Treatment and Surgical Complications of Cataract.

When a person complains of  Cataract Eye  Symptoms, he has to undergo certain tests to confirm his eye cataract.  Once the cataract is confirmed,  he is taken up for treatment of cataract which is mainly cataract eye surgery. Testing for cataract, surgery options for cataract and complications that may arise after cataract eye surgery is  discussed in this article.

Testing for cataract:

• Eye drops are put into the eyes to dilate the pupils. With the help of an ophthalmoscope, the  lens of the eyes are examined to look for any opacity that may have developed in the lenses of both the eyes. This test will also help to rule out any other eye pathology, which may have reduced your vision. The opacity of a mature cataract can be seen even with the naked eye as shown below.

Image of normal and cataract eye.

• Visual Acuity test for cataract is carried out using the conventional Snellen’s chart to test for close and distant  vision.
• Refraction for cataract is done to determine if there has been any change in your eye glasses.
• Color Contrast Sensitivity for cataract testing is carried out to see if you can determine the difference in the various shades of gray, which you will not, if you are having cataract.
• Glare testing  for cataracty is done to test your tolerance against light with different light sources of varying potential.
• Tonometry for cataract is done to measure fluid pressure inside your eyeballs, to rule out Glaucoma.

Treatment of Cataract:

About 3 million Americans undergo Corrective Eye Cataract Surgery every year and 9 out of 10 regain their good  eye sight. If both eyes have developed Cataract,  surgery is performed only on one eye at a time. After seeing the prognosis of the surgery on the first eye, the second eye is then taken up for surgery after due period.

After the cataract has matured, surgery is the only proper option. Basically, cataract eye surgery consists of making an incision into the capsule of the lens and the cataract lens is removed. The surgery for cataract takes about 30 minutes and the patient is sent home the same day.

Cataract eye surgery options are explained below:

• Extra capsular surgery for cataract consists of making a small incision in the capsule of the lens and cataract lens is then broken into tiny fragments by sound waves using an ultrasound probe. The fragmented pieces are then sucked out through the same probe. An intra ocular lens  (IOL) is then implanted back into the capsule. This procedure is called Phacoemulsification.  This is the procedure that is followed nowadays.

Sometimes, the lens is too mature and dense to be dissolved by ultra sound technique. In such cases, a larger incision is required to be made so that the whole lens is removed from the capsule and a new IOL is then implanted through the ultrasound probe. The incision is then sutured. This surgery requires an injection of local anesthesia to be injected into eye.

• Intra Capsular Surgery for Cataract is not performed nowadays. In this surgery, the lens is removed along with the capsule and the new lens implant is then placed in a new position in front of the iris. This procedure is useful in cases of eye trauma where the capsule of the lens is also damaged.
• Laser Eye Surgery for cataract is an option which is not popularly followed. In this procedure an incision is required and the cataract lens is broken into small pieces with the help of the laser. The fragments of the cataract lens are then removed. However, laser treatment for cataract is useful when the posterior surface of the capsule of the eye lens becomes cloudy, sometimes years after cataract surgery. This produces blurring of vision. An opening is then made into the affected part of the capsule to restore vision. This is a painless procedure and  takes little time.

Post operative Care after Cataract Surgery:

• Periodic visits to your Eye Surgeon.
• Use Eye Drops several times during the day to prevent infection and inflammation.
• Do not bend, stoop or lift heavy objects. This will prevent pressure from being exerted in the eye.

The Cataract Surgery Intraocular Lens (IOL).

IOL is made of plastic and stays in position permanently after it has been implanted.  Normally, a mono focal lens is implanted and use of eye glasses may be required to see near or distant objects clearly. However, more expensive multi focal lenses are also available and use of eye glasses with such a lens may or may not be required.

After Cataract Surgery Complications.

Cataract Surgery has a very high success rate. However, as with any surgery, the possibility of complications does exist. The complications  which may arise are:

• Bleeding in the eye.
• Swelling and/or Clouding of the cornea.
• Endophthalmitis is the inflammation of the endophthalmus, which is the innermost coat of the eyeball. This is a serious complication and if not controlled can result in loss of vision of that eye.
• Retinal Detachment is a condition wherein the retina peels off. This is a medical emergency and can result in loss of vision in that eye.
• Posterior capsular Opacification is a  complication which occurs after cataract surgery and involves cloudiness of the posterior part of the capsule. If it hinders visibility, then an opening is made in this part of the capsule with the help of laser to allow light rays to pass through.

Previous: Cataract – Causes, Symptoms and Prevention.

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