Cataract
Medical information gathered by Dr. Marco Abbondanza on experience with ocular surgery.
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The eye is made up of two lenses, the outermost being the cornea and the inner the crystalline. The crystalline, which has a round flat shape, directs bright rays onto the retina. It must be totally transparent to allow light to filter correctly onto the retina and the patient to see well.
There are several types of cataracts.
congenital
post-traumatic
resulting from general illness
resulting from senile ocular illnesses
Normally cataract appear with old age although more and more patients under 50 have this problem. Once opacity has begun, it will progressively worsen. Until now no medication exists which can slow this process. Surgery is the only solution available today: the opaque crystalline is extracted and substituted with an artificial one, with the same optical power of the natural lens.
Symptoms
The first symptoms of cataract are the following:
cloudy vision
weak eyesight
trouble with lights
rings around lights
myopia or worsening of this condition
Surgery
At one time cataract were only operated when "mature" or when a person couldn't see well any longer.
Today this is false and inaccurate.
Cataract are currently operated when a person has problems with vision in his everyday life, depending on his lifestyle.
Today sophisticated equipment make surgery very safe. Complex microscopes and ultrasound machinery melt the opaque crystalline and then suction it through 3mm incisions.
Two techniques are used:
Programmed extra-capsule extraction
Phacoemulsification
Programmed extra-capsular extraction
An incision of 6-12mm is made along the border of the cornea, opening the fore crystal capsule. The center of the crystalline is extracted through this incision and the artificial crystalline is inserted where the natural lens was.
10/0 nylon is then used to stitch the incision.
Phacoemulsification
With this technique, the natural crystalline is melted with ultrasounds. Through an incision between 2 and 3,2 mm, a tiny probe with three ways is inserted through a 3,2mm incision, bringing the ultrasounds directly to the crystalline. Once this has melted, it is suctioned and a soft artificial crystalline rolled like a small cylinder is then inserted through the same incision into the eye. It opens up and takes the place of the natural lens which was earlier eliminated.
Sometimes one stitch is applied but often none are required.
Which is the best technique?
The best technique is by all means phacoemulsification since it has a very quick recovery of vision and gives fewer problems.
There are also fewer risk factors than those involved with extra-capsular extraction.
This doesn't mean that extra-capsule extraction is dangerous; on the contrary, many times it is the best technique to use. The condition of the patient's eye determines the choice.
When can vision increase?
Dr. Abbondanza is among the first surgeons to use the technique of optical correction during cataract surgery. Before, when the opaque crystalline (the cataract) was extracted, an artificial lens having certain powers was used in its place. Through this crystalline, better vision was obtained, coming into focus clearer. But a far-sighted person would still need reading eyeglasses.
Now, thanks to a new technology used by Dr. Abbondanza, the patient operated for cataract can see well both near and far after having this operation without any need for eyeglasses!
Therefore it's possible for the patient to see as naturally as he did before the age of 40.
Of course all this can happen when the rest of the eye is normal and there aren't other factors causing poor vision, like for example damages to the retina.
Post-operative course
The healing process and recovery of vision is brief thanks to modern surgical aids allowing a patient to go on with his life and return to normal habits.
The patient must remember that this is an operation and occasionally things may not turn out as the surgeon planned. Sometimes complications set in either because the patient failed to carry out post-operative therapy or due to particular anatomical characteristics of the patient.
However, these cases are rare since most cataract operations are completely solved in just a few
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