How is the operation to replace the lens of the eye going: possible complications and rehabilitation. Can a modern intraocular lens become clouded - what is the service life of the artificial lens of the eye? Can the lens be replaced again?

Hello, is it possible to do a second operation to remove a cataract, I just got a clouding after a year and a half! and got the best answer

Answer from. [Guru]
No. If a cataract has already been removed, then a new one will never appear again. Cataract affects the lens; during cataract surgery, the affected lens is removed, and an intraocular lens is implanted in its place. After cataract removal, some patients experience opacification of the posterior lens capsule holding the IOL in place. This phenomenon, known as secondary cataract, is sometimes mistaken for cataract, but essentially it refers to one of postoperative complications... A patient may develop cataracts in both eyes, but there are no more than two cataracts in a person's life.
You can read more detailed information on vision restoration here link

Answer from Kondor01[active]
I advise you to pay attention to the organization of tinsha there really good medicines they may even cure some of them he himself didn’t believe in them, but how I drank vitamins from them now, like 2 years, I never got sick and my grandmother got up on her feet

Answer from Puppeteer[guru]
This is what the Internet gives out
1) Those who cannot really help, except for scam, frighten the master. Treatment of severe, neglected, overripe cataracts - even for a high-class professional - is not easy, and the likelihood of complications increases exponentially the more the longer you coward and delay with the surgery. On the conscience of these scarecrows are many ruined human destinies. The question is solved not painfully, beautifully and reliably, if we talk about replacing a decaying and cloudy lens with a transparent artificial one. 2) Not repeated, but secondary cataract. This name has long outlived its age, since it does not mean a cloudy lens that has grown out of an empty place again, but only a clouding of a thin capsule bag, which contains a transparent artificial lens. This is not always the case, and the longer you wait with the operation, the more likely fibrosis of the capsule is. This problem is solved without surgery. In a few minutes without hospitalization, a laser beam without pain and risk makes a hole in the opaque capsule and vision improves immediately. You go home immediately after the procedure. The procedure is performed once in a lifetime.

Answer from Valery Shchetkin[newbie]
Now in the field of microsurgery of ophtolmology, a new achievement has appeared; cataract treatment with laser therapy should undergo a comprehensive examination and discuss all the nuances with the attending physician

Answer from Tatjana Zaika[guru]
incorrectly observed caution .. tilted her head and many others. other ..

Answer from Vikusha[guru]
probably the lens was not changed, otherwise the question did not arise.

Answer from Elman Piriev[newbie]
GO TO THE DOCTOR!! ! HE KNOWS BETTER !!!

Answer from Alina Kostyrya[newbie]
consult a doctor, health is your treasure and there is no need to scatter treasures

Answer from Boris Pustovalov[newbie]
the eye is constantly watering. upper eyelid looks inflamed and narrows the eye severely, hanging overhead.

Answer from Nata Petrenko[newbie]
good day. if you think the answer is incomplete - we are ready to answer additional and clarifying questions on the site link

Answer from 3 answers[guru]

Hello! Here is a selection of topics with answers to your question: Hello, is it possible to do a second operation to remove a cataract, I just became cloudy after a year and a half!

A procedure such as replacing the lens of the eye is effective method treatment for cataracts. Modern medicine allows you to carry out the operation quickly and painlessly, the procedure does not take much time. Since any surgery is dangerous and has its own indications and contraindications, it is important for the patient to conduct a thorough assessment of his condition before the intervention. In order for the recovery period to pass without complications, it is important for the patient to follow the recommendations of the attending doctor. It is advised to prepare very responsibly for the replacement of the lens.

Indications for

The operation to replace the lens of the eye is indicated for cataracts, presbyopia, myopia and high astigmatism, when irreversible pathological processes have occurred in the visual organ (opacity, structural change). Treatment allows the patient to return to a full-fledged lifestyle, to fully restore visual function. The risk zone includes elderly people with degenerative changes cornea, as well as the procedure is indicated for myopia and hyperopia. The effectiveness of treatment depends on the timely detection of the disease and early surgical intervention.

Well-chosen posture during sleep after surgical intervention promotes early recovery. When patients lie on their stomach or side, the risks of postoperative complications increase significantly.

Preparation for the procedure

Laboratory diagnostics will help prevent the development of postoperative complications.

During eye surgery, hospitalization is not needed, all manipulations take little time, they are done in 1 day. Preparing for surgery includes a thorough examination. To reduce the risks of complications during surgery, the patient is recommended to consult a cardiologist and anesthesiologist. You should prepare for the procedure by passing all the necessary tests, such as:

• blood for sugar, hepatitis B, RW;
• general blood analysis.

Laser lens replacement in glaucoma requires prior consultation with a therapist and dentist, the latter issues a certificate of sanitation oral cavity... You need to prepare for cataract surgery. The patient needs to take a shower, wash his hair, put on completely clean clothes (preferably made from natural fabrics). On the eve, it is forbidden to drink alcohol, exclude excessive physical activity, replace them with gentle ones. If a person uses medicines for the treatment of diabetes, normalization of blood pressure and blood sugar, he must be sure to notify the treating doctor.

Lens types

The selection of an implant is a purely individual process.

In order for the replacement of the lens in cataract to give positive results, a suitable intraocular lens is selected individually by an ophthalmologist surgeon. There are these types of artificial implants (IOLs) that successfully change the lens of the eye:

• accommodating monofocal lens;
• multifocal;
• monofocal;
• aspherical IOL.

Procedure

Lens replacement surgery for cataracts is called ultrasonic phacoemulsification. The technology helps to correct cataract defect and lens opacity, restore vision. A specialized instrument is inserted through a small incision, then the defective organ is converted into an emulsion using ultrasound. The split particles are removed from the eye, and the IOL is implanted. After the lens is placed, it straightens itself out and falls into place. The time of the manipulation depends on the characteristics of the development of the pathology, the operation usually lasts 30 minutes. It is recommended to change the lens under local anesthesia.

Complications

The latest technology reduces the risk of complications to a minimum.

Replacement of the lens, which has the name - refractive lensectomy, if done correctly and followed by all the recommendations of an ophthalmologist, rarely causes side effects. Possible complications in children and adults include development secondary cataract... The deviation is expressed in the clouding of the posterior capsule, a color change from transparent to turbid. The use of silicone and PMMA prostheses increases the chances of this side effect... Removing the lens of a child's eye can stimulate fluctuations in intraocular pressure; IOP rises in cases of poor washout of vicoelastic or lens displacement. Refractive lens replacement can cause swelling of the optic organ, sometimes cataract removal provokes pseudophase bullous keratopathy, rhegmatogenous retinal detachment, choroidal hemorrhage, astigmatism, inflammation.

Lens replacement is a microsurgical procedure in which an artificial acrylic or silicone lens is implanted into the eye after removing its own lens. These devices are called intraocular lenses or IOLs. After implantation, a person does not feel them; they do not require additional care or replacement after a certain period of time. Lens replacement is the only way to get rid of cataracts and the associated blurred vision. There are other indications for such an operation - for example, correction of refractive errors.

Indications for surgery

There are the following indications for surgical treatment:

This operation is more complicated and carries more risks compared to laser correction of refractive errors. Therefore, each case is assessed individually, the decision on the operation is made jointly by the doctor and the patient.

Contraindications

There are clinical situations in which lens replacement is contraindicated. Let's consider the main ones:

Inflammatory processes eyeball in the acute or subacute phase. The decision about the potential for intervention is made only after the relief of the acute inflammatory process.

Retinal pathology, including detachment, tears, macular edema. These conditions are threatening and require urgent treatment... Routine surgical interventions, which include lens replacement, are not performed in such a situation.

The small size of the anterior chamber of the eye or eyeball, which seriously complicates the technical performance of the operation.

Concomitant general medical conditions, including a recent myocardial infarction or stroke.

This operation is planned, therefore, it should be performed against the background of compensation for somatic and concomitant ophthalmic pathology.

Choosing a prosthesis

There are many types of artificial lenses on the market today. The material, properties and manufacturer of the lens directly depends on and total price operations. Depending on the model, intraocular lenses are divided into:

Hard - previously used. Less practical - for their implantation, a large incision is required, requiring suturing and long-term restoration.

Soft - implanted through a self-sealing corneal puncture several millimeters long. This is achieved due to the fact that the lens is introduced into the folded eye, and then straightened and fixed.

The following artificial lenses exist depending on the number of focuses and the ability to accommodate:

Monofocal lenses - Provide good vision at only one focal length (near, far, or mid-range). The advantage of such a device is its low price and, as a result, availability for a wide range of the population. The disadvantages include the need to use glasses or contact lenses for adequate vision at any distance.

Multifocal lenses are a great option for correcting presbyopia. Such IOLs are classified as premium in terms of functionality and price. They have a magnifying ability in certain areas, which allows you to clearly see objects at any distance without glasses or contact lenses.

Accommodating IOLs. This view lenses, thanks to a combination of aspherical shape and soft "hooks" - legs that support the position of the lens in the eye, provides good vision at various distances. "Hooks" allow the lens to slowly move forward when it is necessary to examine an object close, and when you move your gaze to distant objects, the intraocular lens is displaced posteriorly.

Toric IOLs are suitable for correcting astigmatism in combination with hyperopia or myopia. This happens due to the different power of refraction at different meridians of the artificial lens. These IOLs also have special markings on the peripheral portion that allow the surgeon to optimally position the lens during implantation.

Manufacturing firm

When choosing a suitable prosthesis, the patient often encounters not only their many varieties, but also variations of countries and manufacturers. Let's consider the most common:

Domestic lenses. You can get such an IOL free of charge, subject to a quota operation ( compulsory medical insurance policy). Russian artificial lenses are monofocal IOLs. Currently, the development and implementation of multifocal implants is underway.

American lenses. These prostheses are one of the most popular and reliable in the world. The most famous manufacturers are ALCON and CRYSTALENS, which produce the entire line of artificial lenses. Such lenses are reliable, but they are distinguished by their high cost, which in some cases limits their use.

German lenses. The Russian market is represented by such firms as Human Optics, Carl Zeiss... These manufacturers produce high-quality prostheses, including aspherical and toric. They are used to correct complex astigmatism and other refractive disorders.

Lens replacement surgery can be performed both on an outpatient basis and after preliminary hospitalization in a hospital. In the course of preoperative preparation, a comprehensive examination of the organ of vision is performed, ophthalmoscopy is performed, and the fundus is examined. If necessary, ultrasound or optical coherence tomography is performed. This is necessary to identify diseases that affect visual acuity and potentially predetermine the outcome of the operation. In the process of preparation, general clinical blood tests, electrocardiography, radiography are carried out.

30-40 minutes before the start of the operation, a drug that dilates the pupil is instilled into the eye. Local anesthesia is used in the form of pain relievers eye drops... In addition, intravenous sedation is performed. If indicated, regional or general anesthesia is possible.

The patient is located on the operating table. The surgeon excises the anterior lens capsule through the corneal puncture, thus gaining access to the lens substance. Then a special titanium needle is inserted into the eye, connected to a source of ultrasonic radiation. With the help of ultrasound, the own lens is crushed - phacoemulsification is carried out. The crushed residues are removed from the eye cavity using an aspirator.

The next stage of the operation is the implantation of an artificial lens. Modern intraocular lenses are soft and foldable, so there is no need for large incisions. After the implant is inserted into the eye cavity, it is independently fixed in the same place where the patient's lens was previously located. No suturing is required. The eye is closed with a sterile bandage, which is allowed to be removed the next day. The duration of the entire operation takes 15-20 minutes.

Recovery period

During recovery from lens replacement surgery, the patient should carefully consider all medical recommendations. In the first postoperative day, rest and bed rest are required.

The operated eye is covered with a special protective bandage. In the following days, it is advisable to adhere to the following tips:

Bury the operated eye regularly according to the doctor's recommendations.

Avoid excessive sun exposure, use protective goggles in sunny weather.

Avoid heavy lifting physical activity.

Do not rub or scratch your eyes.

During hygiene procedures, while washing your hair, make sure that detergents do not get into the eye.

For 2-3 weeks, refuse to apply creams and decorative cosmetics on the eyelids.

Limit reading, watching TV, working at the computer and other activities that require eye strain.

Temporarily refuse to visit the baths, saunas.

Driving can only be resumed with the permission of the attending physician.

Change in vision

The early postoperative period is accompanied by blurred vision, moderate painful sensations... This is absolutely normal, you should not be afraid. Subsequently, a smooth restoration of visual acuity is noted. At first, double vision, flickering of flies, and disturbances in color perception are permissible.

As the restoration progresses, the outlines of objects become clearer, all artifacts disappear, color perception and contrast improve. The duration of the recovery period is individual. It is important during this period to visit a doctor in a timely manner for early diagnosis complications and control of the rehabilitation process.

Possible complications

Lens replacement surgery is one of the safest in the world. Tens of thousands of such interventions are carried out annually. There are still risks of complications.

Below we will consider the most common options for an unwanted scenario:

Infectious inflammatory processes eyeball.

Retinal changes - detachment, macular edema.

Increased intraocular pressure. Diagnosis requires periodic measurement of intraocular pressure and the use of eye drops that relieve hypertension.

Intraocular lens dislocation

The formation of a secondary cataract, which can be eliminated with a laser.

All complications, if detected early, are well treated. Therefore, in the event of anxiety symptoms, increased pain, or flashes of light, it is important not to postpone the visit to the doctor.

The procedure for obtaining free medical care

This operation can be carried out free of charge, under the compulsory medical insurance policy. There are quotas for such interventions in government institutions. The patient, if indicated, must wait in line. Refractive lens exchange is a cosmetic operation, therefore it is performed only on a paid basis.

Implantation of a domestic lens is carried out on a free basis. Imported counterparts are paid independently.

Operation cost

In any private ophthalmology clinic, lens replacement can be performed commercially. The cost of the operation is influenced by the reputation of the clinic, its technical equipment and the specialists working there. The cost of a lens replacement surgery on average varies from 40 to 100 thousand rubles. The choice of the implant model significantly affects the pricing. Often, the actual cost of the artificial lens exceeds the cost of the operation by 1.5-2 times. So, the cost of a premium class intraocular lens is 45-85 thousand rubles, depending on the model and manufacturer.

Replacement of the lens of the eye in Moscow in 95% of cases is performed by the sutureless method of ultrasonic phacoemulsification, which over the past 15-20 years has almost completely replaced the traditional technique of extracapsular extraction. Moscow Clinic. Fedorov is one of the main eye clinics a region where the lens of the eye is replaced annually in more than 3000 patients with cataracts and refractive errors.

Thanks to the support of the Moscow Government and the Foundation for Assistance to the Development of Advanced Medical Technologies named after Svyatoslav Nikolaevich Fedorov, the Clinic pursues a liberal pricing policy, combining the high quality of the provided medical services and low cost of surgical treatment. At the same time, the Clinic aims to ensure the availability of high-tech medical care the general population, in connection with which in the Clinic. Svyatoslav Fedorov has a system of social benefits and discounts when replacing the lens of the eye.

Lens replacement in the Fedorov Clinic is

Hi-tech... Lens replacement in the overwhelming majority of cases is carried out by phacoemulsification. The traditional technique of replacing the lens through the corneal incision is used only in extreme cases of impossibility of phacoemulsification. Since 2017, along with ultrasound phacoemulsification, femtosecond cataract support has been performed for patients of the Fedorov Clinic. The introduction of laser cataract removal into the daily practice of our specialists has raised the level of surgery and patient comfort during surgery, postoperative treatment results to a qualitatively new level.

Operation safety... More than half a century of observation of patients with lens replacement allows us to firmly state the minimal risks of surgical treatment, high results of the operation and the invariability of the postoperative effect. Constant technical improvement is also important, both in the operation technology and the instruments and equipment used during surgery.

Versatility... Lens replacement at the Fedorov Clinic is performed for various ophthalmic pathologies. Both in older and elderly people with cataracts, and in young people with a high degree of myopia, astigmatism and hyperopia, the replacement of the lens of the eye allows you to completely restore acuity.

Minimally invasive character... Thanks to technical progress, it became possible to abandon extracapsular extraction with a wide corneal incision, use during surgery general anesthesia, the need for hospitalization of the patient in a hospital, and from the need for "maturation" of the cataract, when the patient on his own could no longer navigate in space. Now, lens replacement can be performed if the patient has minimal visual discomfort on an outpatient basis, under local anesthesia, without incisions and sutures through special self-sealing micro punctures 1.8-2.2 mm wide, formed by a metered diamond blade or using a femtosecond laser.

No age qualification... Lens replacement at the Clinic. Svyatoslav Fedorov is performed at any age of the patient. Limitations to surgical intervention in patients of the age group may be due exclusively to the general serious condition of the patient. In young people, the operation can be performed from the age of 18 in cases high degrees ametropia when opportunities laser correction limited vision.

Short-term operation... The total duration of the entire operation, taking into account the preparatory stages, is about 15-20 minutes. Moreover, the duration of the actual surgical intervention does not exceed 10 minutes. According to the internal regulations of the Clinic, surgical treatment is always carried out only on one eye. If there are indications, it is recommended to operate the paired eye no earlier than two weeks after the first operation.

Painlessness surgical treatment ... Replacing the lens of the eye is an absolutely painless operation for the patient. The minimally invasive nature of the intervention allows you to operate on the background of local anesthesia. Pain relievers eye drops completely exclude the occurrence of pain.

Lack of hospitalization. Operative treatment in the clinic. S. Fedorov is carried out without hospitalization in a hospital. In just 1-2 hours after the surgical intervention, the patient receives recommendations from the attending physician and can leave the clinic.

Short rehabilitation period... The patient notes the restoration of vision after replacing the lens within a few hours after the operation. However, the process of improving visual functions and stabilizing vision will occur within the first two weeks from the moment of surgical treatment.

Stages of treatment at the Fedorov Clinic

After completing the necessary medical records the patient is located in the preoperative ward, where he is examined by the attending physician, and preoperative preparation is carried out. After preoperative measures, the patient is invited to the operating unit.

Despite the outpatient nature of the operation and the absence of general anesthesia, the replacement of the lens of the eye in the Clinic. Svyatoslav Fedorov is performed in a sterile operating room. During the operation, only disposable consumables and microsurgical instruments are used, which completely eliminates the possibility of infection during surgery.

After disinfecting treatment and local anesthesia in the form of anesthetic drops, an eyelid dilator is applied to the operated eye, preventing spontaneous blinking of the eyelids.

Using a diamond ultra-thin dosed knife, the surgeon forms a tunnel corneal micro-puncture 1.8-2.2 mm wide, which is the main incision through which all further stages of the operation are performed. Special profile tunnel cut and its small size provide good self-sealing in postoperative period without the need for suturing.

Micro-puncture of the cornea with a diamond blade	Removal of the anterior wall of the lens capsule

After capsulorhexis is performed - a circular dissection of the anterior wall of the capsular sac - the surgeon, using an ultrasound probe, crushes the lens substance to the state of suspension, which is simultaneously aspirated from the eye. Currently, the Clinic. Svyatoslav Fedorova offers her patients a completely innovative way lens replacement - femtosecond support of the operation. The main difference from ultrasonic phacoemulsification is the use of a femtosecond laser during surgery to form a corneal incision, create capsulorhexis, and crush the substance of the native lens.

Crushing of the lens of the eye

Having completely released the "bed" of the lens, a rolled intraocular lens (IOL) is implanted into the capsule bag. An IOL is an artificial lens of the eye, individually designed for each patient. Inside the capsule bag, the artificial lens opens independently, the surgeon controls correct position haptic elements of the intraocular lens and its centering relative to the visual axis of the operated eye.

Artificial lens implantation	Artificial lens position

After the completion of all stages, the edges of the tunnel incision are hydrated, the eyelid expander is removed, antibacterial eye drops are instilled, and a protective aseptic bandage is applied to the operated eye. And the patient is escorted to the recovery room, which he can leave in 1-2 hours after being examined by the attending physician and go home.

The next morning after the operation, the patient arrives for a control examination of the surgeon, receives all postoperative recommendations, medical appointments and a postoperative visit schedule.

Artificial lens. Types and models

In the Soviet Union, an ophthalmologist academician Svyatoslav Nikolaevich Fedorov was a pioneer in the implantation of an artificial lens, and our Clinic proudly bears the name of a great doctor and scientist with a worldwide reputation. Fedorov's lens was the first rigid artificial lens designed for intraocular implantation after extracapsular cataract extraction.

Later, Fedorov's lens underwent significant changes in shape, design, used in the manufacture of the material, but long time remained the only option for an intraocular lens when replacing the lens.

The rapid transition to microinvasive surgical technologies and the development of cataract phacoemulsification have led to significant changes in implantable IOL models - the design of lenses and materials has radically changed, which has led to the production of modern soft artificial lenses.

The need to replace the lens, not only for cataracts in the elderly, but also in young and middle-aged patients, has led to the creation of various types of intraocular lenses.

And now the Clinic named after Fedorova carries out implantation of all types and models of modern artificial lenses from leading world manufacturers, thereby providing a personalized individual approach to each patient and his needs.

After replacing the lens at the Clinic. Fedorov you will receive

Replacing the lens of the eye is a completely new quality not only of your vision, but also of your level of life. The Fedorov clinic will forever relieve you of low vision, and you can enjoy the world around you without glasses, capturing the subtlest nuances of shape and color. The assistance of the Moscow Government ensures the provision of ophthalmic surgical care at affordable prices for each of our patients.

Lens replacement. Price in Moscow. Clinic Fedorov

The cost of replacing the lens at the Clinic. Svyatoslav Fedorov, price per eye, rub.

The lens is one of the most important parts of the eye, which acts as a natural lens and is responsible for refracting light rays, as a result of which an image of surrounding objects is formed on the retina. Any violation of its structure leads to deterioration of vision up to its complete loss, therefore, requires immediate treatment, most often surgical. Lens replacement surgery is a serious procedure that requires a certain professionalism from the doctor, entails the risk of complications and requires the patient to strictly adhere to medical recommendations.

Indications for lens replacement

Surgical intervention to replace the lens is carried out in case of violations of its structure or shape, which do not lend themselves to therapeutic or laser correction, and can lead to complete loss of vision. Usually these are the most common ophthalmic pathologies that tend to progress - presbyopia, astigmatism and myopia.

Table. Indications for lens replacement.

In addition, surgical intervention is carried out in case of dislocation of the lens (for example, due to eye injuries), violation of its refractive ability, which is observed due to some diseases of internal organs, intolerance to conservative or optical correction.

For reference: most often, lens replacement is necessary for people with a diagnosis, since the disease progresses rapidly and leads to complete loss of vision. With myopia, the operation is performed only in difficult cases in the presence of concomitant pathologies.

Contraindications to the procedure

Contraindications to surgical lens replacement include:

• inflammatory and infectious diseases eye tissues, including keratitis, conjunctivitis, blepharitis, etc.

• decompensated glaucoma - a pathology that is accompanied by an increase in intraocular pressure, after surgery can lead to serious complications and complete loss of vision;
• lack of light perception is a serious dysfunction of the retina with a poor prognosis - if the patient has this symptom, replacing the lens will not make sense;
• serious diseases of internal organs, including diabetes, multiple sclerosis, cancerous tumors, heart attack or stroke, suffered for six months;
• too small size the eyeball or its anterior chamber, which may interfere with the procedure;
• pregnancy and lactation.

Some of the above contraindications are relative. For infectious or inflammatory diseases eye surgery can be performed after the pathological process is arrested. If a lens replacement is planned for a pregnant or lactating woman, doctors recommend waiting for delivery and the end of the lactation period. With the rapid progression of the disease, patients are prescribed maintenance drugs.

Important: in the presence of contraindications in the form of diseases of the internal organs, the patient is advised to consult a narrow specialist (cardiologist, neurologist, endocrinologist, etc.) and discuss the issue of surgical intervention.

Is it possible to do without surgery?

Lens replacement surgery entails certain risks of complications, but in some cases it is the only chance to preserve vision. With cataracts (especially age-related), conservative or laser therapy is ineffective, the pathological process progresses rather quickly, therefore, without surgical treatment, patients will be completely blind. Moreover, a few years ago, ophthalmologists performed lens replacement only for mature cataracts, but today the operation is recommended to be done immediately after irreversible changes began in the eye tissues.

It is possible to dispense with surgical intervention only with myopia, presbyopia, astigmatism and other visual impairments, provided that the disease does not progress, and the patient is helped optical correction vision. If the doctor advises to replace the lens, you should not abandon the operation for fear of complications - the consequences of improper treatment can be much worse.

Lens replacement efficiency

According to medical statistics, the effectiveness of surgery with lens replacement is 98%, that is, almost all patients experience a significant improvement in vision. In 80% of patients, the result of treatment was preserved 7 years after the operation, and slight deterioration in visual function was observed in only 20% of cases. The need for use after surgery depends on clinical course diseases, the general condition of the human visual system and the functions of the implant, which was installed instead of a natural lens.

Operation methods

There are several ways to perform an operation to replace the lens, and the method and treatment regimen are selected by the doctor, taking into account the characteristics of the course of the disease, the age and general condition of the patient.

1. Extracapsular extraction... During surgery, a small incision is made in the eye at the confluence of the sclera and cornea. Through it, the damaged lens is removed, pthrosis is placed in its place, after which sutures are applied to the incision site. The patient stays in the hospital for several days, and the stitches are removed after about 3 months.
2. Ultrasonic phacoemulsification... The main advantage of the procedure is that the removal of the lens and the installation of the implant are carried out in one step. A microscopic (no more than 2.5 mm) incision is made on the surface of the eyeball, into which an ultrasonic probe is inserted, which converts the tissue into liquid. The liquefied lens is pumped out of the capsule, after which an artificial substitute is placed in it. Before performing manipulations, special substances are introduced into the eye, which protect its structures from damage and prepare the tissues for implantation. The operation is performed on an outpatient basis, and stitches are not required.

In addition, there is a new technology of surgical intervention using a laser device that makes an incision on the surface of the eyeball. It is believed that the use of a laser reduces the risk of complications, but the cost and time of the procedure increase significantly.

For reference: in modern ophthalmology clinics, lens replacement is usually carried out using phacoemulsification. Outdated techniques such as extracapsular extraction are rarely used, only if the patient has certain medical indications.

Implant selection

Implants that are inserted in place of the damaged lens are called intraocular lenses. From the right choice such a lens largely depends on the success of the operation, visual function and the patient's quality of life. Dentures are distinguished by several parameters: rigidity, number of foci and accommodative ability (to adapt to focusing when looking at objects located at different distances).

The material from which artificial lenses are made can be soft or hard - hard lenses are cheaper, but are significantly inferior to soft ones in functionality. In addition, soft implants can be rolled up prior to insertion, allowing surgery to be performed with a minimal incision.

Depending on the number of foci (points at which the clearest image is formed), prostheses are divided into monofocal, bifocal and multifocal. The most common are bifocal implants with two focuses, which make it possible to see objects well at short and long distances. The principle of choice is as follows: the fewer tricks, the more often the patient will have to use optical correction.

Not all artificial lenses (as a rule, only the most expensive ones) have the ability to accommodate, but such prostheses have an undoubted advantage - they can change their curvature, that is, they completely replace the natural lens.

For reference: the cost of an artificial lens depends on its features, functions, company and country of origin, and varies between 20,000 and 100,000 rubles. Prostheses from Russian companies can be obtained free of charge if replacement is carried out under a compulsory health insurance policy.

How is lens replacement performed?

The lens replacement operation is performed in several stages, each of which is of no small importance for the final result.

Important: immediately after, vision may be impaired, and some patients experience difficulties with orientation in space, therefore it is best to come to the clinic accompanied by loved ones.

Possible complications

Through the use modern techniques and equipment, the risk of complications after lens replacement surgery is minimized. Sometimes patients have the following pathologies:

• tissue infection;
• swelling and inflammation of the eye;
• intraocular bleeding;
• displacement of the artificial lens;
• increased intraocular pressure;
• retinal detachment;
• secondary cataract;
• clouding of the back of the capsular bag;
• double vision due to the difference in characteristics of an artificial and natural lens.

Some of the above conditions require immediate medical attention, so if you have intense pain lasting for several days, fever, severe eye redness or bleeding, or if your vision is severe, you should see a doctor immediately. Pain during the first days after surgery, a feeling of discomfort and a slight burning sensation, as well as a small veil before the eyes are a normal reaction of the body and go away without medical intervention.

Postoperative period

After replacing the lens, vision begins to improve within a few hours, and the full effect of the operation will be felt in a month. To make the healing process of tissues faster, the following recommendations must be followed:

• in the first days after the procedure, you should refrain from physical exertion and drinking alcohol, do not rub your eyes or put pressure on it;
• rinse the eye with boiled or bottled water, instill drops prescribed by a doctor;

• protect the site of operation from mechanical damage and water ingress, and apply a special bandage on it at night;
• do not expose the operated eye to stress, avoid reading for too long, working at a computer, using mobile gadgets and watching television;
• when going outside, wear dark glasses - the artificial lens lets in more light, which can cause some discomfort;
• avoid temperature extremes, do not visit the bathhouse or sauna, try not to go outside in frost or snow.

After about a month, most patients return to their usual life and professional activities, but this issue is best discussed with the attending physician, especially if the work is connected with physical and visual stress. The same applies to practicing some sports (swimming, weightlifting, etc.) and driving vehicles - if indicated, postoperative restrictions are extended by several months.

Lens replacement surgery is an effective, painless and relatively safe procedure that allows you to maintain vision and performance in people with complex eye diseases. With the right approach to treatment and careful attention to your health, the procedure is quick and successful, and the risk of complications is minimized.

Video - Lens replacement surgery for cataracts