Cataract

What are the causes of cataract?

Cataract; Behind the pupil, there is a natural lens for our eyes that gives a refractive index of 10 at far distance and 13 at near. The condition that our natural lens loses its transparency is called a cataract problem. As the natural lens becomes opaque, we see the world as if we are looking through a blurred glass.

The most important cause of cataract formation in adults is the changes in the lens that occur with aging. Consanguineous marriage, metabolic diseases, diseases in the womb, drug use during pregnancy, microbial conditions and injuries are also causes of cataract formation in children.

In addition, blows to the eye (trauma), diabetes, inflammation of the eye (uveitis), kidney disease, glaucoma, radiation, high blood pressure (hypertension) and long-term use of cortisone drugs can also cause cataract problems.

The age-related progressive clouding of the eye’s lens is the primary cause of cataracts. Loss of visual clarity occurs as a result of protein clumping and breakdown in the eye’s lens. Cataracts tend to manifest more often in people over the age of 60 due to the inevitable structural changes that occur in the eye with aging.

Smoking, prolonged exposure to ultraviolet (UV) light, and certain medical disorders, such diabetes, are also major contributors to cataracts. Cataracts may develop more quickly when exposed to the sun’s ultraviolet (UV) rays, which hasten the breakdown of lens proteins. Additionally, the lens might be damaged over time due to the toxic compounds produced by smoking. Furthermore, cataracts are more common among diabetics since the disease is associated with blood sugar swings, which may harm the eye.

Possible risk factors for cataract formation include eye injuries, long-term use of certain drugs (such as corticosteroids), and history of eye surgery. Cataracts are more likely to develop when certain conditions alter the lens’s structure or induce inflammation.

Additionally, heredity plays a role, making some individuals more susceptible to acquiring cataracts at an earlier age than others. Early onset cataracts are more common in families when the condition runs in the family.

Sunglasses with ultraviolet (UV) protection, a balanced diet, and not smoking are some of the preventative steps that might lessen the likelihood of developing cataracts. Preventing or postponing the beginning of cataracts, a frequent eye ailment, requires an understanding of its origins.

Is there a drug treatment for cataract?

Any form of treatment other than surgical methods is not valid for cataracts. Although there are some drugs that have been experimented on, no successful results have been obtained yet.

At this time, no pharmacological therapy exists for cataracts. Cloudiness of the eye’s lens, which occurs naturally with age but cannot be remedied with medicine, leads to cataract development. Surgery to remove the clouded lens and implant an artificial intraocular lens (IOL) is the only option for treating cataracts.

Because they can’t fix the structural changes that happen within the lens of the eye, medications or eye drops can’t dissolve or remove cataracts. Potential pharmaceutical therapies for preventing or slowing the development of cataracts are the subject of ongoing research, however at this time, these medicines are only accessible to those in the experimental phases of the study.

One of the most popular and safest procedures done on a global scale is katarakt surgery, which is a very successful surgical treatment option. By exchanging the defective lens with a new, artificial one, the operation fixes blurry vision and, in many cases, improves eyesight instantly.

Delaying the onset of cataracts is possible with preventative actions such as not smoking, eating healthily, and wearing sunglasses that block ultraviolet light. The only way to restore eyesight when cataracts have severely impaired it is via surgery. Because there is presently no medication that can cure cataracts, it is more important than ever to have your eyes checked regularly in order to catch the condition early and devise a treatment strategy.

In which cases is cataract surgery inevitable?

When cataracts cause severe visual impairment, making reading, driving, or recognizing faces difficult, surgery to remove the cataracts is the only option. Cataracts gradually enlarge and obscure the eye’s lens, making vision less clear, more sensitive to light, and impaired night vision. The only way to alleviate these symptoms to a satisfactory degree is to undergo surgery.

Beyond visual impairment, there are medical reasons why surgery may be essential in some circumstances. To avoid future difficulties, surgery may be necessary if the cataract raises intraocular pressure, which increases the risk of glaucoma. Cataract removal may also be required to allow a clear picture of the retina for the correct treatment of other eye disorders including diabetic retinopathy.

When cataracts reach their hypermature or mature stages, the lens becomes very hard and might induce inflammation or other problems; doctors may also advise surgery at this point. Surgery becomes more complicated and even dangerous if postponed in many circumstances.

If avoiding more eye problems and restoring clear vision are your only options, then katarakt surgery is unavoidable. Patients may expect a significant enhancement to their standard of living after undergoing this safe and extremely successful operation. To determine whether katarakt surgery is the correct decision, it is important to get a diagnosis early and have frequent eye examinations.

Surgery is recommended in case of any of the following situations:

Observation of conditions that may lead to congenital cataracts and loss of vision (strabismus)

Raised eye pressure due to cataracts

Having visual impairment that cannot meet daily needs

The formation of cataracts due to a problem such as inflammation in the eye and the difficulty of treatment and follow-up

What are the surgical methods for cataracts?

Cataract surgeries have been performed for a long time with a method called FAKO. FAKO is a needle-free, sutureless and painless surgical method.

The eye to be operated on is anesthetized with only drops, an incision of 2.2-2.4 mm is made into the eye. In the surgery, where all procedures are performed through this small incision, first of all, a round piece is peeled from the front part of the membrane surrounding the katarakt lens.

Then, with the help of a device called phaco and working with ultrasonic sound waves, the lens with katarakt is divided into small pieces. Then, these small parts are cleaned by suction with the phaco device. An artificial intraocular lens suitable for the patient’s eye is placed in the pocket consisting of membranes, the interior of which is completely cleaned. At the end of the surgery, an antibiotic is injected into the eye. Finally, the incision is closed seamlessly.

The most common method developed today is “Femtosecond Laser Surgery”.

Due to the initiation of Laser application in surgeries, surgeries can now be performed in a much safer, safer, comfortable way with a reduced risk of complications compared to the classical phaco method.

In the laser method, the patient’s eye is anesthetized with drops. First, the patient’s eye, which is placed under the laser device, is applied to create an incision, open a window in the anterior capsule and split the lens into pieces by means of a computer-controlled laser, in a way that the patient does not feel (about 30-45s).

The patient is then placed under the operating microscope. Here, by entering through the incision created by the laser (without a blade), the lens pieces that the laser has broken apart are sucked with the Phaco device and cleaned in a short time. In the next step, an artificial intraocular lens is placed, antibiotics are injected into the eye and the surgery is completed.

What is done before cataract surgery?

Various tests can be performed for this surgery in cases deemed necessary depending on other diseases the patient has, the age of the patient, the drugs used, and the type of surgery to be performed.

Before the operation, the patient should inform his physician about all the drugs he is using and follow the advice he will give according to the type of drugs. Some medications can be administered orally, on the arm, or on the hip before or after being taken into the operating room.

You should not eat or drink anything at least 6 hours before the surgery. The person must have a companion with him. Make-up should be removed and jewelry should be removed, as some drops will be dripped into the eyes and redness may occur in the eye.

In order to assess the severity of the cataracts and your general eye health, a thorough eye exam is performed prior to surgery. Before prescribing an intraocular lens (IOL) to treat nearsightedness, an ophthalmologist will take precise measurements of your eye. Because this lens will cover your hazy natural lens during surgery, choosing the correct one is critical for the best possible outcome.

It is common practice to advise patients to discontinue the use of blood-thinning drugs and those that raise the risk of bleeding in the weeks before surgery. The specific drugs to avoid and when to stop taking them will be laid out in great detail by your doctor. In order to avoid infection both before and after surgery, you may be given antibiotic eye drops.

In addition, you and your doctor will decide which intraocular lens (IOL) is ideal for your eyes and way of life. There are a variety of lenses available, including monofocal lenses (which only correct vision at one distance) and multifocal or toric lenses (which correct astigmatism in addition to near and far vision).

Because you will have hazy vision immediately after surgery, you should make transportation arrangements for a ride home in advance. Preparation for surgery is key to having a successful procedure that goes off without a hitch. A speedier recovery and improved eyesight after katarakt surgery are possible outcomes of meticulously following these instructions.

Do cataracts recur?

After having surgery, the condition will not return. It is impossible for cataracts to develop when an intraocular lens (IOL) has been implanted to replace the natural clouded lens. Since the surgically implanted artificial lens does not degrade or become clouded over time, patients experience no loss of visual clarity.

However, posterior capsule opacification (PCO) is a disease that may occur months or even years following surgery in some situations. In a process comparable to katarakt, posterior chamber opacity (PCO) develops when the membrane encasing the intraocular lens (IOL) becomes hazy. This is a typical adverse reaction after surgery and is not a sign of future cataracts.

The good news is that YAG laser capsulotomy, a painless and fast laser surgery, may effectively cure PCO. Without undergoing further intrusive surgery, this outpatient technique restores eyesight by clearing the clouded membrane. Patients are usually able to resume their regular activities immediately after the operation, and the benefits are usually seen straight away.

While cataracts never grow back after surgery, postoperative kataraktopacity (PCO) may be successfully managed to keep eyesight clean. To monitor your eyesight and make sure they stay healthy following surgery, it’s important to see your eye doctor often for follow-up visits.

Re-cataract formation is not observed in those who have undergone surgery. With the operation, the membrane in which the lens is placed may become thicker over time. Although the popular term for this is “secondary surgery”, it is not a katarakt.

This formulation can usually be easily treated with a laser. In children or in rare cases where the membrane becomes very thick, it may be necessary to surgically clean this formation.

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