Restore your vision with cataract surgery

Cataracts are an age-related clouding of the lens of the eye and the most common eye disease. The eyes natural lens changes over a lifetime, growing bigger and thicker to a limited extent. As a result, the inside of the lens becomes increasingly dense, which leads to cloudiness. Metabolic changes in old age or even injuries also contribute to this.

This process occurs in everyone at some point in their life. The cataract usually begins to impair vision around the age of 60. You may notice the cataract as a cloudy visual impression, a grey vale over your vision, and a sudden change in glasses strength.

Cataract surgery is the most common and most successful operation in eye surgery. 15 million procedures are performed annually.

During cataract surgery, the eye surgeon removes the cloudy lens and replaces it with an artificial lens. We can use different kinds of lenses to correct long-sightedness, short-sightedness, astigmatism and presbyopia.

During a consultation and examination, we will examine your cataract. Using this information, we can inform you about the different treatment options.

The treatment of a cataract is generally covered by public health insurance. At Eyelaser, we can offer you many years of surgical experience and the most modern lens implants – without months of waiting time. We can even help you achieve complete independence from glasses if we find you suitable.

All about the operation

The only treatment option for cataracts is surgery. To date, there is no effective alternative that can prevent or fix cataracts.

We perform this 15-minute procedure using local anaesthesia, which we apply in the form of eye drops.

Step 1: The surgeon removes the clouded lens through a tiny incision.

Step 2: The surgeon implants an artificial lens that has been precisely calculated ahead of the procedure in its place.

Thanks to modern lens technology, we can tailor the lenses to suit your individual needs. For example:

• We can create lenses to provide optimal distance or near vision.
• Toric intraocular lenses (IOL) make it possible to correct astigmatism.
• Multifocal IOLs or EDOF (enhanced depth of focus) IOLs can correct all ranges of vision. These can remove your dependence on glasses and contact lenses entirely.

In order to achieve the best possible result, a comprehensive and precise examination and measurement of the eye, as well as an in-depth consultation is of great importance. We are happy to take the time to explain all possible variations and options to you and to match them with your wishes and ideas.

Already a few days after the surgery you can enjoy your “new eyes”, even though a certain period of habituation and slight fluctuations in visual acuity during the first weeks are quite normal. During this time, eye drops help with care and controlled wound healing.

Despite precise measurement and calculation, in rare cases the wound healing process may cause a deviation from the desired goal. But don’t worry, even then the result can be perfected by means of a short correction intervention.

Cataracts – How to spot them

The clouding of the vision often becomes noticeable in the dark. Patients often say that they feel like they are looking through soiled glasses or a dirty windowpane. But everyone experiences cataracts differently. The clouding of the lens goes quickly with one person, with another very gradually.

Often the lens becomes cloudy to such an extent that the nearsightedness increases sharply. You may be unable to see anything without glasses.

Either way, you should quickly arrange to see an ophthalmologist. We will need to examine the eye and carry out some tests. Using a slit lamp, we can determine whether a cataract is present or whether other causes are responsible. This usually involves dilating the pupil.

Cataract surgery is one of the safest and most successful procedures in medicine. The doctor and the patient decide together the right time for the operation, depending on the intensity of the symptoms.

The operation

The preliminary examination

To guarantee the highest degree of safety and precision during the operation, we first need to conduct an extensive examination. During this examination, we will take many measurements to establish the precise fitting of the artificial lens.

If you take medication, it is helpful to bring a report from your GP with you.

We will need to dilate your pupil with medication before the examination. Therefore, please note that you should not drive for 3 hours following this examination. Ideally, you should be collected from the clinic by someone you trust.

The day of the operation

On the day of the operation, please have a normal breakfast and take your medication as usual. However, please refrain from wearing make-up, face creams, perfume or eau de toilette.

Local anesthesia

Generally, we anesthetize the eye with eye drops during the operation. This keeps the impact of the procedure on the body to a minimum, and the effect wears off quickly. In addition, we can provide a small dose of sedative. In rare cases, we can give an injection next to the eye or a general anaesthetic if we feel that you need the eye to be immobilised.

Preparation

After dilating the pupil with the help of drops or the insertion of a tablet into the palpebral fissure, we will lead you to the operating theatre in special surgical clothing (gown, cap, etc.).

We will position you on the operating table and cover the operating area with sterile drapes and foil.

We then insert an eyelid holder to keep the eye open during the procedure. To prevent the eye’s surface from drying out, we moisten the eye with a special fluid.

The operation

The surgeon operates using a high-resolution microscope. With a steady hand, they make a tiny incision in the eye. Through this access, the surgeon can open the lens capsule. Now the surgeon can crush the cloudy lens and suction it out with the help of ultrasound waves. What remains is the empty lens capsule.

The surgeon can now insert the new tightly rolled lens into the eye through the small incision. The lens will unfold slowly.

The surgeon will then seal the wounds and insert an antibiotic into the eye to prevent infection.

Finally, the surgeon will apply a temporary eye patch to protect it.

Can there be complications?

Cataract surgery is one of the safest and most successful procedures in medicine. However, surgery always involves risks. Up to 95% of all operations of this type are uneventful, with complications in the remaining cases. However, these are complications that can be treated directly by the doctor, so no problems remain.

Below are some of these potential difficulties and what we can do about them:

• In rare cases, the intraocular pressure may rise or fall after the operation. Treatment is usually with eye drops or tablets.
• Swelling of the cornea can delay the recovery of visual acuity after surgery. In most cases, no special treatment is required. In extremely rare cases – especially in the case of congenital weakness of the innermost corneal layer – a corneal transfer may be necessary.
• If the structure of the eye is too weak, we cannot fit the artificial lens. We must then implant the lens in front of the capsular bag, fixed to the iris or sewn in. Special eye drops are usually effective against retinal swelling. Rarely, a so-called IVOM (injection of medication into the eye) may be necessary.
• Retinal detachments as a result of cataract surgery are extremely rare events. In this case, treatment is carried out by laser or another operation, the so-called pars plana vitrectomy (PPV).
• Even the loss of vision or the eye cannot be ruled out with absolute certainty – for example, mass hemorrhage or severe infection. The risk of this, however, is not even in the per thousand range.

After the procedure: how to proceed

We will apply an eye cup to protect the eye from involuntary touch during the first night after the operation.

In the first few days, the eye may water a little and scratch. Sensitivity to light and glare is not uncommon either. Vision is still somewhat blurred, and visual acuity fluctuates during the first few days. After one week, the symptoms are usually significantly improved. You will achieve the final result after approx. 8 to 12 weeks.

During this time, there are a few things to note:

• You must take the prescribed eye drops as directed by the doctor. You cannot overdose. If the eye is moist enough, the excess amount of liquid simply escapes. When in doubt, it is better to use one drop too much rather than too little.
• We will arrange a check-up on the day after the operation and in the period afterwards.
• Avoid touching the eye during the first weeks, especially strong pressure on the eyeball.
• A few days after the operation, it is okay to wash your hair and face, but with due care. You should avoid contact with soap and shampoo. We recommend postponing sauna visits and swimming for after 6 – 8 weeks at the earliest.
• Avoid eye make-up and eye creams for the first four weeks.
• Driving a motor vehicle is usually possible again after approx. one week. However, a release by the ophthalmologist is necessary.
• Refrain from heavy physical exertion in the first week after the operation and avoid dirty or dusty environments. Normal physical activity – e.g. in the household – is not problematic. The general guideline is: feel and use common sense. Avoid anything that seems unwise or risky and interrupt your activity if it causes discomfort.
• If your vision shakes or flickers during the first few weeks after the operation, this is no cause for concern. The artificial lens adjusts slowly into the new environment so that it starts to sit a little loosely. During this time, light may be refracted at the edge of the lens. This can cause reflections that look like crescent-shaped objects. You may feel scratching in the eye or notice that the new lens feels like a foreign body. This is normal. The incisions in the eye are healing, and the surface of the eye is drying faster than normal because the eye drops contain cortisone. You can counteract this with artificial tears (jelly or drops). After a while, these symptoms disappear completely.

Generally, vision recovers within a few days after the operation. However, fluctuation in visual acuity or moderate discomfort such as a foreign body sensation or eye tears may persist for some time. If the result still deviates from the desired goal due to wound healing, a correction with temporary glasses may be useful.

In the case of emergencies

If you suddenly experience severe pain or an abrupt deterioration of your vision, please contact an ophthalmologist immediately or visit the emergency outpatient clinic. Even if you suddenly see flashes of light and “black clouds” in one eye – an immediate clarification is necessary. If in doubt, don’t hesitate to contact us.

Secondary cataract

The artificial lens is usually implanted in the capsular bag, which surrounds the lens like a natural shell. In the course of the wound healing, the tissue first shrinks and sometimes becomes opaque. This results in a slow deterioration of vision and blurred vision. We call this an “after-cataract”, and it can appear in some patients after only a few weeks or after many years. But – no need to worry. With a short and painless laser treatment, we can remove the after-cataract within a few minutes. A recurrence after the laser treatment is virtually impossible.

Preparation

We will give you local anesthesia in the form of eye drops or a syringe next to the eye.

Aspirating the lens

In the first step, we will make a small incision on the edge of the cornea, which allows us to access and liquify the natural lens and suction it out.

Inserting an artificial lens

We can now insert a multifocal lens in its place. The multifocal lenses – as the name suggests – enables the eye to focus at multiple distances. This means you can see near and far again after the procedure.

Postoperative phase

After the procedure, we will apply eye patches. This will prevent environmental influences such as dirt and dust from entering the eye and slowing down the healing process.

The eye will heal well in the next few days.