Lens Implant: Basic To Guide Cataract Surgery

A lens implant provides a viable way to restore the focusing power of a natural lens following a cataract surgery.

Benefits of a lens implant

Patients who undergo a cataract surgery have three options to restore vision: glasses (spectacles), contact lens and a permanent intraocular lens implant (IOL). Spectacles provide optimal lens power, but are not ideal for cataract surgery on one eye. This is due to the magnification effect induced by one thick lens, which has the capacity to compromise binocularity.

When it comes to contact lens, patients can use them on both eyes, but some people struggle tolerating these types of lens, particularly children. Intraocular lens implants, on the other hand, are more comfortable and promote better vision. IOLs have been used successfully for a number of years. Until recently, patients were given only one option in the form of standard intraocular lenses, which are monofocal. The lenses are designed to focus at one vision range.

Nowadays, cataract and presbyopic patients can take advantage of advanced lenses capable of providing optimum vision at all ranges: near, middle and distant. The multifocal lenses eliminate the need to use spectacles when engaging in a wide variety of activities. When the spectacles are needed, patients use a milder prescription than monofocal lenses.

Multifocal units have been shown to provide exceptional visual quality, thus making them a viable solution for patients with various conditions, including presbyopia, cataracts and astigmatism.  Presbyopia is an age-related ophthalmological disorder that deteriorates vision at close range.

IOLs provide a flexible solution to suit varying needs. A custom fit ensures overall comfort and superior vision, which contributes to a positive effect on the patient’s life. Cataract patients no longer have to worry about deteriorating vision. Intraocular lenses drastically reduce the risk for vision aberrations. The solution also minimizes problems associated with night vision, glares and halos.

Additional benefits of eye lens implants

– The presence of the lens is imperceptible (the IOL is located behind the iris and pupil)

– Lens does not interfere with separate eye functions

– Stays in a fixed position and does not need regular adjustment

– Provides a permanent solution unlike contact lenses

– Provides flexibility by allowing patients to wear spectacles or contact lenses, if necessary

– Short post-operative recovery time

– Cataract surgery does not alter the eye unlike procedures involving laser (no tissue is removed)

– The lens implant procedure is reversible

Cataracts

Cataracts contribute to vision loss in millions people over the age of 40. The problem is more prevalent when compared to macular degeneration, glaucoma and diabetic retinopathy. It is characterized by the clouding of the natural lens, which is located behind the pupil and the iris. The number of people affected by the condition is expected to rise in America and the rest of the world.

The Cataracts can be grouped into three types.

These include:

– Cortical cataracts have white, wedge-like opacities, which are known to begin at periphery of the lens. They eventually spread to the centre and have a spoke-like appearance.

– Nuclear cataracts originate from deep within the central zone or nucleus of lens and they are typically caused by ageing.

– Subcapsular cataracts appear at the back of the lens and they usually affect people taking high doses of steroid drugs and diabetes sufferers.

Cataract symptoms

Cataracts cause minor effects on vision when they first appear. The blurry vision may make light from a lamp or the sun appear brighter than usual. As a result, drivers may notice that oncoming headlights cause disturbingly high levels of glare than before. On the other hand, colours may seem duller.

Symptoms are determined by the type of cataract affecting one’s eyes. Nuclear cataracts tend to cause a temporary improvement in near vision. This happens during the early stages of the cataract’s development. However, the optimal vision disappears as the condition worsens. Conversely, a subcapsular cataract does not show any signs until the problem reaches an advanced stage.

Causes of cataracts

The lens plays a crucial role in ensuring clear vision and it is made of protein and water. The protein is intricately structured to help keep the lens clear. With age, the structure may deform due to clumping of protein. As a result, the deformation leads to cloudy and hazy vision. The clouding, which occurs over a small area is a cataract that grows over time. A larger cataract makes it increasingly difficult to see.

Scientists have identified a number of potential causes of cataracts apart from ageing. These include:

– Obesity

– High myopia

– Smoking

– Diabetes

– Hormone replacement therapy

– High doses of steroid medications

– Hypertension

– Statin medications used to lower cholesterol

– Significant alcohol consumption

– Ultraviolet radiation

– Eye inflammation

– Family history

Cataract prevention

Research studies have shown that diets high in antioxidants can help prevent certain types of cataracts. The best sources include vegetables and fruits. One study conducted over a period of 10 years demonstrated that high intake of vitamin E, zeaxanthin and lutein may reduce risks of developing cataracts. Some of the good sources of vitamin E include spinach, almonds and sunflower seeds.

Carotenoids lutein and zeaxanthin can be found in green, leafy vegetables like kale and spinach. Some researchers are convinced that foods containing omega-3 fatty acids and antioxidant vitamins can help prevent the development of cataracts. Protective sunglasses also provide a practical way to block the harmful effects of the sun’s ultraviolet (UV) rays.

Cataract surgery

Cataract surgery is aimed at removing the cloudy lens and replacing it with a lens implant. This helps restore clear vision. In most cases, the procedure known as phacoemulsification or phaco does not require overnight stays in a healthcare facility like Sight Clinic. It entails the use of a high-frequency ultrasound device designed to rupture the cloudy lens into pieces. Once the lens has been broken up, the pieces are carefully extracted from the eye using a suction mechanism.

The procedure can be performed using smaller incisions to achieve shorter post-operative recovery times. Doing so has the capacity to reduce the likelihood of developing cataract surgery complications like retinal detachment. The procedures also involve the insertion of a clear intraocular lens. It is placed carefully and securely behind the pupil and the iris where it is imperceptible. The patient feels comfortable because the lens does not shift or irritate the eye.

It is possible for the surgeon to position the lens in front of the iris and pupil. This is only done in special cases. The replacement surgery is completed by closing the incision before placing a protective shield over the patient’s eye. The shield plays a critical role in the cataract surgery recovery phase.

The US Food and Drug Administration (FDA) recently approved a number of advanced femtosecond laser cataract surgery equipment. The lasers are designed to reduce the need to use hand-held, such as surgical blades. They can fragment the cataract, extract the lens anterior capsule and create peripheral corneal incisions.

Preparing for cataract surgery

Eye doctors perform a comprehensive eye exam before surgery. This is aimed at evaluating the health of the patient’s eyes. The procedure may be cancelled if the ophthalmologist identifies any risk factors. During the examination, the practitioner evaluates the patient’s near or far-sightedness. The eyes are measured to determine length and curvature of the cornea.

Measurements enable the practitioner to use the appropriate lens power to achieve optimal vision. The surgeon also needs to administer preoperative medications and dilate the patient’s pupil.

Cataract surgery recovery

The procedure can take only 15 minutes if there are no complications, but patients can expect to spend more than an hour at the healthcare facility. The preparatory phase and post-operative evaluation and briefing sessions form part of the surgery routine. Patients should avoid driving following a cataract surgery until the doctor has given them the green light. Follow-up tests help determine when its safe to drive.

Patients use eye drops on a daily basis for a few weeks and are expected to wear the protective shield while sleeping. In addition, the doctor gives the patient a pair of post-operative sunglasses that are designed to protect the eyes from bright light. In some cases, physicians may request patients to be accompanied by someone. This is aimed at ensuring a safe trip home after receiving anaesthesia.

During the recovery stage, patients may notice some blurred vision and eye redness. This usually dissipates within a few days or weeks.

Physicians provide detailed guidelines about what to avoid. Some the activities to avoid include:

– Exposure to infection-causing contaminants, including grime and dust.

– Strenuous physical activities, such as heavy lifting

– Water splashes into the eye that might cause an infection. Swimming and hot tubs are not recommended and eyes must be shut when bathing

–  Bending, exercising and similar activities have the capacity to stress eyes

The surgeon may provide additional recommendations based on specific needs to ensure faster recovery and a positive outcome.

Cataract surgery cost

In the United Kingdom, the cost of cataract surgery hovers between £1,800 and £3,000 depending on the healthcare facility. The charges incorporate the physician’s fees and other related charges. It is possible that some physicians and facilities in other cities charge differently depending on a wide variety of factors. Cataract surgery procedure cost relatively more in London when compared to facilities in northern parts of the country.

Some of the key factors that determine higher fees include quality and specialisation. A number of healthcare facilities, including the Sight Clinic offer special deals on a regular basis.

Macular degeneration

Age-related macular degeneration (AMD) affects the central portion of the retina. The condition triggers significant adverse changes to an individual’s vision, which makes it difficult to handle some everyday tasks. The macular features millions of photoreceptor cells known as cone cells. Patients suffering from the condition have damaged cone cells, thus undermining their ability to function properly.

Some of the symptoms of macular degeneration include experiencing difficulty reading small print. Additionally, sufferers have a blurry vision and straight lines may seem distorted or wavy.

AMD comes in different types, including dry and wet age-related macular degeneration. The most common variant is the dry AMD, which entails a gradual development and the appearance of symptoms. In the advanced stages, the condition results in a black patch in the central part of the retina. In turn, an individual notices the centre patch in their vision. Wet AMD, on the other hand, progresses rapidly and damages central vision in a matter of days or weeks.

The body responds to damage by growing new blood vessels. However, this leads to swelling and bleeding below the macula. As a result, scarring may occur and the central vision is affected by the appearance of a blank patch. Peripheral vision remains unaffected despite these developments. Early detection of age-related macular degeneration can help prevent loss of central vision.

Doctors treat the condition with laser coagulation or medication designed to inhibit the growth of blood vessels. Some healthcare facilities have previously used photodynamic therapy to treat wet macular degeneration. The procedure entails the administering of the drug verteporfin intravenously. This is followed by the use of light of a particular wavelength to target the blood vessels. This action is designed to activate verteporfin, which leads to the destruction of the vessels.

Cataract surgery has the capacity to improve visual outcomes for patients suffering from age-related macular degeneration. Studies have shown that AMD patients that undergo cataract surgery within two weeks experience improved visual acuity. In contrast, patients who underwent the procedure late (after six months) did not show the same positive outcomes.

Avastin treatment for eye diseases

Ophthalmologists leverage the power Avastin to treat patients suffering from a wide variety of eye disorders, including macular degeneration. The treatment helps prevent blindness caused by retinal and other diseases. Avastin is also effective when used in the treatment of central vein occlusion (CRVO) and diabetic macular edema.

A number of eye complications can lead to the abnormal growth of blood vessels. These include histoplasmosis, wet macular degeneration, eye injury, high myopia (nearsightedness) and angioid streaks. Timely intervention is required to prevent loss of vision. Chronic macular edema affects vision by causing swelling in the central part of the retina. The condition is resistant to standard medications, such as eye steroids.

Avastin is approved by the FDA for the treatment of metastatic colorectal cancer. Physicians later discovered its capacity to treat age-related macular degeneration and similar disorders that cause the abnormal growth of blood vessels. The medication’s mechanism of action involves the blocking of a substance called endothelial growth factor or VEGF.

VEGF is also linked to eye disorders and listed as one of the major causes of abnormal vessel growth. A patient suffering from eye disorders experiences relief as the medication reduces fluid in the vessels, thus leading to improved vision and the disappearance of enlarged blood vessels. For this reason, medical practitioners use Avastin to treat macular edema in diabetic patients

Avastin treatment is primarily aimed at counteracting further loss of vision. However, the medication lacks the capacity to restore lost vision. Yet, it is possible for some patients to react positively to the treatment and regain vision.

Avastin eye injection procedure

The physician first dilates the patient’s eye and administers anaesthesia in preparation for the injection. This is followed by the injection of a jelly-like substance, which is deposited in the back part of the eye. The injections may be administered at regular intervals (after every few weeks), if deemed necessary.