detailed individual examination of the patient before the operation.
- Subsequently, no sutures are applied, since due to the minimal incision, it tightens itself.
The rehabilitation period is only a few days. The person completely restores the visual apparatus without subsequent restrictions.
If we consider this operation step by step, then we can distinguish several stages:
The procedure itself to remove cataracts takes place in a specially designated operating room, under sterile conditions and lasts no more than half an hour. After dilation of the pupils due to the instillation of drugs in the eyes, the operated person is given local anesthesia. If the patient has both eyes affected, his vision between the two operations will not be balanced.
This method of restoring vision is also used in conjunction with other surgical operations, for example, to correct vision for astigmatism.
Intraocular lenses
As mentioned earlier, in the process of performing phacoemulsification, any type of intraocular lens is implanted. At the moment, a large number of such lenses are known that help to solve almost all problems with the organs of the visual apparatus. The main ones are:
Monofocal lens
This type of lens is the most commonly used in a large number of operational processes. The main advantage of the lens is that after its implantation, the patient's visual acuity increases dramatically, designed for viewing distant objects. But there is also a minus. The problem is that, when deciding the issue of the ability to look into the distance, a person has to wear either glasses or contact lenses in the form of additional correction to examine closely spaced objects. In addition, the regularity will be the appearance of astigmatic dots, which distort the visible image.
Accommodating lens
It is used in a surgical operation at the request of a person who refuses to wear glasses or contact lenses when working with closely spaced objects (computer, books, etc.).
As a result of the operation, the patient's visual acuity improves both in the distance and at close range. That is, the ability of accommodation, characteristic of a young age, is imitated. This is the best option for people whose lifestyle is associated with a large amount of visual work.
Multifocal lens
This type of artificial implants enables a person to examine the surrounding objects from any distance, from a few millimeters to a couple of kilometers. The principle of operation of these lenses is very similar to that used in multifocal glasses or contact lenses. A multifocal intraocular lens is a good option for treating eye health problems expressed as presbyopia.
Aspherical lens
Toric lens
The best option for correcting astigmatism. The effectiveness of lenses is expressed in the possibility of getting rid of a person from visual pathology, reaching twelve diopters. Manufacturing is carried out strictly according to the individual characteristics of the eyes, where it will be introduced in the future. The main disadvantage of toric lenses is their relatively high cost and are manufactured long time, roughly, it takes at least two months to make lenses.
Phacoemulsification method for cataract treatment - a guarantee of quality and reliability
Cataract is a complete or partial cloudiness of the eye. As a result of this disease, the eyes are gradually clouded. If this ailment is not promptly treated, the organ of vision will become completely cloudy and the person will become blind. Phacoemulsification is considered the most modern, painless and effective method of treatment.... This ultrasonic phacoemulsification does not require suturing, as only the latest modern technologies are used.
In order to carry out a phacoemulsification operation, one should not wait until the cataract is fully ripe, and also tolerate this decline in vision. Since the time during which it ripens may be about ten years, a person had to radically change his rhythm of life. He quit his job, stopped driving a car, began to experience great inconvenience in case of insufficient lighting. Today, it is possible to carry out ultrasonic phacoemulsification of cataracts even before the stage of full maturation, at a cost it will be even cheaper.
The risk of complications
a - lens; b - sound waves break the lens, which is then absorbed through the needle
Phacoemulsification has a number of distinctive properties from other conventional methods of cataract operations, that is, before intra-, as well as extracapsular extraction. This method is considered the safest and less traumatic, because with it the opaque nucleus is crushed using ultrasound, and then removed using an aspiration system. Due to the fact that such an incision does not subsequently require suturing, the risk of complications after surgery is reduced.
Ultrasound phacoemulsification is considered to be such a perfect operation that there is practically no risk of complications after all stages. If we consider all cases of domestic and foreign medicine, then only 1% of patients in the most difficult operations complained of complications after phacoemulsification. Possible complications include:
Complications after phacoemulsification are the most common and the latter option occurs. With this removal technique, it is worth paying special attention to patients who suffer from diabetes mellitus, uveitis, one of the forms of AMD. Treatment of this complication will require the use of corticosteroids, angiogenesis inhibitors.
The first item on the list, induced (postoperative) astigmatism, can also be attributed to a fairly common complication. It can lead to the fact that even the final function of the result of the course of the operation deteriorates. Its value will depend on which extraction method was used, what was the localization and length of the incision.
To correct this complication, you need to wear glasses or special lenses, in the event that the patient after phacoemulsification acquires pronounced signs of astigmatism, refractive surgery may be performed to remove and treat the complication.
Carrying out the operation process
Phacoemulsification operation progress:
a) Sound waves break the lens of the affected cataract and is absorbed through the needle; b) An artificial lens is carefully implanted into the eye; c) Correct IOL position and seamless closure of the inlet.
Benefits of early treatment
Torsion ultrasound
Torsion ultrasound
Torsion phacoemulsification is the latest word in surgery. This method is much faster and more reliable than traditional phacoemulsification. This is considered a fundamentally new option for cataract treatment. Torsion phacoemulsification, its advantages lie in the fact that torsion ultrasound gradually destroys the infected lens. Phacoemulsification of this type includes the entire process during the oscillatory movements of the needle. Iol implantation in this case is easier to transfer.
Phacoemulsification is an effective method of fighting cataracts
What it is
Phacoemulsification is a cataract surgery that involves replacing the affected lens with a special lens. It is indicated for those patients who, in addition to the cataract itself, do not have other diseases. For them, this procedure has a good prognosis and, in the vast majority of cases, leads to a complete recovery.
Phacoemulsification is carried out using a special microscope and high-precision instrumentation, which allows you to work through a minimal incision without injuring other tissues of the eye. For complete patient comfort, it is carried out under local anesthesia; general anesthesia is practically not used here.
Unlike other methods of treatment, this operation can be prescribed to the patient before the "maturation" of the cataract. It does not require hospitalization and allows a person to return to normal life almost the next day after.
Features of the procedure
The main feature of this procedure is the removal of the lens and the subsequent insertion of the lens through a small incision - up to 3 mm in total (compared to a 10 mm incision with other surgical methods). This was achieved by crushing the cataract itself with ultrasonic action and subsequent removal of its granules, for which a large hole in the mucous membrane was not required.
Phased procedure
As a result of the development of such technology in the 1960s, doctors were able to shorten the operation time, as well as eliminate the need to suture after it. Today, phacoemulsification, carried out according to such standards, provides for only 20 minutes of the manipulation itself, about 10 minutes of preparation and 24 hours full recovery vision for every patient.
Patient preparation
Preoperative preparation of the patient for the replacement of the lens by phacoemulsification consists in taking special medications designed to strengthen the body, as well as to exclude the development of complications immediately after the operation. The preparation period, like the type of medications required for it, is selected for each patient on an individual basis.
The general condition of the patient before the operation also plays an important role in the success of such an intervention. That is why patients who agree to phacoemulsification are advised to switch to a normal daily routine a few weeks before it, to adhere to a diet. excluding spicy, salty and fatty, as well as temporarily stop drinking alcohol and nicotine. This will help the person to endure the procedure and the recovery period easier.
Immediately before the operation, the patient is prepared as follows:
After carrying out these preparatory measures, the doctor proceeds to the operation itself.
Phased process
Phacoemulsification has a universal algorithm with the following sequence of actions:
- The doctor, using a diamond tool, makes a micro-incision of no more than 1.8-3 mm, through which all further manipulations are carried out.
- Viscoelastic is injected into the anterior chamber of the eye through a cannula - a substance that provides the internal structures of the eye with protection from mechanical and ultrasonic effects directly during the operation.
- Through a micro-incision, the doctor inserts a probe, through which the cataract-affected lens is converted into an emulsion.
- A flexible intraocular lens is inserted through the incision, which will continue to act as the affected lens. After the introduction, it unfolds and fixes itself.
- By means of an irrigation solution, the entire mass of viscoelastic is removed from the chambers of the eye. The operation is considered complete at this stage.
- When going outside, put on sunglasses to avoid eye injuries;
- Refrain from touching the operated eye with your hands;
- Reduce the load on eyesight, temporarily refuse to work at a computer or read for a long time;
- Refuse to drive vehicles.
At the end of the operation, no sutures are applied to the incision site, since the micro-incision is always self-sealing.
The patient can be discharged from the clinic on the same day and return to a normal rhythm of life. Until he fully recovers, he only needs to follow individual recommendations of the doctor for care.
Postoperative period
After phacoemulsification, the patient is recommended to remain at rest for 24 hours. If he is worried before the procedure, bed rest may be indicated. The patient is allowed to eat already 2 hours after the operation, however, initially it is recommended to be limited to only light snacks. A special bandage is put on the eye.
The first control examination, as a rule, is appointed the next day after the operation, at the same time the next dressing is carried out. Further, the patient will need to go to the doctor for examination 7 and 14 days after the operation.
At this time, the patient may experience photophobia, the appearance of dark spots in the eye, discomfort, and increased fatigue. All these symptoms are purely individual, and their appearance depends on the general condition of the body. They are situationally removed with medicines.
In the event that the patient after the operation has vomiting or severe nausea, fever and dizziness, you should consult a doctor. These symptoms usually go away very quickly and are easily relieved with medication, but you should not try to eliminate them yourself.
Also, the lens can be liquefied so that it itself then comes out through the lacrimal canals.
In order for a person to recover easily and without complications, it is recommended to follow these general recommendations in the first 2-3 weeks after the operation:
To speed up the recovery after surgery, it is recommended to stick to a diet, refuse heavy fatty foods, and also follow the correct implementation of the hygiene recommendations of the operated site.
Otherwise, the recovery process after such treatment does not have any special strict prescriptions for care.
Reviews of people
Phacoemulsification of cataracts is an operation that thousands of people undergo every year. We suggest that you familiarize yourself with the reviews of patients who have already undergone such treatment, so that you can make an informed decision on replacing the lens and get rid of doubts before the procedure.
The operation turned out to be completely fearless. I am very sorry that I did not dare to do it earlier, because as a result of the treatment, I almost completely restored my vision. The whole operation took half an hour at most, I did not feel pain. After the operation, there were no complications, on the same day he could read and write, behind the wheel, however, they were allowed to sit in only two weeks. For those who have not yet started a cataract, I recommend agreeing to the procedure as soon as possible. Save your sight.
Thanks to the operation, my vision was completely restored, I am very glad that I agreed to it. The preparation, of course, was hard, the operation itself was also not the most pleasant event, after that the period passed very easily. A minimum of drugs, the rhythm of life was normal for me. Six months have passed since then, and I cannot complain about any complications. On the contrary, my colleague with the same diagnosis, who refused the operation, is very sorry. His cataract is progressing, he cannot stop medication. Hopefully it will follow my lead over time.
Complications of cataract surgery
In addition, now there is no need to wait for a particularly suitable occasion to perform an operation - it can and should be done immediately.
Complications after cataract surgery
In some cases, surgery can lead to certain complications. It is worth mentioning that earlier the operation was performed when the lens “matured”, and this contributed to its strong compaction, significantly increased the time surgical intervention, could result in complications. Therefore, cataracts must be removed immediately, at the moment when it becomes a hindrance to normal life.
Secondary cataract
It is common, manifested by opacification of the posterior capsule. It has been proven that the incidence of secondary cataract depends on the material of the artificial lens. For example, polyacrylic IOLs are capable of causing it in 10% of all cases, silicone - already in 40%, and lenses made of polymethyl methacrylate, in almost 56%. The causes of postoperative cataract, effective ways to prevent it have not yet been studied.
It is generally accepted that its development is due to the migration of the lens epithelium into the space between the lens and the posterior capsule. The epithelium of the lens is the cells that remain after its removal. They degrade image quality by forming deposits. Other possible causes include fibrosis of the lens capsule.
In order to eliminate postoperative complications, a YAG laser is used, with which a hole is made in the center of the opaque zone of the posterior capsule.
Increased IOP
Increased IOP is characteristic of the early postoperative period. It degrades due to incomplete washout of viscoelastic - a gel-like preparation that is specially introduced into the anterior chamber to protect the intraocular structures from surgical damage. After cataract removal of the eyes, one of the complications is the development of pupillary block, which occurs when the IOL is displaced towards the iris. It is not difficult to eliminate this complication; in most cases, you can limit yourself to instilling antiglaucoma drops for several days.
Cytoid macular edema (Irwin-Gass syndrome)
In 1% of cases, postoperative complications develop after phacoemulsification of eye cataracts, and with an extracapsular technique - in 20%. At the same time, people with diabetes, uveitis, or wet AMD are at greatest risk. Also, the occurrence of macular edema is possible after cataract extraction, complicated by rupture of the posterior capsule or loss of vitreous... Complications are treated with corticosteroids, NSAIDs, and angiogenesis inhibitors. If conservative treatment is ineffective, vitrectomy is sometimes prescribed.
Corneal edema
Quite a common complication after surgery. The reasons may be: violation of the pumping function of the endothelium, due to mechanical or chemical damage to it during surgery, as well as an inflammatory reaction and concomitant ocular pathology. Usually, the swelling goes away on its own in a few days. Sometimes (0.1%) there is pseudophakic bullous keratopathy. with the formation of corneal bullae (small bubbles). For treatment, hypertonic solutions can be prescribed, as well as ointments. Special contact lenses are often used. Be sure to carry out therapy for the pathology that caused this condition. Ineffectiveness of treatment may be the reason for the appointment of a corneal transplant (keratoplasty) operation.
Postoperative astigmatism
It occurs often, leads to a deterioration in the operational effect. The degree of induced astigmatism. at the same time, it is directly related to the technology of cataract extraction, the length of the incision, its localization, the presence of sutures, the occurrence of complications in the operating process. Small degrees of astigmatism can be corrected with spectacle correction or contact lenses, with severe astigmatism, refractive surgery is recommended.
Dislocation (displacement) of the IOL
It is rare. Retrospective studies show that the risks of IOL displacement in patients 5, 10, 15, 20 and 25 years after surgery are approximately 0.1, 0.2, 0.7 and 1.7%. At the same time, it was found that pseudoexfoliation syndrome, as well as weakness of the zinc ligaments, can increase the risks of lens dislocation.
Phacoemulsification is the most modern, effective and practically safe method of radical cataract treatment. True, like any operation, it has a certain risk of developing certain complications.
Other complications
Surgery may increase the risk of rhegmatogenous retinal detachment. Usually, patients who have experienced complications in the operating process or those who have injured the eye in postoperative period, as well as those with myopic refraction and diabetics. In half of all cases, such a detachment occurs in the first year after surgery. It especially often occurs as a complication of intracapsular cataract extraction (5.7%), but practically does not occur after extracapsular cataract extraction (0.41-1.7%) and phacoemulsification (0.25-0.57%). For early detection of such a complication, the physician should monitor patients with implanted IOLs. The principle of treatment for such a complication is no different from the treatment for detachments of a different nature.
Choroidal (expulsive) bleeding can very rarely occur during cataract surgery. This condition is quite acute and completely unpredictable. It is characterized by the development of bleeding from the injured vessels of the choroid. which are sub-retina. providing her food. Risk factors for the development of this condition are arterial hypertension and atherosclerosis, a sudden rise in IOP, glaucoma. aphakia. axial myopia. or a small anteroposterior size of the eyeball, as well as old age, taking anticoagulants, inflammatory processes of the eye.
Often, it stops on its own without changing visual functions, but occasionally the consequences of bleeding lead to the loss of an eye. Basic therapy - complex treatment, including the use of local or systemic corticosteroids, medications with cycloplegic and mydriatic properties, antiglaucoma drugs. In some cases, a second eye surgery is recommended.
Endophthalmitis Is a complication of cataract surgery, in which the patient sees poorly, and sometimes completely loses his vision. Endophthalmitis can significantly reduce visual acuity. A similar complication occurs in 0.13 - 0.7% of cases.
The risk of developing endophthalmitis increases significantly when a patient develops blepharitis. canaliculitis, conjunctivitis. entropion, obstruction of the nasolacrimal ducts, after immunosuppressive therapy, when wearing contact lenses or a prosthesis of a paired eye. Signs of eye infection are: severe tissue hyperemia, pain, increased photosensitivity, the patient begins to see worse. In order to prevent endophthalmitis, instillations of 5% povidone-iodine are prescribed before the operation, as well as the introduction of antibiotics into the eye chamber or subconjunctivally, and the sanitation of potential foci of infection. Also, it is very important to use disposable surgical instruments, or careful processing of reusable disinfectants. How to behave after cataract surgery, the doctor will tell you, he will give recommendations and prescribe eye drops, preparations for postoperative eye care.
Lightning in a person's eyes is scientifically called photopsy; it can manifest itself as an imaginary sensation in the form of sparks in the eyes, flashes, glowing lines, spots, rings, all kinds of zigzags or fiery surfaces. Such situations are due to inappropriate stimulation of the neuroreceptors of the retina and other parts of the visual analyzers. This phenomenon is a kind of visual phenomena, which is united by the common name "entoptic".
They are often observed closer to old age in the case when the movement of the vitreous body has pressure on the retina. These flashes that appear last 1-2 seconds and are more noticeable when you move your eyes or find yourself in the dark. In some, such flashes in the eyes provoke a severe migraine. Then the phenomenon will be longer - up to 20 minutes.
This impression - as if lightning flashed in the eyes - is familiar to many people. Lightning in human eyes manifests itself in various places of the visual field, characterized by all kinds of forms. What distinguishes them from flares is the locality of manifestations, the high brightness of the flare.
Flickering in the eyes of lightning is due to irritation of the neuroreceptors of the retina, other parts of the visual analyzers. The type of stimulus can be electrical (i.e., phosphenes) or mechanical. Irritations of an electric type occur when pressure is applied to the inner or outer corners of the eye, and mechanical irritations occur with sudden movements of the eyeball, and this causes vibrations of the vitreous body itself.
Often, the phenomenon when lightning flashes in the eye becomes initial sign the fact that an ophthalmic disease develops. But in most situations, patients do not take this symptom seriously.
Causes of lightning in our eyes
The reasons for this phenomenon are quite numerous, they differ in nature. An optical phenomenon of this kind can occur in the following pathological processes:
tears, retinal detachments (this is one of the main causes of lightning); detachment of the posterior part of the vitreous body, which leads to tension of the retina; chorioditis (this is an inflammation of the vessels that provide blood to the retina); different types of tumors leading to primary or secondary damage to the retina; eyeball injuries that cause secondary retinal detachment; various disorders in the normal circulation of the retina and other parts of the eye; eye migraine, at which lightning occurs at the same time before the eyes, and they are accompanied by severe and prolonged headaches; the presence of asteroid bodies; hemorrhage in the retina; macular edema.
Glittering in the eyes of lightning comes in various degrees of brightness and in the most diverse forms of manifestation. They can be like this:
Zigzags. Spots. Broken lines. Rings. Fiery surface, etc.
Diagnostics: when lightning flashes in the eyes, a study is assigned, which is designed to assess the state of the retina itself. The following types of examination are recommended:
using a slit lamp - ophthalmoscopy; cT scan; ultrasound examination of the eyeballs.
In order for the diagnosis to be performed, the necessary course of treatment is determined, you need to contact an ophthalmologist. The cure of lightning that occurs in the eyes is characterized not by the elimination of the symptom itself, but by getting rid of the cause that led to this phenomenon. If this is a detachment of the retina or vitreous body, you will need surgical treatment... Surgical intervention in this case involves vitrectomy with further filling of the empty space with silicone or gas.
See also: Is it possible to wash your eyes with a furacilin solution
For small hemorrhages in the retina, the most effective method of cure is laser coagulation, which prevents pathological processes in the future.
Preventive actions
If lightning has thrown into your eyes, you can apply some preventive actions... For example, in order to prevent problems with blood vessels, we recommend that you keep your cholesterol and blood sugar levels under control, check your blood pressure, make visits to the ophthalmologist from time to time. In particular, it is advisable to consult a doctor in the event that flashes in the eyes occur unexpectedly, accompanied by the same loss of lateral vision.
Many people are familiar with the situation when bright fireworks, flashes, lightning flashes in their eyes. Most people don't pay any attention to them. However, such phenomena before the eyes during the day and in the dark can have serious reasons - dangerous diseasesthat even lead to blindness.
Discomfort in the eyes
Flashes in the eyes - a hidden danger
Visual images in the form of flashes of light, lightning, flickering dots, rings, zigzags and threads are commonly called photopsies in medicine. Why do they happen? Often this problem has an ophthalmic nature, and may be associated with thinning or rupture of the retina. Flashes of light in the eyes in this case, without seeking medical help, can lead to retinal detachment, which inevitably leads to partial or complete loss of vision. Another major reason why outbreaks occur frequently are cancerous tumors tissues of the eye.
Eye structure
Eye problems leading to flares
By themselves, flashes before the eyes are not a disease, they do not need to be treated and removed. But if such pseudo-sensations appear more and more often, suddenly, and at the same time peripheral vision deteriorates significantly or completely disappears, then you should immediately look for and remove the cause. After all, visual disturbances interfering with the normal functioning of the eyes can play a cruel joke at any time - when crossing the road, when driving a car and in other important situations.
Pain in the eyes
Details of the main reasons
Let's list the main reasons for periodic, constant or sudden flashes of light in front of the eyes:
Detachment of the vitreous body. This substance, which fills the center of the eye, is attached to the retina. The older the person, the more likely this part of the eye will shrink, gradually peeling away from the attachment sites. Flares usually appear with eye movements and head movements. Migraine attacks. The causes of flash in the eyes in the dark, with closed and open eyes can be neurological in nature. In this case, visual images first appear, flashes of light in the form of zigzags, shiny dots, white lines, as in the photo, in one or both eyes. This is followed by headaches. However, the feeling of pain may not be with ocular migraine - a common ophthalmological ailment. Detachment of the retina. This process is often preceded by heavy physical exertion, stressful situations. At the same time, light images in front of the eyes are accompanied by deterioration of vision, dragging of the eyes - timely assistance is very important here. Vascular disease. Many hypertensive patients, diabetics and other people with vascular diseases complain about the appearance of flashes in the eyes, as in the photo. Light images in such patients more often appear in the dark or with closed eyes. Sparks, lightning and flashes in this case are the causes of vasospasm of the eyes. In this case, the eyes may become cloudy, which indicates serious problems requiring urgent surgical intervention. Tumors in the brain. Tumor-like formations in the occipital part of the brain are manifested by many signs, including visual sensations of flashes of any color, size and shape. Inflammatory processes in the tissues and blood vessels of the eye are a common reason why there is a feeling of fog in the eyes. This process is accompanied by other signs of inflammation and visual impairment. Post-traumatic cause. Bruises, blows to the eyes, nose and head are accompanied by symptoms such as flashes in the eyes in the dark and in bright light, as well as dizziness and headache of varying intensity. In this case, pseudo-sensations of light can arise when the head is turned to any or one of the sides. Such outbreaks usually go away on their own, but may also indicate retinal detachment as a result of trauma.
Diagnostics
Light false flashes in front of the eyes are common for those suffering from cataracts, corneal edema, and those who have problems with the cerebellum. In people over 40 years of age, flashes with closed eyes, in the dark or in daylight are not uncommon, and it is almost impossible to remove them. This is due to the aging of the body, which is accompanied by visual impairment in general.
Other reasons
Visual images in the form of flashes are most often a singular phenomenon. Consider why other flashes in the eyes are formed:
from friction of the eyes, from fatigue, from a sharp turn of the head, as a result of looking at bright sunlight, illumination, etc .; due to damage to the lenses on the glasses.
Infrequent outbreaks are not a cause for concern. Visual pseudo-sensations can be a sign of an overdose of drugs, as well as a consequence of alcohol, tobacco and drug abuse.
It is important to know
When to see a doctor immediately:
when outbreaks last for several seconds with significant injuries and bruises in the head area; bright, large-sized flares that do not stop for up to 20 minutes, associated with a semi-faint state; along with flares, images of small spots are observed; when there are already chronic eye diseases and other disorders of the body.
Prolonged, more frequent flashes over time, which are accompanied by pain in the eyes, head, neck, loss or deterioration of vision, are the reason for contacting an ophthalmologist. To relieve the patient of the causes of outbreaks, the ophthalmologist can send the patient for an additional examination - ultrasound of the eyeball, MRI, X-ray, an appointment with a neurologist, therapist and other specialists. Most of the diseases that cause outbreaks are treatable with timely access to a medical facility.
I am 65 years old. I am a doctor. In 2013, he removed a cataract in his right eye. In 2016 - in the left. Both operations were performed at the Lege artic clinic on Federated Prospect. Both lenses are from the same company, AcrySof IQ.
The postoperative process went well. Eyesight was perfectly restored. Two months after the operation, a feeling appeared in the right eye that something was interfering. I went to the clinic, where, after examination, they revealed demodex. A course of treatment was prescribed. Another two months have passed, but there is no effect. Sensation foreign bodythat interferes with life does not pass. I went to the clinic again. They replied that everything is fine. The operation went great, you have a dry eye symptom. Drop Artelac into the right eye.
Another 2 months passed. The sensation of a foreign body only in the right eye remains. There was constant tearing from this one eye. At the present time, in addition to the sensation of "interference" in the eye, there is double vision when reading. When you close one or the other eye, the picture is clear and reading is a pleasure. When reading with two eyes, reading is impossible due to double vision. Sent for a consultation at the Eye Surgery Center. There they made me an optical coherence tomography of the retina. The diagnosis of OD AMD, "dry" form.
Considering all of the above, I want to ask. With this feeling of "interruption" to continue living? By and large, this is not fatal. Maybe after 2-3 years I will get used to it. I will read less. Listen more. I ask for advice.
Asks: Vladimir
Cataract specialist's answer
Hello.
The foreign body sensation is unlikely to be associated with demodex, but is more commonly associated with dry eye syndrome. However, to exclude other reasons, it is better to see an ophthalmologist. To reduce discomfort, you can try to drip an artificial tear (this is a group of drugs that improves the properties of the tear film and has no side effects). Examples of drugs: Hilokomod, Systain, Oftolik, Natural tear, etc. Dripping at least 4 times a day into both eyes for at least two months. However, it is recommended that you investigate the cause of your problem at an in-person appointment with an ophthalmologist.
After operation
Immediately after cataract surgery
The results of surgery may vary from person to person. The information provided here does not in any way replace the advice of a physician.
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Laser treatment
Laser cataract treatment is the most progressive and high-tech method of performing cataract surgeries today. This is the latest achievement in the field of ophthalmic surgery, well established in the world. Now, cataract treatment with a femtosecond laser is available in modern clinics.
Benefits of laser cataract treatment:
- the highest level the accuracy of the operation.
- Laser technologies used during the intervention ensure ultra-precision at all stages;
- quick recovery after surgery.
- The use of a laser eliminates the use of mechanical instruments, and after the operation, all micro-accesses to the internal structures of the eye are quickly self-sealing;
- sparing effect.
- The use of a laser minimizes the effect of ultrasound on the internal structures of the eye during the operation and avoids the risk of postoperative corneal edema;
- maximum quality of visual characteristics.
- The accuracy of the laser action allows you to achieve the maximum quality of vision during the implantation of intraocular lenses, especially high-tech (toric, multifocal, pseudo-accommodating);
- quick restoration of visual acuity.
- The laser ophthalmological system allows automating the most difficult stages of cataract surgery, the quality of which has a direct impact on the final result of the operation - the patient's visual acuity;
- stable, predictable results.
The equipment and technologies used during the operation make it possible to carry out a truly personalized operation, taking into account the individual characteristics of the visual system of each patient, and therefore predict the result.
What is the difference between laser cataract treatment and traditional surgery?
The main difference between the new technology and traditional surgery is the way of forming access to the internal structures of the eye, the lens, as well as the mechanism of destruction of the lens. During a traditional operation, these stages of the intervention are carried out using special microsurgical instruments. When using a surgical laser, manipulations are performed contactlessly using a laser beam. The fragmentation of the lens before it is removed from the eye in traditional surgery occurs using only ultrasound. Laser treatment allows this stage to be carried out using a laser beam, therefore, the effect of ultrasound is reduced.
Stages of a cataract surgery with a laser
- On the basis of studies of an optical coherence tomograph (OCT) before the operation, all the necessary parameters of the eye are determined, on their basis the course of the intervention is calculated and the configuration of the corneal approaches is modeled.
- A femtosecond laser forms accesses of a given configuration to the internal structures of the eye and to the lens, the process is broadcast on a special monitor in 3D mode.
- The femtosecond laser system exfoliates the lens core. The destruction of the lens can be done in two ways: by sectors or circularly.
- A femtosecond laser is used to form a hole in the lens capsule. Due to the unique properties of femtosecond technologies, as well as ultra-precise research, the hole is perfectly flat, and its centering is absolutely accurate. At this stage, the laser effect is completed, and the ophthalmic surgeon performs further manipulations using a microsurgical system.
- The lens, fragmented by a laser beam, is converted into an emulsion by means of a microsurgical system under the action of ultrasound and is removed from the eye.
- Through a micro-access up to 1.6 mm in size, a flexible intraocular lens is inserted into the capsule, where the lens was previously located, in a folded state, which independently unfolds inside the eye and is securely fixed.
Equipment used for laser cataract treatment
To carry out the operation according to the new technique, the LenSx surgical femtosecond laser system from Alcon (USA) is used. This is the first of its kind femtolaser system specially designed for cataract surgery and receiving FDA approval. The system has been registered and certified in Russia. The equipment has all the necessary certificates, warranty coverage and multilevel clinical support.
The LenSx surgical laser system is equipped with an integrated intraoperative optical coherence tomograph (OCT). This allows you to explore and automatically calculate the parameters of the intervention, and during the operation - to fully control the state of the internal structures of the eye. As a result, the highest level of accuracy and safety of the intervention is achieved. Laser treatment of cataracts can be called a truly personalized operation: the system calculates all parameters individually for each patient.
How does a surgical femtosecond laser work?
The peculiarity of the femtosecond laser is that its beam can be focused at any depth with an accuracy of several microns. This creates a layer of microbubbles that exfoliates tissue at the molecular level without generating heat or affecting the surrounding tissue. A femtosecond laser arranges multiple bubbles in a neighborhood to create an accurate profile of the desired configuration. Thus, there is no cutting, but delamination of the tissues.
Results of laser cataract treatment
Rehabilitation
To protect the damaged eye from any damage and infection, it is necessary to strictly adhere to the rules of rehabilitation. Usually, they are the same for everyone, but in some cases, an ophthalmologist can develop an individual list of rehabilitation rules.
During postoperative rehabilitation, you must adhere to the following recommendations:
Complications
According to the American Society of Cataract and Refractive Surgeons, about 3 million cataract operations (IOL implantations) are performed annually in the United States (no data for Russia). Moreover, the number of successful operations is over 98 percent. The complications that have arisen are currently in most cases successfully treated conservatively or surgically.
The most common complication is clouding of the posterior capsule of the lens or "secondary cataract". It was found that the frequency of its occurrence depends on the material from which the lens is made. So, for polyacryl IOLs, it is up to 10%, while for silicone - already about 40%, and for those made from polymethyl methacrylate (PMMA) - 56%. The true reasons leading to this, and effective methods prophylaxis is not currently established.
It is believed that this complication may be caused by migration of epithelial cells of the lens left after removal into the space between the lens and the posterior capsule, and, as a result, the formation of deposits that degrade image quality. The second possible cause is fibrosis of the lens capsule. Treatment is carried out using a YAG laser, with the help of which a hole is formed in the central zone of the opaque posterior capsule of the lens.
In the early postoperative period, an increase in IOP is possible. The reason for this may be incomplete washout of viscoelastic (a special gel-like preparation introduced into the anterior chamber of the eye to protect its structures from damage) and its ingress into the drainage system of the eye, as well as the development of the pupillary block when the IOL is displaced to the iris. In most cases, the use of antiglaucoma drops for several days is sufficient.
Cytoid macular edema (Irwin-Gass syndrome) occurs after phacoemulsification of cataracts in approximately 1% of cases. With an extracapsular lens removal technique, this complication is detected in about 20 percent of patients. People with diabetes, uveitis, and “wet” AMD are at greater risk. The incidence of macular edema also increases after cataract extraction, complicated by rupture of the posterior capsule or loss of the vitreous humor. For treatment, corticosteroids, NSAIDs, angiogenesis inhibitors are used. If conservative treatment is unsuccessful, it is possible to perform vitrectomy.
Corneal edema is a fairly common complication after cataract removal. The reason may be a decrease in the pumping function of the endothelium, provoked by mechanical or chemical damage during surgery, an inflammatory reaction, and concomitant ocular pathology. In most cases, the swelling goes away without any treatment within a few days. In 0.1% of cases, pseudophakic bullous keratopathy develops, in which bullae (blisters) form in the cornea. In such cases, hypertonic solutions or ointments, therapeutic contact lenses are used, and the pathology that caused this condition is treated. If there is no effect, corneal transplantation can be performed.
K enough frequent complications IOL implantation refers to postoperative (induced) astigmatism, which can lead to a deterioration in the final functional result of the operation. Its value depends on the method of cataract extraction, the location and length of the incision, whether sutures were applied to seal it, the occurrence of various complications during the operation. To correct small degrees of astigmatism, glasses or contact lenses can be prescribed, with severe ones, refractive surgery is possible.
IOL displacement (dislocation) is much less common than the complications described above. Retrospective studies have shown that the risk of IOL dislocation in patients 5, 10, 15, 20, and 25 years after the implantation was 0.1, 0.1, 0.2, 0.7 and 1.7 percent, respectively. It has also been found that in the presence of pseudoexfoliation syndrome and weakness of the zinc ligaments, the likelihood of lens displacement increases.
After IOL implantation, the risk of developing rhegmatogenous retinal detachment increases. To a greater extent, this risk is exposed to patients who had complications during the operation, who received an eye injury in the postoperative period, who had myopic refraction, and who were suffering from diabetes. In 50 percent of cases, detachment occurs in the first year after surgery. Most often it develops after intracapsular cataract extraction (5.7%), less often - after extracapsular (0.41-1.7%) and phacoemulsification (0.25-0.57%). All patients after IOL implantation should be monitored regularly by an ophthalmologist for early detection of this complication. The principles of treatment are the same as for detachments of a different etiology.
Choroidal (expulsive) bleeding develops extremely rarely during cataract removal. This is an acute, absolutely unpredictable condition in which bleeding occurs from the vessels of the choroid, lying under the retina and feeding it. Risk factors are arterial hypertension, atherosclerosis, glaucoma, aphakia, a sudden rise in IOP, axial myopia or, conversely, a very small PZR (anteroposterior size) of the eye, inflammation, taking anticoagulants, old age.
In some cases, it stops on its own and affects the visual functions of the eye only slightly, but sometimes its consequences can lead to loss of the eye. For treatment, complex therapy is used, including local and systemic corticosteroids, drugs with cycloplegic and mydriatic effect, antiglaucoma drugs. In some cases, surgical treatment may be indicated.
Endophthalmitis is a rare complication of cataract surgery, leading to a significant decrease in visual functions, up to their complete loss. The frequency of occurrence, according to various sources, ranges from 0.13 to 0.7%.
The risk of development increases if the patient has blepharitis, conjunctivitis, canaliculitis, obstruction of the nasolacrimal ducts, entropion, when wearing contact lenses and a prosthesis of a paired eye, after recent immunosuppressive therapy. The symptoms of intraocular infection are marked redness of the eye, pain, increased photosensitivity, decreased vision. In order to prevent endophthalmitis, instillations of a 5% povidone-iodine solution are used before the operation, injected into the chamber or subconjunctivally antibacterial agents, possible foci of infection are sanitized. The preferred use of disposable or careful handling of reusable surgical instruments is important.
Contraindications for removal
In order to somehow cope with the disease, it is necessary to carry out an operation. But, like any other surgical intervention, there are also contraindications for cataract surgery. The operation itself can be performed by several methods, but the choice of method depends on which clinic the operation is performed in and how much the disease process has gone.
There are no true contraindications for eye cataract removal yet. That is, the operation can be performed at almost any age. However, there are so-called relative contraindications that you should definitely pay attention to.
Such contraindications include the following diseases:
These contraindications for cataract surgery should be taken into account, but this does not mean that the operation will be impossible with them. Just before removing a cataract, you should definitely consult with your doctor and find out exactly how the above listed diseases will affect the course of the operation itself and the healing process.
After the operation, restoration of a person's vision can take up to a week. However, everything here is strictly individual. It will depend on what method the operation was carried out, and what was the success of its implementation.
After an operation to remove a cataract, the patient is simply required to follow a number of rules.
Firstly, for a long time, he cannot lift more than three kilograms of weight.
Secondly, you should not make too sharp movements and do not tilt your head down too much. This can cause a bad effect in the postoperative period, and in some cases it can lead to re-operation.
Thirdly, limit your stay in the open sun, do not visit the bathhouse or sauna, do not use too hot water when washing.
Fourthly, when leaving the house at any time of the year, be sure to wear sunglasses.
If the patient after the operation has any other diseases that affect vision and the condition of the eyes, then the rehabilitation period can drag on for a rather long period.
Complications of lens replacement
After lens replacement, complications are minimal. The most common clouding of the posterior capsule of the implant. This condition is called secondary cataract... But this interpretation is incorrect, since the cataract itself cannot arise. This pathology is not terrible and can be successfully corrected using a laser. Displacement of the lens, inflammation and infection are also possible after surgery. To avoid infection, ophthalmologists recommend using special anti-inflammatory drops after replacing the lens. With a properly organized postoperative period possible complications are reduced to a minimum.
Drops
It should be remembered that eye drops can only slow down the development of the disease, but not completely heal it. But in some cases, the operation cannot be performed, and then eye drops become the main method of treatment. The earlier you start treatment with drugs, the better the result. Since cataract is a chronic disease, treatment with drops must be carried out constantly, breaks lead to the progression of the disease.
Pharmaceutical companies have developed a huge number of drugs for the treatment of cataracts. Eye drops differ in price, effectiveness and side effects.
The most common cataract drops are vitayodurol, vitafacol, Smirnov's drops, quinax, oftan-katachrom. The composition of any drops from the progression of cataracts include vitamins of group B and C, potassium iodide, amino acids and antioxidants.
The situation in ophthalmology is such that no comprehensive efficacy study has been conducted for any of the cataract drugs independent of the pharmaceutical company. This means that numerous cataract drops do not have an evidence-based scientific basis for use. Of course, vitamins will not harm you. But whether they will cure cataracts is a big question.
Experts believe that of the whole variety of drops, only eye drops for cataracts "Quinax" deserve special attention. For a stable result, you will need regular use, you need to bury it in the sore eye - one drop three times a day.
Cataract
Cataract - clouding of the lens, leading to a decrease in the transmission of light rays and a decrease in visual acuity. In most cases, cataracts are age-related pathology... The disease can be diagnosed in children as congenital or develop at any age due to trauma, inflammation, or the presence of a general pathology. READ MORE
The only way to eliminate the pathology is a microsurgical operation, which consists in removing the clouded lens of the eye and replacing it with artificial lens (IOL).
Currently, in the practice of the IRTC "Eye Microsurgery", a high-tech method of sutureless surgery is used, in which cataract removal is carried out by the method of ultrasonic phacoemulsification. and the artificial lens is implanted through an ultra-small incision or laser comminution of the cataract is performed, followed by suction of the lens fragments. In these operations, the incision is so small that it does not need to be sutured.
Today, MNTK "Eye Microsurgery" uses advanced femtosecond technologies to perform key stages in cataract surgery.
Most of the stages of cataract surgery, previously performed directly by the surgeon, the femtosecond laser system takes over. The laser independently forms a corneal incision, circular capsulorhexis and crushes the lens.
The advantages of using Femtolaser are:
In some cases, when phacoemulsification or laser removal of cataracts is impossible, the surgeon uses other methods of removing a cloudy lens, in which the operating incision is sutured with a special superfine thread.
The MNTK "Eye Microsurgery" has accumulated a tremendous experience in surgical interventions for cataracts, more than 1 million operations have been performed in 20 years. Thanks to the works of S.N. Fedorov and his school, these interventions became available to many patients around the world, and their prospects for the coming decades were determined.
DIAGNOSTICS OF CATARACT
TREATMENT
Continuous improvement of cataract phacoemulsification technology, introduction into clinical practice of new models of intraocular lenses and devices for surgical treatment have made cataract surgery a safe, highly effective and predictable method of treatment that practically does not reduce the performance of our patients. The modern technique of performing cataract surgery allows you to get maximum visual functions already on the first day after surgery.
What is cataract
Cataract - This is a deterioration in vision due to clouding of the eye lens. A person suffering from cataracts experiences severe discomfort. The contours of objects sees blurred, indistinct, doubled. As the cataract develops, it is often necessary to change the lenses in glasses for stronger ones. The disease is widespread.
Causes of cataracts
Some eye injuries, such as mechanical and chemical injuries, are the cause of cataracts. Also, the occurrence of cataracts is influenced by reasons such as some eye diseases for example, glaucoma or high myopia as well as diabetes mellitus vitamin deficiency or long-term use of certain drugs. According to some sources, in more than 20 million people worldwide, this disease was the beginning of the onset of blindness. Poor ecology, poisoning with various toxic drugs, ultraviolet or radiation exposure, microwave and smoking can also become the cause of cataracts.
The main causes of eye cataracts
Eye cataracts in the elderly
In older people, cataracts are most common, and many experts even consider it a natural part of the aging process. In most cases, it affects both eyes, although one lens is often more opaque than the other. Typical symptoms of age-related cataracts:
Sometimes elderly people have symptoms of glaucoma and cataracts at the same time, and it is not always possible for the patient to distinguish one from the other. The main symptom of open-angle chronic glaucoma is the gradual deterioration of vision, which is also characteristic of cataracts. Less common is acute open-angle glaucoma, among the signs of which - strong pain in the eyes, headache, eye redness, tenderness or soreness of the skin around the eyes.
These symptoms usually appear for one to two hours, at more or less long intervals, but each time they occur, vision deteriorates slightly. If any of the above signs appear, you should seek medical attention as soon as possible. In acute open-angle glaucoma, especially if it is accompanied by cataracts, vision can decrease very quickly, and this process is irreversible; in the absence of treatment acute glaucoma can lead to complete loss of vision.
Cataract symptoms
Cataracts usually develop slowly and do not cause pain. In the beginning, cataracts may only take up a small part of the lens and you may not notice any vision problems. Over time, the size of the cataract increases. The moment the amount of light rays reaching the retina is significantly reduced, your vision is impaired. Cataract symptoms include:
Cataracts usually do not cause any external eye changes. Pain, redness, itching, and irritation of the eyes are not symptoms of cataracts, but may be associated with other conditions. Cataracts are not harmful to the eyes, unless the lens turns completely white. In these cases, the development of inflammation, pain and headache is possible. This type of cataract is rare and requires urgent surgical treatment. Do not forget that an examination by an ophthalmologist is recommended every 2-4 years for persons under 65 and every 1-2 years for persons over 65, as well as after the appearance of new vision problems. If you have cataract symptoms, it is recommended that you visit an ophthalmologist for an examination.
Stages of cataract
Cataract, the symptoms of which appear depending on the course of the disease, has four stages of development:
Stage I (initial)
Vision decreases insignificantly, a person begins to see poorly in one or both eyes. During observation by an ophthalmologist, a streaky turbidity of the lens from the periphery to the central part is visible. Symptoms are varied: some patients do not experience deterioration of vision, others complain of the appearance of "flies" in front of their eyes, while others experience changes in refraction, which requires a relatively quick change of diopters in glasses.
Stage II (immature)
A distinctive characteristic of the disease is noticeable changes in the level of vision. Visual picture becomes very blurry and not clear. The stage is characterized by the fact that the opacity of the lens is drawn to the central optical zone. An increase in the lens often provokes an increase in intraocular pressure.
Stage III (mature)
It is characterized by the fact that vision decreases almost to light sensations, there is a clear visible clouding of the lens, which completely reduces vision. The patient sees hand movements only near the face.
Stage IV (overripe)
The lens shrinks or liquefies. The patient can see a milky, almost white lens. The only way out to avoid loss of vision at this stage and prevent the occurrence of secondary glaucoma is to apply laser exposure.
Diagnosis of cataracts
Cataract is an insidious disease and to determine if you have it only a qualified specialist... Unfortunately, many patients pay attention to their eye health only when it starts to bother them. The main method for diagnosing cataracts is to examine the fundus of the eye in good lighting. Sometimes such an examination already indicates certain problems. A more in-depth study is carried out using a light (slit) lamp - biomicroscopy of the eye, which gives directional illumination and magnification.
Its light beam is slit-shaped. The development of this technology was based on the discovery of the Swedish physicist Guldstrandt. In 1911, he created a device designed to illuminate the eyeball, which was later called the slit lamp. To illuminate the eye, the scientist used not the light source itself, but its actual reverse image, projected in the region of the slit diaphragm. A narrowly limited beam of light made it possible to create a clear contrast between the examined (illuminated) and unlit participants in the patient's eye, which later specialists began to call light activity.
Biomicroscopy allows the ophthalmologist to see all the details of the eyeball and examine in detail not only the external, but also deeply located tissue structures of the eye. In addition to examining the fundus with a slit lamp, cataract diagnostics include: techniques that allow you to calculate the strength of an artificial lens (intraocular lens). Individual calculation of parameters is carried out thanks to a device unique in Russia - "IOL-master" (ZEISS firm). Such a device makes it possible to simultaneously measure not only the length of the eye, the curvature of the cornea, the depth of the anterior chamber, assess the state of the natural lens, but also optimally calculate the parameters
Cataract surgery
Today, the most popular types of cataract surgery are: phacoemulsification of cataract and extracapsular cataract extraction with IOL implantation. Both of these surgeries are performed under local anesthesia.
Phacoemulsification of cataract with IOL implantation
The principle of the operation is that the surgeon inserts an ultrasonic instrument through 2-3 mm corneal incisions, breaks the lens substance with it and removes its remnants by microsurgical suction. After that, an artificial lens rolled into a tube is implanted into the freed lens sac, straightens it and centers it. The operation takes on average 10-20 minutes. No seams are applied. Pain relief is provided by pre-instillation of anesthetic drops.
Preparation for cataract surgery
After examining the eyes by the surgeon and deciding the method of surgical intervention, the patient receives a list of necessary laboratory tests and consultations from other doctors. After all, a surgical operation of even such a small organ as an eye is a great burden for the body, and an ophthalmic surgeon must be sure that a person will withstand, and his eye will heal quickly and without complications. 3-5 days before surgery, you will need to instill antibacterial drops to minimize the risk of eye infection.
How does cataract surgery work?
After cataract surgery
A healing gel and a protective bandage will be applied to the eye. When the anesthetic wears off, the patient may feel mild discomfort and pain in the eye. These unpleasant sensations are relieved by pain relievers. Before being discharged home, the patient will be instructed on how to cleanse and properly instill drops into the eye.
Recovery after cataract surgery
Vision will begin to improve a few hours after surgery and will finally recover in a month. The result after the operation depends primarily on the initial condition of the eye. Since the fundus of the eye is not visible behind the cloudy lens, the ophthalmologist can judge the retina and optic nerve only by the results of additional studies - tomography, perimetry (lateral vision assessment) and ultrasound of the eye. If the patient has long-term diabetes mellitus or glaucoma, this may worsen the prognosis and the postoperative result may not be satisfactory.
For 2 months after cataract surgery, it is necessary to protect the eyes from excessive stress, avoid sharp bends and heavy lifting. The patient can watch TV, read, write, sew, swim, eat any food, sleep in any position - within a week after the operation. If the bright light causes discomfort, you can use sunglasses.
To shorten the recovery period after the operation, the attending physician will determine the procedure for using the eye drops and draw up a schedule for visiting the doctor for a preventive examination. Exact adherence to all doctor's prescriptions will shorten the time for tissue repair, protect the patient's eyes from any side effects, accelerate adaptation to new vision and restore binocular vision. Rules of conduct after cataract surgery
While your eye is healing, your doctor may ask you to follow one or more special precautions to help protect your new artificial lens and make the healing process faster and safer. These can be the following precautions:
Drops from cataracts
In the same cases when cataract surgery is undesirable, doctors prescribe cataract eye drops. In fact, such drugs cannot completely cure this disease. They are designed to slow down the process of lens opacity. It should be remembered that the sooner such treatment is started, the greater the results will be achieved. Therefore, at the first suspicion of the presence of such a disease, you should immediately seek medical help.
It should be understood that cataracts are a chronic disease, and therefore drops should be used almost constantly. Long breaks can lead to even greater progression of the disease and decreased vision. Such drugs, as a rule, have practically no side effects, which means they are very safe. Cataract eye drops can be prescribed to any sick person. The only contraindication for such drugs is the individual intolerance of its components. the human body... They are very often prescribed even before surgery.
Today there are a lot of such drugs, which differ in price, effectiveness and the presence of contraindications. For example, “Vitafacol”, “Quinax”, “Taufon”, “Vitaiodurol”, “Vicin” and many others are popular. In most cases, the effect of the drug is based on the protection of the protein part of the lens from further opacity. In any case, only a doctor who is familiar with the medical history can prescribe suitable eye drops for you. Self-medication and unauthorized use of such drugs is fraught with negative consequences.
Treatment of cataracts with folk remedies
For the treatment of cataracts, traditional medicine offers its own methods and medicinal plants. Here are some common recipes:
Prevention of cataracts
In order to prevent cataracts, it is recommended to replenish certain substances in the body, for example, antioxidants. These include: glutathione, lutein, vitamin E. A balanced diet, abstinence from smoking and alcohol, and physical activity can prevent the development of cataracts. Regular examination by an ophthalmologist for persons over 50 years of age.
In the case when an ophthalmologist diagnoses a patient initial cataracteye drops are often prescribed, which provide improvement metabolic processes in the lens. These drugs are needed to slow the progression of lens opacities. Unfortunately, eye drops are not always effective remedy prevention and in the patient, almost always, further progression of cataract is noted.
I am 65 years old. I am a doctor. In 2013, he removed a cataract in his right eye. In 2016 - in the left. Both operations were performed at the Lege artic clinic on Federated Prospect. Both lenses are from the same company, AcrySof IQ.
The postoperative process went well. Eyesight was perfectly restored. Two months after the operation, a feeling appeared in the right eye that something was interfering. I went to the clinic, where, after examination, they revealed demodex. A course of treatment was prescribed. Another two months have passed, but there is no effect. The feeling of a foreign body that interferes with life does not go away. I went to the clinic again. They replied that everything is fine. The operation went great, you have a dry eye symptom. Drop Artelac into the right eye.
Another 2 months passed. The sensation of a foreign body only in the right eye remains. There was constant tearing from this one eye. Currently, in addition to the sensation of "interference" in the eye, double vision has appeared when reading. When you close one or the other eye, the picture is clear and reading is a pleasure. When reading with two eyes, reading is impossible due to double vision. Sent for a consultation at the Eye Surgery Center. There they made me an optical coherence tomography of the retina. The diagnosis of OD AMD, "dry" form.
Considering all of the above, I want to ask. With this feeling of "interruption" to continue living? By and large, this is not fatal. Maybe after 2-3 years I will get used to it. I will read less. Listen more. I ask for advice.
Asks: Vladimir
Cataract specialist's answer
Hello.
The foreign body sensation is unlikely to be associated with demodex, but is more commonly associated with dry eye syndrome. However, to exclude other reasons, it is better to see an ophthalmologist. To reduce discomfort, you can try to drip an artificial tear (this is a group of drugs that improves the properties of the tear film and has no side effects). Examples of drugs: Hilokomod, Systain, Oftolik, Natural tear, etc. Dripping at least 4 times a day into both eyes for at least two months. However, it is recommended that you investigate the cause of your problem at an in-person appointment with an ophthalmologist.
Modern surgical treatment is low-traumatic, due to which the postoperative period after it is almost painless and does not last long. As a rule, vision is restored almost immediately. However, for a certain time after the person must follow the regimen and carefully follow the doctor's recommendations.
Many people underestimate the importance of the rehabilitation period, which leads to undesirable consequences. As a result, these patients develop complications that could have been avoided. In order not to damage the cornea, dislocate the implanted lens and not bring an infection to the eye, you need to know how to behave after cataract surgery.
In the postoperative period, people have to deal with such problems.:
- Eye hurts after cataract surgery. Pain is caused by tissue damage and is completely normal. Drops prescribed by a doctor will help remove discomfort.
- Profuse lacrimation and itching appeared in the operated eye. This symptom occurs due to eye irritation during surgery. This often happens during cataract surgery; special eye drops also help to correct the situation. As a rule, doctors prescribe Indocollir, Naklof or Medrolgin - drugs that have analgesic and anti-inflammatory effects.
- Red eye after cataract surgery. Hyperemia of the eye occurs due to the expansion of the conjunctival vessels. The phenomenon is harmless and does not pose a serious threat to eyesight. However, if there is extensive subconjunctival hemorrhage, it is best to see a doctor immediately.
- After cataract surgery, the eyes do not see or they see very badly. This happens if a person has retinal diseases, optic nerve or other structures of the eye. This is not the fault of the doctors. Slight blurred vision can occur in the early postoperative period due to edema of the cornea of \u200b\u200bthe eye after cataract surgery. As a rule, soon it completely disappears, and the person begins to see much better.
The unpleasant sensations can persist for several days. After that, the eye calms down, the redness disappears, and the vision improves significantly. It takes several more weeks for the tissues to heal. Special eye care after cataract surgery helps speed up the process of vision recovery.
How to choose the right glasses
After removing the lens, a special intraocular lens is placed in the eye. It is designed in such a way that a person can see well into the distance, but he has difficulty reading newspapers and working at a computer. This is due to the fact that the implanted lens cannot accommodate, that is, focus the gaze at different distances. This is why many people require reading glasses after cataract surgery. They should be picked up 2-3 months after surgical treatment.
Nowadays, there are multifocal intraocular lenses (IOLs) on the market that provide good visual acuity at different distances. Unfortunately, they are expensive and many people cannot afford them.
Sunglasses are used to protect the eyes from ultraviolet radiation after cataract surgery. They prevent harmful rays from reaching the retina and protect the visual organ from the harmful effects of the sun. It is better to give preference to glass glasses from trusted companies.
Rules for using drops
Patients who have undergone surgery are wondering which eye drops are best to use after cataract surgery. However, all the necessary medications are selected by the attending physician. All a person needs is to follow the recommendations specified in the statement.
After cataract surgery, the following drops are prescribed:
- anti-inflammatory drugs - Indocollir, Naklof;
- antibiotics - Tobrex, Floxal, Tsiprolet;
- combined preparations containing antibiotics and corticosteroids - Maxitrol, Tobradex.
Medicines need to be instilled regularly throughout the period recommended by the doctor. In no case should you pause or stop the treatment spontaneously. In the postoperative period after cataract removal, it is very important to observe the regimen and all the prescribed restrictions.
What is strictly prohibited after surgery
Human behavior in the postoperative period is of great importance for the restoration of visual functions after cataract surgery. Heavy physical activity, prolonged tilted position and heavy lifting can lead to serious consequences, up to displacement of the IOL or curvature of the cornea.
- refusal to play sports and work in an inclined position;
- restriction of working at the computer and watching television;
- complete refusal to lift weights weighing 3 kg.
It is recommended to adhere to these restrictions for a month or more. All this time, the person should sleep on their back or side opposite the operated eye. A clean eye patch should be put on for at least a week before going outside to prevent infection.
Many people are wondering if it's okay to watch TV and ride a bike after cataract surgery. Working at a computer and watching television in moderation is allowed for a person a few days after being discharged from the hospital. But not cycling, horseback riding, lifting weights over 5 kg for the operated person is prohibited until the end of his life.
Why is it so important to follow the regime
It is not enough just to know which jobs are prohibited after eye cataract surgery. All restrictions must be strictly observed, since a lot depends on this. If the patient does not follow the recommendations, the lens may shift or the cornea may become deformed. Naturally, this will lead to a deterioration in vision, due to which the results of the operation will not be satisfactory.