What can be seen with overripe cataracts. Mature and contemptuous stages of cataract development

One of the most common (in 60-90% of cases) vision problems that develop in people after 60 years. The pathogenesis of the disease at this age is associated with a decrease in the amount of soluble proteins, amino acids, active enzymes, as well as the amount of ATP in the blood, and an increase in the amount of insoluble proteins, which becomes the main cause of lens opacity.

The most common occurrence is the German dog where recessive inheritance of multipath cysts has been reported. More common in some retrievers is that they may be involved in glaucoma. We exclude congenital cysts in older and older dogs with acquired cysts. They arise spontaneously, probably as a degenerative phenomenon, and are more of a cosmetic finding. The diagnosis is simple, often visible to the naked eye without magnification, however, we need to be aware of the iris neoplasm in the differential diagnosis.

Among age-related cataracts, it is customary to distinguish pre-senile ones. For example, coronary cataract, which occurs in more than 20% of people during puberty. It is a crescent-shaped opacity - a strip of blue color, with rounded edges, spreading in the form of a crown along the periphery of the lens.

In addition, clinically insignificant are pigmentation disorders affecting the iris, without accompanying clinical signs... Rarely do we come across various degrees of local albinism, subalbinism, where part of the iris is colored domdora or red. However, complete albinism does not occur in a dog. In essence, heterochromia iridis is more common. This is the difference in color between two ducts or their parts. The predisposition of the breed is found in breeds with colored "merle", that is, collie, long-haired dachshund, german dog and less often others.

Often, age-related cataracts are found in people with active mature age... As a rule, it is bilateral, but the opacity develops in both eyes not always simultaneously.

The localization of senile cataracts is also completely different. The most common are cortical cataracts (90%), less often - subcapsular and nuclear.

However, for some breeds, these changes are important. Coloboma, aplasia or hypoplasia of the iris are iris developmental defects that we rarely encounter and are associated with merle coloration. Appearance at position 6 is typical. The clinical change is related to the size of the missing bearing. Probably the closest issue to the anterior anterior chamber of the eye is the condition and position of the lens. Disease illness in ophthalmic workplaces is a very common problem, and we face it with up to 40% of patients under investigation.

Senile cataract stages

Senile cataract in its development goes through four stages: incipient cataract, immature (swelling), mature, overripe cataract.

initial stage... The first signs of lens opacity appear in the cortex at the equator. Its central part long time maintains transparency. The resulting opacities develop in the form of radial stripes or sector-like stripes, with a wide base directed to the equator, which is due to the structure of the lens. When examined in transmitted light, they are found as black backs against a red pupillary background. The first symptoms at this stage are flies and spots in front of the eyes, a desire to rub the eyes.

By changing the curvature of the lens, its refraction changes, the lens accommodates, so the so-called focusing occurs. The lens consists of 35% protein and 65% water. In ophthalmoscopic diagnostics, we evaluate the presence of the lens, its location, shape, size and transparency. The exam is done mainly in mydriasis, preferably using a narrow beam of a slit lamp. The study of a cloudy lens should be complemented by electroretinography to assess the condition of the retina. Rare birth defects include unsteadiness - the complete absence of lenses.

Lens hydration is also characteristic. Being saturated with water, it seems to be poured, water gaps appear - radial black stripes. Lens tissues along the periphery are stratified, there are spoke-like opacities. With an incipient cataract, a decrease in vision is possible only if the opacities have reached the pupil area. In this case, myopia occurs. Patients who have developed myopia due to hydration of the lens, note that they no longer need to use plus glasses, since their vision has improved or a smaller plus correction is required when reading. At this stage, the appointment of vitamin drops is recommended.

The lens can also be abnormally small, which is common with other congenital anomalies of the eye, such as bee microfalm and St. Bernard's dogs. Other anatomical lens deformities are very rare and may be part of a more pronounced attachment along with dysplasia and retinal ablation. As mentioned above, we track the location and storage of the lens. Congenital dislocation is rare, hereditary due to defective fixation of fibers in the lens capsule with subsequent release.

We will meet her especially with various terriers, poodles and miniature schnauzers. Affects young and middle-aged groups, mainly bilaterally. An even more noticeable change in the lens is the change in its transparency, i.e. transparency. This change is called a "cataract" cataract, be it a point or diffuse disability. Different layers of the lens can be affected, so we come to the classification of cataracts. Another commonly used classification measure is the so-called maturity.

To diagnose the pre-catarrhal state of the lens, a biomicroscopy is used, which reveals:

• Dissociation of the cortex, in which it seems to be dissected, with the appearance of dark layers of water localized between the lens fibers;
• Gaping seams, or a sign of the formation of water gaps with liquid in the space between the zones of separation;
• Vacuoles under the anterior and posterior capsules - vacuolization of the lens. The appearance of water in the lens leads to its clouding, but without reducing visual acuity.

An incipient cataract can remain as if conserved for a long time, but sooner or later its progression begins, which passes into the stage of an immature (swelling) cataract.

The etiology of cataract formation is very diverse, but we will focus more on congenital and hereditary. The localization of changes on the lens is often breed specific, and in some cases it is also possible to predict the development of cataracts based on it. For example, cortical cataract is a common ophthalmic finding. They start with a small vacuum, the opacity develops gradually. A typical hereditary phenomenon is described in poodles, Afghan hounds, retrievers and the American cocker spaniel.

Immature cataract... At this stage, the opacity increases, merging with each other and gradually closing the pupil. Their color becomes gray-white, the seams of the nucleus become cloudy. Due to the swelling of the cloudy fibers, the lens increases in volume. At the same time, its anterior chamber becomes somewhat smaller, which provokes an increase in intraocular pressure in comparison with the second eye. True, at this stage, not all cortical layers become cloudy, the anterior layers remain quite transparent. At the same time, the degree of maturity of the cataract is determined by the shadow, which is visible if lateral illumination is created and a shadow falls on the lens from the pupillary edge (from the illuminated side). It is generally accepted that the wider the anterior transparent layers of the lens and the wider the shadow from the iris, the less mature the cataract. In addition, the degree of maturity of a cataract can be determined by the state of vision. The progression of cataracts gradually decreases visual acuity. The more mature the cataract, the lower the object vision becomes. Sometimes it decreases to the degree of inability to see the subject even at a very close distance. A swollen lens can cause phakomorphic.

Nucleus kataaraks are often diagnosed bilaterally, affecting more puppies. The origin is congenital, or hereditary, or associated with the influence on the development of the fetus for intrauterine development. The typical breed is again the American Cocker Spaniel, Retriever and Poodle. Posterior lens cataract is caused by developmental abnormalities affecting the fetal intraocular vascular system - the so-called persistent hyperplastic primary vitreous tissue.

The rest of the vessel is separated from the lens pole, and the axial opacity of the so-called "Mittendorff point" remains on the lens surface. It is diagnosed in young animals and is lost in the first few weeks of life. It is described by the Irish Cetra, German Shepherd, Greyhound, Poodle, Doberman, and Staffordshire Terrier. From a diagnostic point of view, severe cataracts occur as concomitant changes in more ocular conditions. An important group is cataracts in the generalized form of progressive exin atrophy.

Mature cataract... The lens, losing water, becomes a dirty gray color, all its cortical layers, up to the anterior capsule, become cloudy. The clouding of the lens occurs evenly; with lateral illumination, the shadow from the iris is not visible. The anterior chamber begins to deepen, by the time of maturation, the lens, losing water, decreases in size. Examination in transmitted light with a dilated pupil reveals the absence of its glow. Object vision is completely lost, only light perception remains. Under the capsule, against the background of homogeneous opacity, subcapsular plaques may appear. Senile cataract matures slowly: from one year to three years. Those of the forms in which opacity develops from the nucleus or from the layers adjacent to it mature most slowly.

They are found in older poodles, cocker spaniels and retrievers. The disability is mostly bilateral and is often a blurred lens for blindness. Specialized research needed functional state the retina with electroretinography, which will help us determine the prognosis and therapy. Cataract is one of the most common eye diseases. It consists of a complete or partial blur of the lens - a biconvex lens responsible for correct visual acuity.

As a consequence, lens opacity leads to progressive deterioration in the quality of vision and even blindness. Cataracts can occur at any age. This is due to different lens opacities, which can be congenital or acquired, for example, as a result of concomitant diseases. Cataracts are very common, diagnosis and treatment are not a problem for the ophthalmologist, but the knowledge of this disease is still insufficient for patients. This leads to excessive concern about the cause of the decline in the quality of vision and a lack of determination in deciding on an effective treatment.

Overripe cataract... As a rule, cataract overripe occurs in two ways. In the first case, the lens gives off water, shrinks and shrinks. The cortical cloudy masses become dense; the lens capsule accumulates cholesterol and lime, which forms white, shiny plaques on it.

In the second case, which happens more rarely, the cloudy cortical substance with the lens masses acquire a liquid consistency, milky. The breakdown of protein molecules leads to an increase in osmotic pressure, moisture penetrates under the lens capsule, increasing its volume, and the surface capsule becomes smaller. This condition is called milk cataract. Thus, in the stage of overripening, dehydration of the lens occurs. The first sign of overripe can be considered the appearance of folding of the lens capsule, a gradual decrease in its volume. The bark also liquefies when overripe, with the nucleus drooping downward. Overriding of the cloudy lens and prolapse of the nucleus are called morganic cataracts. A reflex can be seen through the upper zone of such a lens, and with a positive correction from above, the patient's vision is also possible.

Cataract caused by birth defects: congenital cataract, childhood, juvenile or metabolic disorders, acquired cataract: age-related primary cataract, secondary cataract.

Cataract due to congenital factors

Cataract - Less turbidity in the central part of the lens, so vision impairment is only partial. Nuclear cataract and complete cataract completely prevent the development of vision in newborns. Other forms such as frontal and reverse cataracts, polar, perinuclear, membrane. The most important cataract symptoms are the appearance of the so-called. the white pupil, which is the result of rendering through the pupil opening of the opaque mass of the lens, which is usually transparent and therefore invisible.

In the absence of surgical intervention in such cases, the patient's capsule begins to pass the lens protein. What can cause the occurrence of phakogenic or phacotoxic glaucoma associated with the accumulation of lens protein in the corner of the anterior chamber of the eye.

Nuclear cataract

It must be differentiated from the lens. Clouding with such a cataract extends to the seams and the embryonic nucleus. Central vision in age-related nuclear cataract is disturbed early: vision falls into the distance, "false myopia" develops near, sometimes up to 12 D.

It is not a symptom of cataracts as it is also present in other eye conditions such as retinal detachment, retinopathy, or retinopathy. Another cataract symptom that occurs in infants with a common bilateral cataract is the so-called. Frankshetti's reflective gaze, which consists of clenching his eyes with his fists or thumbs. This cataract is also present in blind children for other reasons. Due to the lack of characteristic cataracts congenital anomaliesthat may remain unrecognized for a long time.

First, clouding is formed in the embryonic nucleus, then it begins to spread to all layers. In this case, the turbid central layers are sharply delimited from the transparent peripheral zone. The disintegration of the lens substance does not occur. This is a dense cataract. Occasionally, the core becomes brown or black. This cataract is also called borax. A nuclear cataract remains immature for a long time. When it matures, we are talking about a mixed cataract - nuclear-cortical.

One of the most common types of cataracts is cataract. Depending on which layer of the lens is opaque, there are three types of cataracts: cataract, subcapsular, and nuclear cataract. Most cases of cataracts are in subcortical-cortical or cortical-mixed form. Symptoms usually appear slowly to track the progression of the disease. Subsequent cataracts occur, the cataract is full, the cataract swells and eventually cataract. To prevent further phases of disease, systemic eye drops should be used to improve lens metabolism.

Subcapsular cataract

This age, very insidious disease, as a result of which the youngest peripheral zone of the lens becomes cloudy. The anterior capsule, first of all, with the development of vacuoles of different sizes under it. Clouding, as it grows, spreads to the equator, which resembles a cup-shaped cataract. But, the opacity does not apply to the cortex in the lens. Such a cataract must be distinguished from a complicated cataract.

Mention should be made of the need to differentiate aging cataract from old sclerosis - phasclerosis. In the case of the old opacity, the lens transmits light, so vision is not impaired, and in the cataract flow it is absorbed to a large extent, which leads to a decrease in visual acuity depending on the progression and degree of cataract.

Secondary cataracts can cause metabolic disorders. One of the most common such disorders is diabetes. Diabetic cataract, because it is called this form, is caused by long-term hyperglycemia, causing a disruption in the biochemical processes in the lens and its opacity. The result of hyperglycemia is the accumulation of glucose metabolic products within the lens, which in turn results in an excessive lens overflowing with a physiologically filled eyeball.

Treatment of age-related cataracts

The emergence of senile cataracts today is associated with violations in the lens of oxidation processes, which is due to a lack of ascorbic acid. Vitamin B2 (riboflavin) deficiency is also of particular importance in the development of age-related cataracts. Therefore, with an incipient cataract, to prevent its progression, it is prescribed ascorbic acidas well as riboflavin or riboflavin with potassium iodide in the form of eye drops.

This entails a loss of visual acuity when viewed from a distance, that is, the development of myopia. Changes affecting normal vision already at an early stage of diabetes, with high fluctuations in blood sugar levels. All the unfavorable biochemical and physical processes described above lead to the development of diabetic cataracts. There are two main types of diabetes. Type 1, also called insulin-dependent diabetes, is primarily diagnosed in young people and even children. This is due to the production of antibodies against pancreatic cells, which then cause the destruction of these cells.

As a rule, today cataracts are treated by implantation (implantation) of an artificial intraocular lens (IOL), which replaces the clouded lens and takes over all its functions.

This procedure is possible only in ophthalmological clinics equipped with modern high-tech equipment.

The Moscow Eye Clinic offers its patients all types of cataract surgery operations. The intervention will be carried out on the latest equipment using the most advanced techniques. The best ophthalmic surgeons in Moscow are involved in performing operations in our clinic. We have a wide range of intraocular lenses of various prices, which will greatly facilitate your choice.

It does not trigger the secretion of the pancreas, which is insulin. Cataracts in this type of diabetes occur in about 10% of patients. It is recognized mainly in the first two decades of life, but can also occur in children. He is most often seen through binoculars. Characteristic feature this cataract is the ability to regress changes following a balanced carbohydrate economy. Type 2 diabetes or non-insulin related diabetes usually begins in adults. The lower the sensitivity of the cells of the human body to insulin, the so-called. insulin resistance.

Do not expect a miracle, do not let the disease develop to a critical state, which will make it very difficult to achieve best effect from the operation. Come to the specialists right away and excellent eyesight will delight you to a ripe old age!

Senile cataract treatment cost

A person who has been diagnosed with "mature and overripe cataract" finds himself in a difficult life situation. A catastrophic deterioration of vision threatens to turn into complete blindness in the near future. Surgery - the only chance to regain vision - is associated with the risk of complications. After all, late cataract is a disease of old age, when it is difficult for the body to recover from stress. Having discovered such a disease in oneself, it is important to take necessary measures... What is the correct way to treat cataracts at all stages of its development?

Causes of the disease

The cause of the disease is clouding of the lens - the main optical lens in the vision apparatus. The structure of the lens is represented by three media.

1. A capsule bag containing the body of the lens.
2. The epithelium of the capsule is cells that divide and renew throughout life. Old epithelial cells dry out, thicken and accumulate at the periphery of the lens. They maintain its size and form a surface with reduced transparency, which increases with age and becomes one of the causes of lens opacity.
3. Lenticular substance - an internal content that does not have blood vessels... The metabolism in it occurs due to the absorption of food and intraocular fluid during contraction and stretching of the eye muscles.

A metabolic disorder between the lens and the environment is the second reason for its clouding:

• with age, the number of free radicals increases, destroying the structure of healthy cells and forming extraneous neoplasms;
• the number of free radicals increases when exposed to ultraviolet rays, a lack of vitamins A and E, and smoking;
• the quality of the intraocular fluid that feeds the lens deteriorates when inflammatory processes in the eye, systemic diseases ( diabetes, skin diseases);
• cataracts can cause eye injuries, myopia high degree, hereditary factor.

The most common cause of cataracts is age changes, both throughout the body and in the tissues of the eye. Age-related (senile) cataracts account for 70% of all cases of the disease. 20% are accounted for by complications of eye diseases. The remaining 10% is clouding of the lens due to trauma.

The rate of development of age-related cataracts

The disease itself can begin at 40-50 years old, the largest percentage of cataract detection occurs in patients aged 60-70 years.

The course of the disease depends on the rate of maturation of the pathology in the lens.

1. A fast-flowing cataract lasts from 4 to 6 years: the first signs of lens opacity during this time culminate in a complete loss of lens function, which requires urgent surgical intervention... This type of disease develops in 12%.
2. At a moderate rate of development of pathology, the disease stretches for 6-10 years, at this rate cataracts mature in 70% of patients.
3. The slow course of the disease stretches in time for 10-15 years and occurs in 15% of patients.

It is very important to detect the pathology as early as possible and slow down the process of its maturation until the period when surgical intervention is required. In this regard, the stages of development of pathology are distinguished: initial, immature, mature and overripe cataracts.

The first stages of the disease

• itchy eyes, desire to rub them;
• blackheads in front of the eyes;
• painful reaction to bright light;
• a halo forms around light sources;
• all objects appear yellowish;
• sometimes with hyperopia, there is a sudden temporary improvement in vision.

For patients diagnosed with cataracts, the medical history, unfortunately, is rarely written by the doctor with initial stage... As a rule, they go to the hospital much later. But it was in the first period conservative treatment can slow down the process of formation of cloudy spots, and postpone the operation for several years. There are cases when the disease stopped at the initial stage and did not progress, which cannot be said about the next stage.

1. Immature cataract. During this period, single spots on the periphery of the lens begin to unite and move towards the central zone. Intraocular pressure rises, because the lens increases in size - "swells". The visual impairment becomes noticeable, typical symptoms occur:

• visual acuity weakens, it is difficult to see small letters, details;
• fog appears before the eyes;
• difficult to distinguish color shades and colors;
• objects become indistinct, double;
• in the dark, vision deteriorates, and in the light there is pain in the eyes.

As vision deteriorates rapidly, this stage accounts for the main referral to medical help. The turbidity reaches a significant size, and conservative therapy has no effect. It makes no sense to hope that drops and exercises will stop and reverse the irreversible process of lens opacity - this is a waste of precious time.

Please note: the stage of immature cataract - optimal time for an operation if changes in vision cause significant discomfort.

Today there is no need to wait until the cataract matures in order to implant an intraocular lens in its place. On the contrary, the late terms of the operation are associated with difficulties in removing too dense lens.

Mature cataract stage

• extracapsular extraction - the nucleus of the lens and its contents are removed, but the capsule remains, separating the media of the anterior and posterior parts of the eye;
• intracapsular extraction of the lens together with the capsule;
• phacoemulsification, when the lens is crushed using ultrasound, is removed from the capsule into which the artificial lens is implanted.

The first two types of operations give a large percentage of complications, because in this case, long incisions are made in the cornea, requiring sutures.

Phacoemulsification is a low-traumatic, but expensive method of eye microsurgery.

Cataract overripe process

On last stage cataract diseases overripe - the lens masses are destroyed. This manifests itself in several ways:

1. Lens dehydration: it decreases, which is why folds form on the capsule, it shrinks.
2. The bark of the lens turns into a liquid consistency, its core goes down, this pathology is called morganic cataract. In this state, the eye completely loses the ability to see.
3. Lactic cataract - the proteinaceous structures of the lens are decomposed and dissolved by the liquid that accumulates in the capsule. Intraocular pressure rises.

Overripe cataract gives the greatest risk of complications during surgical treatment. Firstly, when the capsule is opened, the pressure drops rapidly, it decreases sharply, and it becomes difficult to make a puncture for lens implantation. Secondly, a rupture can occur in the capsule bag, and the decomposition products of the lens, entering the cavity of the eye, cause its inflammation.

Thus, cataracts are not a sentence that inevitably leads to blindness. Vision is successfully restored if the disease is not started to the stages of mature and overripe cataracts.

Cataracts are treated without surgery only at the initial stage of the disease. There are various agents that stop the clouding of the lens and improve the metabolism in the tissues of the eye. However, your doctor must select them for you. Whether baths with iodine and calcium, cysteine \u200b\u200bare suitable for you, whether you have to prescribe vitamin drops - Catalin, Catachrom, Quinax, Taufon, or is it better to take Mirtilene Forte or Adruzen Zinko capsules inside - all these are questions that can only a specialist can decide. He should also monitor whether the use of these drugs helps, whether the clouding of the lens stops, or whether the patient still needs surgery. Usually the lens of the eye loses its transparency within 2-5 years. When vision deteriorates so much that the eye no longer distinguishes anything around, but only distinguishes light from darkness, it is considered that the cataract is "ripe". That is, the changes in the lens are already irreversible. With a mature cataract, there is only one way out - surgery.

Doctors examine in detail the state of the fundus, lens and cornea to determine the severity of the disease. This makes it possible to predict visual acuity after lens removal. But the most important thing is that with the help of ultrasound, the size of the lens is determined with high accuracy. According to the shape and size of the "damaged" lens, doctors select a lens made of a special polymer material. It will take on the role of the lens after surgery and should be as close to the eye as possible. It happens that the use of such lenses is contraindicated for health reasons of the patient. For example, he suffers chronic disease eye. Or it turns out that the artificial lens is rejected from him. Then glasses are selected that can compensate to some extent for the lack of a lens. In most cases, even patients with cataracts, aggravated by glaucoma, or those suffering from diabetes tolerate the implantation of an artificial lens well. Such an operation is performed under a microscope to minimize injury to the sore eye. However, sometimes complications do occur, such as corneal edema.

Therefore, recently, not surgical treatment, but ultrasound is increasingly used to remove cataracts. This method virtually avoids eye injury. Through a miniature incision, ultrasound quickly and painlessly destroys the inside of the lens, which is then sucked off with a thinnest needle. And one more important advantage of this method: it allows you to remove from the eye not the entire lens, but only its cloudy contents. This operation is easily tolerated. It is no longer surprising that after only a few days the patients start to work. In young people, cataracts often begin to develop during pregnancy. Heredity or eye diseases suffered by the expectant mother are to blame here. Sometimes this also affects the condition of the baby's eyes. But even if this happens, there is no need to despair. In young people, treatment is easier. The fact is that at a young age the lens does not have a dense nucleus.

This allows the cloudy contents of the lens to be removed through a very small opening in the lens capsule. The contents are released into the anterior chamber of the eye and are gradually absorbed. Sometimes a tiny puncture is made in the capsule with a laser to act as a drain. Such operations are less traumatic and usually do without complications. If the cataract has progressed rapidly or was overripe, then glaucoma may develop in parallel. Therefore, it is necessary to monitor the condition of the eyes in order to reduce intraocular pressure in time, if necessary. Otherwise, the nutrition of the optic nerve will deteriorate, and this can result in blindness. To prevent this from happening, you need to drink vitamins A, C, B vitamins, as well as medicines that improve the blood supply to the tissues of the eye. With the rapid development of glaucoma, it helps well laser treatment... Sometimes the artificial lens implanted in the eye is rejected.

Inflammation of the membranes of the eye begins. If you do not pay attention to this and do not take anti-inflammatory drugs, it will turn into a stable form. And to prevent an infection, such as conjunctivitis, the doctor will prescribe special antibiotics for the eyes, which must be taken strictly on his recommendation. In addition, sometimes complications arise when, during an operation to remove a cataract, the back wall of the lens capsule remained unharmed. In some patients, it may become cloudy over time. Secondary cataract develops. In such cases, intervention will be required again, this time using a laser. A small "window" is made in the cloudy wall with a laser, which allows the light to reach the fundus of the eye unhindered.

Before using the drugs listed on the site, consult your doctor.

Cataract surgery in the elderly, features and possible consequences

Surgical removal of cataracts in old age is the only and main way to fully treat pathology. And if the process develops slowly in young people, then elderly patients risk being completely blind in a short time. Therefore, cataract surgery is essential.

Symptoms of cataracts in the elderly

Cataracts are one of the most common causes of poor vision in people over 60. With this disease, the lens is affected - a biological lens, which is necessary for refraction of light and smooth focusing when looking from close objects to distant ones.

Curious! The name of such a dangerous and serious disease is translated as "waterfall" (from the Greek. kataraktes), because with a cataract, a person sees everything very cloudy and indistinctly, as if through falling water.

Indeed, turbidity and fuzziness of objects is the main symptom of cataracts in both the elderly and young people. But it does not appear immediately, but only in the second stage of the disease. There are four of them.

Initial cataract

The lens becomes cloudy at the edges, avoiding the central zone, so the patient has no complaints of decreasing vision. An initial cataract can be discovered by chance, for example, during a medical commission. But, given the fact that older people do not visit an ophthalmologist just like that, it is extremely rare to diagnose and suppress the disease in the embryo.

Immature cataract

The turbidity passes to the optical zone, and the patient begins to complain of visual impairment. He still distinguishes objects, but sees them as if through fog. Elderly people tend to see a doctor at this stage. Conservative treatment is no longer possible; need an operation.

Mature cataract

The turbidity spreads over the entire surface of the lens, due to which the patient ceases to distinguish objects. He sees only contours and only at arm's length. Light perception with a mature cataract is preserved: a person can determine when it is light and when it is dark.

Overripe cataract

Almost complete blindness. In addition to common cloudiness, the lens itself begins to liquefy. If you look into the eyes of an elderly person, you will see a milky color of the pupil. But the danger lies not only in loss of sight, but also in possible complications: glaucoma (increased intraocular pressure), dislocation of the lens, etc.

Features of the operation for elderly patients

Cataract surgery involves destroying the affected lens and installing artificial lens... It sounds creepy, but in fact, all manipulations take about half an hour. The classic method involves a laser technique. But for elderly patients whose body is weakened chronic diseases and "deterioration", ultrasonic phacoemulsification is recommended.

For such an operation, a unique ultrasonic knife is used, which has a beam instead of a tip. With this ray, the doctor makes a very thin incision in the cornea, through it he gains access to the lens, destroys it and takes it out. An intraocular lens is immediately installed in the free space, which is fixed automatically.

The advantages of the ultrasound technique for its use in elderly patients are as follows:

• the minimum duration of the operation (up to 20 minutes);
• no suturing required;
• instant restoration of vision in the operated eye;
• the ability to remove even mature and overripe cataracts;
• rehabilitation for 4 weeks;
• excellent result: the likelihood of distortion of vision and, accordingly, reoperation is minimized.

Ultrasound phacoemulsification (like other methods of cataract removal) is performed under local anesthesia, which is considered a favorable factor for elderly patients. First, a "freezing" solution is instilled into the eye. After the start of its action, the operating area is additionally injected with anesthetic so that during the operation the person does not feel anything. The sensitivity of the eye and eyelids is restored gradually during the day.

Young patients are sent home a couple of hours after cataract removal. Elderly people can be left in the hospital for a day in order to completely eliminate complications and simply reassure an elderly patient who is worried about his health.

Possible consequences after surgery

Despite the high efficiency of cataract removal, complications are not excluded. Most of the negative consequences are stopped conservatively. And only in rare cases it is necessary to carry out surgical intervention.

Corneal edema

The most delicate tissue is subjected to mechanical stress - an incision - therefore, swelling is possible. It persists for 2-3 hours after the operation, during which the patient is left in the hospital. Then the swelling goes away. If this does not happen within 2 days, you need to see a doctor.

Lachrymation

This is a defensive reaction to infection. The operated eye can water for several days, then it goes down. Sometimes lacrimation is not a direct consequence of the operation, but arises from non-compliance with the rules of eye care. For example, you cannot rub it, you only need to wash your face with boiled warm water, drip with prescribed anti-inflammatory drops, etc.

Redness

If a pinkish cobweb appears in the eye, it is a sign of infection. It is treated with special drops, which will be prescribed by an ophthalmologist. If the spot has a deep red color, hemorrhage may have begun, requiring immediate specialist assistance.

Usually associated with increased intraocular pressure. Such pains are often given to the head. It is stopped with medication, but not with the usual analgesics, but with drugs that the doctor prescribes. Self-medication can reduce pain, but if the pressure persists, new complications will arise, up to the displacement of the artificial lens.

Retinal detachment

A severe complication that is more common in older patients with myopia. It can be determined by secondary opacity, which occurs 2-3 days after cataract removal, and by the "flies" in the eyes. Retinal detachment is fraught with loss of vision.

Lens displacement

This is a rare complication associated with a mistake by an ophthalmologist, insertion of a poor-quality lens, or rupture of the posterior capsule holding the new lens. Displacement is manifested by double vision. Some even see the edge of the lens that has gone beyond anatomical limits. Stopped surgically: by suturing the lens to the capsule.

Attention! It is important to diagnose and correct the lens displacement as soon as possible, because after 2-3 months adhesions form, and it will be more difficult to put the lens back in place.

Inflammation of the eyeball

Or endophthalmitis. Elderly patients are at risk because they have weakened immunity due to old age. Even prophylactic drops, which are necessarily prescribed after cataract removal, do not always save. To treat endophthalmitis, antibiotics and stronger anti-inflammatory solutions are prescribed in the eye.

Consequences of canceling the operation

If the doctor prescribes cataract removal, then the situation is hopeless. The disease is not treated conservatively, starting from the second stage. And in the first case, it is impossible to completely return the lens to its original form: you can only suspend the process of its destruction. If he develops, blindness is inevitable.

By the way! If a cataract appears only in one eye, then the probability of affecting the second is 70-80%. Therefore, it makes no sense to refuse the operation, explaining that at least one eye will see.

Young patients almost never refuse surgery because they do not want to live without vision. But older people often ignore the recommendations of ophthalmologists. There are several reasons for this: some are afraid of surgery, others do not trust doctors and fear that they will only make things worse, and still others save money. One of the main arguments of elderly patients is that they don't have much time left anyway.

Estimated cost of cataract removal

By the way, about the price. Removal of cataracts is free of charge, but the cost of the lens has to be paid out of pocket. it is not included in the CHI program. The minimum amount you have to pay for a high-quality imported intraocular lens is 25 thousand rubles.

If the operation is performed in a paid ophthalmological clinic, then the price will include consultations of all doctors, and the work of surgeons, and consumables, and hospital stay. So a round sum can run up (from 60 to 150 thousand). But older patients tend to opt for surgery in municipal hospitals, paying only for the lens.

There is an option to carry out cataract removal on a quota. But not everyone can get it. First, the doctor writes out a direction in which he indicates the indications for surgery and general points on the patient's history. The documents are submitted for consideration to the region, then to the region. But even if a positive response is received, the operation is not carried out immediately. The patient is put on a queue, which can come up after a few months, and sometimes even after a year. But this is a significant savings, especially for elderly patients, sometimes living on one pension.

Complications of cataracts

Cataract is an ophthalmic disease in which, due to partial or complete opacity of the lens, visual impairments of various levels occur, which, if not treated promptly, can lead to blindness. There is a traumatic cataract, congenital, complicated, radiation and cataract, which is caused by general diseases of the body. The most common is senile (age-related) cataract, which develops in people who have reached the age of 50 and older.

If a cataract has been identified and surgery is prescribed for treatment, you should not neglect the doctor's recommendations and postpone treatment for a long time. The formed cataract leads to a significant increase in the size of the lens of the eye, which, occupying a significant area of \u200b\u200bthe anterior chamber, disrupts the outflow of fluid inside the eye, which can provoke increased eye pressure and lead to such a serious complication as secondary glaucoma.

Increased load due to glaucoma optic nerve and other structures of the eye leads to impaired blood circulation, as a result of which the cerebral cortex stops receiving signals. This irreversible process inevitably leads to deterioration of vision (especially peripheral), the lost vision cannot be restored. In order to avoid irreversible deterioration of vision, timely treatment is necessary.

Postoperative complications of cataracts

Surgery to remove a cloudy lens (cataract extraction) is quick, simple, and generally safe. However, even when performing this surgical intervention by an experienced surgeon, a number of complications sometimes arise.

Complications of cataract surgery are subdivided into intraoperative (arising during the operation) and postoperative.

Postoperative complications, the likelihood of which are small and only about 1.5% of cases, can be early or late.

Early postoperative complications

Early postoperative complications include the following pathological processes:

• hemorrhage in the anterior ocular chamber is a rare complication associated with damage to the iris during surgery;
• an inflammatory reaction (uveitis, iridocyclitis) - a complication arising from surgical trauma, which can be prevented by introducing antibacterial and anti-inflammatory drugs under the conjunctiva at the end of the operation;
• increased intraocular pressure is a complication that can arise for a number of reasons: clogging of the drainage system with viscoelastics in case of poor washing out of the eye cavity, development of the pupillary block, etc.;
• detachment of the retina - a complication that occurs in the presence of such predisposing factors as postoperative eye injury, myopia, and some other complications after surgery;
• displacement of the artificial lens of the eye - in case of improper fixation in the capsule bag of the artificial lens, as well as a discrepancy between the reference dimensions of the capsule bag and the lens.

Late postoperative complications

TO late complications after cataract surgery include:

• edema of the macular region of the retina caused by intervention in the anterior segment eyeballthat develops after extracapsular cataract extraction more often than after phacoemulsification (may occur 1-4 months after surgery);
• secondary cataract is one of the most common postoperative complications, which develops as a result of transformation into fibers of non-removed epithelial cells of the lens. The fibers are opaque, not functionally and structurally complete, and have an irregular shape. In the process of their movement from the growth zone to the central zone, clouding occurs, leading to a decrease in visual acuity. In order to prevent the occurrence of secondary cataracts, the lens capsule is polished with the removal of cells. The development of secondary cataracts can occur both a month after the surgical intervention and several years after it.

Complications of progressive cataracts;

Brown, or nuclear, cataract

With nuclear, or brown, cataracts, central vision is impaired early. It is characteristic that a decrease in distance vision at first is not accompanied by a noticeable decrease in near vision.

The patient is tempted to take off the presbyopic glasses and begins to read freely without them. Temporary myopia develops by increasing the refractive power of the lens.

The incipient brown cataract is characterized by the appearance and increase in the degree of myopia, which sometimes reaches 12.0-14.0 diopters. When examining refraction with wide pupil it is found that the center of the lens refracts much more strongly than the periphery; therefore, some authors call the initial nuclear cataract cataract with a double focus.

When illuminated from the side, the lens has a light green tint. In the transmitted light, a pink reflex is preserved, against the background of which fine-grained opacities are visible. When the ophthalmoscope is turned, an annular shadow is captured.

A greenish or slightly brownish tint of a clearly contoured nucleus is especially clearly visible on an optical section during biomicroscopy.

Later, the saturation of the color of the kernel grows to brown-red and brown-black tones. Brown cataracts are more often found in combination with myopia, however, it cannot be attributed to complicated cataracts. Its development is individual, just as the richness of color is individual. Hydration is unusual for a brown cataract, therefore, lens swelling is never noted. The nucleus of the lens with brown cataract is large, the bark is thin, the entire lens looks compacted. It is rarely possible to observe the maturity of brown cataracts. The operation is performed, as a rule, in its immature stage, with preserved residual object vision.

In the process of maturation of a cataract, complications may appear, which are characterized by an acute onset of the disease, a rapid increase in the formidable symptoms of increased intraocular pressure, and inflammation. anterior section vascular tract.

An increase in intraocular pressure with cataracts is accompanied by all the symptoms typical of acute glaucoma... Such glaucoma is due to the pathological state of the lens, in connection with which it is usually called phakogenic. There are two types of phakogenic glaucoma: phakomorphic and phakolytic.

Phacomorphic glaucoma occurs with rapid hydration of the lens, which is characteristic of immature cataracts. At the same time, it increases in volume, the iris is displaced anteriorly and closes the entrance to the bay of the anterior chamber angle, the outflow of fluid from the eye is disturbed. Intraocular pressure reaches 50-60 mm Hg. Art. A typical picture develops acute attack glaucoma. In phakomorphic glaucoma, the anterior chamber is small, the lens has a gray-blue color with a pronounced pearlescent tint, which is caused by uneven clouding of the lens fibers and a large number of water slits filled with transparent liquid.

Phakolytic glaucoma develops with overripe cataract. If it appears in the stage of lactic cataract, then it proceeds as a closed-angle glaucoma, if with morganic cataract, then as an open-angle glaucoma. In lactic cataract, the mechanism of glaucoma occurrence is similar to that of phakomorphic glaucoma. At the stage of milk overripe, secondary swelling is observed in the lens. The lens does not increase as much as with an immature cataract, but it is enough to displace the iris anteriorly and close the entrance to the corner bay, especially since involutional dystrophic changes in the vascular tract, the membranes are made pliable under mechanical stress. Phakolytic angle-closure glaucoma is characterized by high intraocular pressure, small anterior chamber, iris dystrophy III degree, absence of pigment border along the pupillary margin, milky white color of the lens, homogeneity of its structures.

With morganic cataract, the lens masses dissolve, the volume of the lens sharply decreases. Decay products cause a violent phagocytic reaction. A large number of macrophages rush to the lens, which are carried by the current of moisture into the bay of the corner, where they settle on the corneoscleral trabecula, preventing the normal outflow of moisture. Intraocular pressure increases, although the corner bay remains open.

Open-angle phakolytic glaucoma is characterized by a deep anterior chamber, a semi-absorbed lens. Nucleus pubescence is noticeable in a half-empty lens sac. In all cases of phakogenic glaucoma, it is necessary to remove the lens in the capsule, after preliminary unloading therapy, which is carried out in acute glaucoma.

The use of miotics rarely leads to a decrease in intraocular pressure.

In addition to phakolytic glaucoma, with overripe cataracts, the following complications are encountered: rupture of the lens capsule, phakolytic iridocyclitis, and dislocation of the lens nucleus into the anterior chamber. These complications are not independent, more often occur against the background of one of the types of phakolytic glaucoma. The rupture of the lens capsule is observed mainly with milk swelling cataract. In this case, the moisture of the anterior chamber, due to the outpouring of masses, acquires a milky hue. When the masses settle to the bottom of the chamber, they resemble a hypopyon, but unlike it, they are white. The rupture of the lens capsule entails the development of iridocyclitis, since the decay products of the lens protein during cataract overripe have anaphylactic and toxic properties. This iridocyclitis is called phakolytic. Despite the aggravated course, overripe cataract with rupture of the lens capsule and phakolytic iridocyclitis requires surgical treatment - cataract extraction.

At rupture of the anterior lens capsule, dislocation of the nucleus into the anterior chamber is possible. Often, a dislocation of the nucleus is mistaken for a dislocation of the whole lens. Dislocation of the nucleus of the lens is characterized by the following features: a deep anterior chamber, at the bottom of which lies a brown, smooth nucleus with a sharp equator with a diameter of 3-5 mm. In the area of \u200b\u200bthe pupil, if the nucleus does not completely close it, the anterior and posterior capsules of the lens are clearly visible. The edges of the anterior capsule rupture are always turned towards the anterior chamber. As a rule, a capsule with small multiple subcapsular plaques is ruptured. Nucleus dislocation, like other complications in overripe cataract, is accompanied by an increase in intraocular pressure.

Treatment consists in removing the nucleus from the anterior chamber, which is technically easy to do. Preservation of the posterior capsule prevents prolapse vitreous.

A person who has been diagnosed with "mature and overripe cataract" finds himself in a difficult life situation. A catastrophic deterioration of vision threatens to turn into complete blindness in the near future. Surgery - the only chance to regain vision - is associated with the risk of complications. After all, late cataract is a disease of old age, when it is difficult for the body to recover from stress. Having discovered such a disease in oneself, it is important to take the necessary measures in time. What is the correct way to treat cataracts at all stages of its development?

The cause of the disease is clouding of the lens - the main optical lens in the vision apparatus. The structure of the lens is represented by three media.

1. A capsule bag containing the body of the lens.
2. The epithelium of the capsule is cells that divide and renew throughout life. Old epithelial cells dry out, thicken and accumulate at the periphery of the lens. They maintain its size and form a surface with reduced transparency, which increases with age and becomes one of the causes of lens opacity.
3. Lenticular substance is an internal content that does not have blood vessels. The metabolism in it occurs due to the absorption of food and intraocular fluid during contraction and stretching of the eye muscles.

A metabolic disorder between the lens and the environment is the second reason for its clouding:

• with age, the number of free radicals increases, destroying the structure of healthy cells and forming extraneous neoplasms;
• the number of free radicals increases when exposed to ultraviolet rays, a lack of vitamins A and E, and smoking;
• the quality of the intraocular fluid that feeds the lens deteriorates with inflammatory processes in the eye, systemic diseases (diabetes mellitus, skin diseases);
• cataracts can be caused by eye injuries, high myopia, a hereditary factor.

The most common cause of cataracts is age-related changes, both throughout the body and in the tissues of the eye. Age-related (senile) cataracts account for 70% of all cases of the disease. 20% are accounted for by complications of eye diseases. The remaining 10% is clouding of the lens due to trauma.

The rate of development of age-related cataracts

The disease itself can begin at 40-50 years old, the largest percentage of cataract detection occurs in patients aged 60-70 years.

The course of the disease depends on the rate of maturation of the pathology in the lens.

1. A fast-flowing cataract lasts from 4 to 6 years: the first signs of lens opacity during this time culminate in a complete loss of lens function, which requires urgent surgical intervention. This type of disease develops in 12%.
2. At a moderate rate of development of pathology, the disease stretches for 6-10 years, at this rate cataracts mature in 70% of patients.
3. The slow course of the disease stretches in time for 10-15 years and occurs in 15% of patients.

It is very important to detect the pathology as early as possible and slow down the process of its maturation until the period when surgical intervention is required. In this regard, the stages of development of pathology are distinguished: initial, immature, mature and overripe cataracts.

The first stages of the disease

• itchy eyes, desire to rub them;
• blackheads in front of the eyes;
• painful reaction to bright light;
• a halo forms around light sources;
• all objects appear yellowish;
• sometimes with hyperopia, there is a sudden temporary improvement in vision.

For patients diagnosed with cataracts, the medical history, unfortunately, is rarely written by the doctor from the initial stage. As a rule, they go to the hospital much later. But it is in the first period that conservative treatment can slow down the process of the formation of cloudy spots, and postpone the operation for several years. There are cases when the disease stopped at the initial stage and did not progress, which cannot be said about the next stage.

1. Immature cataract. During this period, single spots on the periphery of the lens begin to unite and move towards the central zone. Intraocular pressure rises, because the lens increases in size - "swells". The visual impairment becomes noticeable, typical symptoms occur:

• visual acuity weakens, it is difficult to see small letters, details;
• fog appears before the eyes;
• difficult to distinguish color shades and colors;
• objects become indistinct, double;
• in the dark, vision deteriorates, and in the light there is pain in the eyes.

As vision deteriorates rapidly, this stage accounts for the main referral to medical help. The turbidity reaches a significant size, and conservative therapy has no effect. It makes no sense to hope that drops and exercises will stop and reverse the irreversible process of lens opacity - this is a waste of precious time.

Please note: the stage of immature cataract is the optimal time for surgery if changes in vision cause significant discomfort.

Today there is no need to wait until the cataract matures in order to implant an intraocular lens in its place. On the contrary, the late terms of the operation are associated with difficulties in removing too dense lens.

Mature cataract stage

• extracapsular extraction - the nucleus of the lens and its contents are removed, but the capsule remains, separating the media of the anterior and posterior parts of the eye;
• intracapsular extraction of the lens together with the capsule;
• phacoemulsification, when the lens is crushed using ultrasound, is removed from the capsule into which the artificial lens is implanted.

The first two types of operations give a large percentage of complications, because in this case, long incisions are made in the cornea, requiring sutures.

Phacoemulsification is a low-traumatic, but expensive method of eye microsurgery.

Cataract overripe process

At the last stage of the disease, the cataract overripe - the lens masses are destroyed. This manifests itself in several ways:

1. Lens dehydration: it decreases, which is why folds form on the capsule, it shrinks.
2. The bark of the lens turns into a liquid consistency, its core goes down, this pathology is called morganic cataract. In this state, the eye completely loses the ability to see.
3. Lactic cataract - the proteinaceous structures of the lens are decomposed and dissolved by the liquid that accumulates in the capsule. Intraocular pressure rises.

Overripe cataract gives the greatest risk of complications during surgical treatment. Firstly, when the capsule is opened, the pressure drops rapidly, it decreases sharply, and it becomes difficult to make a puncture for lens implantation. Secondly, a rupture can occur in the capsule bag, and the decomposition products of the lens, entering the cavity of the eye, cause its inflammation.

Thus, cataracts are not a sentence that inevitably leads to blindness. Vision is successfully restored if the disease is not started to the stages of mature and overripe cataracts.

Cataract is called the most common eye disease in people of mature and old age. Due to the severe decrease in visual acuity that causes this disease, it can be complicated professional activity and restrictions arise in the self-service of citizens, and in advanced cases, blindness occurs. However, cataracts are not a death sentence. And with a timely appeal to an ophthalmologist, high-quality treatment of the disease is possible, which will allow a person to restore his vision as much as possible and quickly return to the traditional way of life.

Cataract - what is this disease?

In medicine, cataracts are usually called clouding of the natural lens of the eye - a natural lens that transmits and refracts streams of light rays. While a person is young, the lens is transparent and elastic. It has the ability to instantly change its shape to focus on the subject. Due to this property of the lens, a person has the opportunity to see equally well both close and far.

With cataracts, the transparency of the lens is impaired. Due to its partial or complete opacity, only part of the light rays gets into the eye, leading to blurred vision, blurred vision, and a decrease in its acuity. With the progression of the disease over time, the area of \u200b\u200bopacity increases, increasingly worsening vision. Left untreated, cataracts can lead to blindness.

The causes of the onset of the disease can be many factors: pathologies of intrauterine development, trauma, radiation, general diseases of the body. However, the so-called. age-related (senile) cataract, which is caused by the aging process of the whole organism. It develops, as a rule, after 50 years and at the moment, in the world, at least 17 million people are affected by this disease.

According to WHO statistics, by the age of 70-80, 26% of men and about 46% of women suffer from cataracts. While after 80 years, the disease is detected in almost every person. It is especially alarming that about 20 million people in the world have already completely lost their sight due to cataracts.

The causes of the disease

Normally, the human lens is completely transparent. It contains water, proteins and some minerals. The nourishment of the lens is provided by intraocular moisture, which is produced in the eye. With age, metabolic products with toxic effects accumulate in the intraocular fluid. Thus, a malnutrition occurs, and the lens gradually loses its former transparency. The typical variety of cataracts is very extensive, due to the differences in the resulting opacities of the lens.

The formation of turbidity, in addition to age, is affected by a number eye diseases and pathologies of other organs. The resulting cataracts in this case are called complicated, they can develop against the background of glaucoma, myopia, diseases of the choroid, retinal detachment and pigmentary dystrophies.

Often the cause of lens opacity is also common diseases: diabetes mellitus, diseases of the blood and joints, bronchial asthma, skin diseases (such as eczema or psoriasis).

The development of cataracts is also affected by some external factors: poor diet, vitamin deficiency (calcium, vitamin C), occupational hazards, ultraviolet radiation and radiation, polluted ecology, smoking.

Cataract symptoms

This disease has been known since ancient times. Its name comes from the Greek kataraktes - "waterfall". Indeed, a person with a cataract sees as if in a fog - like through fogged glass or falling water. The development of the disease makes this "fog" even thicker and the person feels the veil before his eyes more and more sharply. An intolerance to bright light appears, sometimes the images are bifurcated, serious difficulties arise when working with small elements, reading, writing. At a later stage of the disease, the pupil becomes white.

As a rule, cataract begins in one eye (usually the left), then gradually develops in the other. Age-related cataract is a progressively developing disease that undergoes several stages in its development:

• The stage of the initial cataract, when the clouding of the lens occurs outside the optical zone - at its periphery. The patient at this moment does not feel anything, and the disease is determined by an ophthalmologist by chance, during the next examination.
• The stage of immature cataract, when the opacity gradually moves to the central optic zone. By this time, visual acuity is already noticeably reduced. The patient complains of the presence of a thick fog before the eyes. He starts having difficulties in the professional and domestic spheres. There is a need for surgical treatment.
• The stage of mature cataract, when opacities cover the entire area of \u200b\u200bthe lens. Visual acuity is reduced to the level of light perception. The patient manages to see only the contours of objects that are at arm's length from him.
• The stage of overripe cataract, characterized by the dilution of the lens substance, after which it acquires a milky white hue. The patient's visual acuity at this moment is such that he is only able to distinguish the bright spot of the window in the room and feel the light of a flashlight directed directly into the eye. At this stage of the disease, numerous complications can occur, the most dangerous of which is secondary glaucoma. It develops as a result of compression of the surrounding tissues of the eye by an enlarged clouded lens. In the dystrophic process, the ligaments that hold the lens are also involved. At the same time, they often break, leading to dislocation (dislocation) of the lens into the vitreous body. The protein composition of the overripe lens is perceived by the tissues of the eye as foreign and this often becomes the cause of iridocyclitis.

The manifestations of cataracts are varied and most often they are associated with visual impairment. Like any other disease, it is better to diagnose it in the initial stages and start treatment immediately.

Cataract treatment

Among the methods of treating cataracts, it is customary to distinguish conservative (medication) and operative (surgical).

At the initial stage of the disease, if the patient does not want to undergo surgery, doctors recommend the use of eye drops: Quinax, Taufon, Vita-Yodurol, Oftan-Katakhrom. These drugs inhibit the progression of opacities, but they are not able to dissolve the existing ones. To prescribe them and determine the correct dosage, a doctor's consultation is required.

However, the radical method of getting rid of cataracts is surgery. This operation is called cataract extraction, and its most commonly used technique is phacoemulsification, with the implantation of a posterior chamber intraocular lens. It is phacoemulsification that is performed in 99% of cases of uncomplicated cataracts. Moreover, the most favorable outcome of the operation can be expected in patients with an early stage of immature cataract.

The method of phacoemulsification has been used by Russian doctors for at least 20 years. The operation is performed under local anesthesia on an outpatient basis.

The course of the operation is as follows: through the corneal micro-incision, the cloudy lens is destroyed by ultrasound and taken out. A folded flexible intraocular lens is introduced into the left lens capsule, which unfolds inside and fixes itself. The operation takes about 20 minutes. Vision, up to the preoperative level, is restored immediately. The maximum possible visual acuity is within 4 weeks.

During the month of the recovery period, the patient needs to instill anti-inflammatory and disinfectant drops... At the end of the recovery period, you can return to the traditional way of life.

If a mature or overripe cataract is identified, which is complicated by the weakness of the ligaments supporting the lens, extra- or intracapsular cataract extraction is prescribed. The essence of the surgical intervention is the removal of the entire lens together with the capsule. Instead, a rigid intraocular lens is implanted, which is sutured to the iris. The operation requires a large incision and overlay postoperative sutures, which are removed after 4-6 months.

For several months after surgery, the patient has low vision due to postoperative reverse astigmatism. But after removing the stitches, the patient's level of vision is the same as it was before the cataract. Particular danger in rehabilitation period represents the discrepancy of the postoperative wound.

Complications of cataract surgery

When an unusable lens is removed, the human eye is deprived of a very important detail - an optical lens. The refractive properties of the cornea, vitreous body and moisture of the anterior chamber, for good visionis not enough. The operated eye needs additional spectacle correction or implantation of an artificial lens.

Artificial lens implantation is the best way to treat cataracts. However, its application is not always possible. The condition of the tissues or blood vessels of the patient's eye in old age, as well as the presence of certain systemic diseases, do not allow the implantation of an artificial lens, due to minimizing the results of the operation. In the stage of mature and overripe cataract, the swollen lens occupies almost the entire volume of the anterior chamber of the eye, due to which the outflow of intraocular fluid is disturbed. As a result, there is often a dangerous complication of the disease - secondary glaucoma. At the same time, the delay in the operation threatens the patient with irreversible loss of vision.

Prevention

The main measure of cataract prevention can be considered a timely visit to a specialist. So, people who have crossed the threshold of forty years of age need to be shown to an ophthalmologist once a year for the detection of lens opacities. It is worth remembering that to determine the need for medication or surgical treatment only a specialist is capable. Self-treatment of cataracts is useless and will only result in lost time and complete loss of vision.

Today, eye drops are widely used to slow down the maturation of cataracts. Such vitamin products contain amino acids, enzymes, and microelements necessary for the lens. With their systematic use, the processes of metabolism and nutrition of the lens are improved, which inhibits the development of cataracts. True, such drops are not able to stop the turbidity process that has already begun. They can only slow down the disease and help pass the time before surgery.

conclusions

Age-related (senile) cataracts can be successfully treated even at the most advanced age. The only condition for an excellent result is the absence of complications from concomitant inflammation, for which it is not worth starting the disease until the late mature and overripe stages. The proven technique of surgical operations, competent anesthesia and a variety of the model range of artificial lenses make surgical treatment cataracts are minimally dangerous. The main thing is to detect the disease in time and to hurry with its treatment as much as possible.

Age-related cataracts appear in more than half of people over the age of 60. This is due to a decrease nutrients, proteins and amino acids in the body and its depletion. This leads to clouding of the lens and deterioration of vision, in some cases even to complete blindness. On early stagessuch as initial and immature cataracts can be managed without surgery. Consider how this disease develops in older people.

Cataracts develop rather slowly in people of advanced age. First, the opacity of the transparent body begins, and then vision gradually deteriorates.

Cataracts can develop from the capsule or nucleus of the lens. Depending on this, cortical, subcapsular and nuclear forms are distinguished.

1. Unlike subcapsular, the nuclear form develops much faster. It ripens not from the cortex, but from the nucleus of the lens, due to which vision is rapidly falling.
2. Cortical differs in that initially changes occur in the very substance of the lens. In this case, the blurred image is noted. Allocate the initial, immature, mature and overripe stages of the development of the disease.
3. The subcapsular view is dangerous for its complications and difficulties in diagnosis. In this form, the anterior capsule becomes cloudy, and the disease spreads to the center of the lens. In this case, the cortex remains unaffected.

Most often, the age-related form of cataracts is bilateral, but visual impairment and clouding of the lens can be observed not simultaneously, but alternately.

It is very important to identify the disease in time and take measures to preserve vision. After all, the more severe the stage and degree of lens damage, the greater the likelihood of complications.

Stages of the disease

Senile cataract is divided into several types, depending on the stage of its development. Let's consider each stage separately.

• The initial stage is characterized by the appearance of foci of lens opacity, and its central part remains transparent. The person does not have visual impairment. Very often, an initial cataract results in only a slight blurring of the image. At this stage, the hydration of the lens is observed, because of this, it increases in volume. Some patients who suffered from myopia before cataracts may experience improvement in vision, but this is all temporary. At the initial stage, patients constantly want to rub their eyes, there are flies before the eyes, double vision, as well as painful perception of bright light.
• Immature cataracts are characterized by significant visual impairment. Areas of opacity merge into one large whole spot and close the pupil. Sometimes intraocular pressure rises. However, at the swelling stage, the front surface remains transparent.

• Mature cataracts are characterized by severe complications. The lens becomes completely cloudy and loses water. Vision falls to the minimum values, the person sees practically nothing, only bright light.
• But the most severe is overripe cataract. At this stage, complete degeneration of the lens is noted, it liquefies, becomes a dull white color. The core goes down. Overripe cataracts are dangerous because the decay products of the lens can enter the cavity of the eye, leading to the development of infection, inflammation and decay. Glaucoma is very common.

How quickly does one stage go into another?

Disease progression

Senile cataract has its own characteristics of development and a certain period from appearance to maturation.

If from primary to extensive opacity of the lens lasts on average up to 6 years, then such senile cataracts are considered rapidly progressive and require immediate surgical intervention. They are observed in 12% of all patients.

Basically, it takes about 10 years from the moment of detection of the disease to surgery. The timing depends on the speed of transition of cataracts from one stage to another.

Important! The rate of development of senile (age-related) cataracts depends on the individual characteristics of the patient.

An incipient cataract does not always progress to the next stage. Most elderly people over 75 years old are diagnosed with senile cataracts at an early stage. Immature cataract occurs in only 30% of these cases.

But it is worth noting that if the disease has passed to an immature stage, then it becomes mature very quickly. This period can last from one to three years.

Patients with a mature form of the disease should soon expect an overripe stage. This can happen within a year. You should not hesitate with treatment, especially with mature cataracts, because at the next stage it is almost impossible to resume vision.