CATARACT: ADVANCED MICROSURGERY TO GET BACK PERFECT VISION
The eye consists of two lenses, the outermost being the cornea and the innermost being the crystalline. The crystalline, which has a biconvex flat shape directs light rays onto the retina and must be transparent to allow light to filter correctly onto the retina and the patient to see correctly. Cataract consists in opacity of the crystalline lens. Several types of cataracts exist:
- resulting from general illness
- resulting from senile ocular illnesses
Dr. Abbondanza has been performing innovative surgery for cataract for over 30 years, becoming one of the most experienced surgeons in this field.
Normally cataract appears with old age, although more and more patients under 50 have this problem. Once cataract formation has begun, the opacity of the crystalline lens will increase progressively. Currently no medication exists which can slow this process. Surgery is the only solution available today and consists in extraction of the opaque crystalline which will be substituted with an artificial lens.
The first symptoms of cataract are the following:
- cloudy vision
- low eyesight
- trouble with lights
- halos around lights
- myopia or worsening of this condition
Today’s sophisticated equipment has made surgery very safe. Advanced microscopes are available and ultrasound equipment melt the opaque crystalline which is then aspirated through small 3mm incisions.
Two techniques are currently used:
-Programmed extra-capsule extraction
-Phacoemulsification cataract surgery
Programmed extra-capsular extraction
An incision of 6-12mm is made along the border of the cornea, then the anterior crystalline capsule is opened. The center of the crystalline is extracted through this incision and the artificial crystalline is inserted where the natural lens was originally. Finally, 10/0 nylon is used to stitch the incision.
With this technique, the natural crystalline is melted with ultrasounds. Through an incision of between 2 and 3,2 mm, a tiny three way probe is inserted into the anterior chamber bringing the ultrasounds directly to the crystalline. Once the crystalline has melted, it is aspirated and removed, then a soft artificial crystalline rolled like a small cylinder is inserted through the incision into the eye. The artificial lens takes the place of the natural lens which was eliminated. Sometimes one stitch is applied but often none are required.
Which is the ideal technique?
The best technique for cataract surgery is by all means phacoemulsification due to quick recovery of vision and fewer post surgical problems.
There are also fewer risk factors than those involved with extra-capsular extraction.
This does not mean that extra-capsule extraction is in disuse; on the contrary, often times it is the best technique to use. As usual, the condition of the patient’s eye determines the choice.
When can vision be improved?
Dr. Abbondanza has been among the first surgeons to use the technique of multifocal optical correction during cataract surgery. In the past when the opaque crystalline (the cataract) was extracted, an artificial intraocular lens having a certain power was fixed in its place. By use of this lens, better far vision was obtained, but patients would still need eyeglasses for reading.
Now, thanks to a new technology adopted by Dr. Abbondanza, the patient operated for cataract can see better both at near and far without eyeglasses.
Therefore it is possible for the patient to see as naturally as he did before the age of 40.
Of course this is possible when the rest of the eye is normal and there are no other factors causing poor vision, like for example, retinal damage.
The healing process and recovery of vision is quick thanks to modern surgical techniques. This allows the patient to resume his previous lifestyle in a very short time after surgery.
However, the patient must remember that like all surgical procedures, rarely results may not be as the surgeon planned. Sometimes complications occur either because the patient failed to carry out post-operative therapy or due to particular anatomical characteristics of the patient.
However, these cases are very rare since most patients recover from cataract operations in a matter of days.