When is a cataract operation necessary and how does it work?

If the cataract is affecting vision, surgery can help. Find out everything you need to know about the process – such as its costs, potential problems afterward, and how to choose the right lens.

cataracts It is mostly age-related clouding of the lens of the eye. If it is not operated on, vision can deteriorate increasingly – in extreme cases it may even reach blindness. However, this rarely happens in Germany and other industrialized countries thanks to the cataract surgery available here.

Cataracts are the most common reason for surgery in Germany. Every year about 700,000 people in this country choose to have cataract surgery. The operation is usually very successful: more than 90 percent of sufferers can see better again afterward.

Cataracts: when do you work

When cataract surgery should be performed mainly depends on its effects. Lens opacities alone are not a reason for cataract surgery. Only when cataracts cause problems in everyday life does the process make sense.

It is therefore advisable to have regular eye examinations. You can discuss with your eye doctor directly when the time is right for a cataract operation.

The time of cataract surgery usually has no effect on the outcome. This is why personal desire is usually crucial to when you have surgery. However, sometimes, for medical reasons, it is advisable to have a cataract operation as soon as possible. For example when

  • Eye injury causes swelling of the lens
  • The fundus is sick but difficult to control because of cataracts
  • Final cataracts cause a sudden, severe rise in intraocular pressure (an attack of glaucoma or more severe .). green star)

important note:
Congenital cataracts also require early surgery: this is the only way to prevent affected children from developing permanent visual impairment.

How does the cataract operation work?

In the case of cataracts, the operation consists of removing the cloudy lens and replacing it with an artificial lens. Most cataract surgeries are performed under local anesthesia: Anesthesia can be used in conjunction with استخدام Eye They are injected or given as eye drops.

The most common surgical procedure used for cataracts is called phacoemulsification: the ophthalmologist removes only the nucleus and cortex from the lens. The capsule that surrounds the lens remains in the eye. This is how the process works:

  • First, a small incision is made at the edge of the cornea.
  • Then a small disc-shaped hole is cut in the front of the lens capsule.
  • The lens nucleus is liquefied through this access using high-frequency ultrasound and is suctioned out with the softer lens cortex.
  • Finally, an artificial lens is inserted into the remaining capsule.
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If a cataract affects both eyesight, it is common for surgery to be performed on only one eye initially. The cataract operation takes about 20 to 30 minutes. The surgery on the other eye will be done at a later time after consulting your doctor.

If there is nothing to contend with, the cataract operation is usually done on an outpatient basis. Then you can go home a few hours after the procedure. Sometimes, it makes sense to have a cataract operation in a hospital. For example, if you need more intensive care because of an illness.

A couple walks down a corridor: If you had a cataract operation on an outpatient basis, you can usually be picked up from the clinic or clinic on the same day. (Source: Secret Anix Productions / Getty Images)

Cataracts: What is the right lens?

The artificial lens that is inserted into the eye during cataract surgery is technically called the intraocular lens (the Latin word “oculus” means “eye”). There are different types of lenses, for example:

  • Monofocal lenses that have only one fixed focal point, so sharp vision is only possible either near, far, or in between
  • Multifocal lenses that, thanks to multiple focal points – similar to multi-focal lenses – ensure a sharp image, both from a distance and from close up.
  • Toric lenses that compensate for the sharp curvature of the cornea
  • Blue filter lenses that filter blue light and thus protect the retina from disease
  • EDoF lenses with extended depth of focus (EDoF = extended depth of focus), such that – similar to multifocal lenses – sharp vision is possible in the vicinity (but no more than the usual screen distance) and in the distance

Before a cataract operation is performed, the question arises about the correct lens. Each type of lens has advantages and disadvantages. With the monofocal lens, before the cataract operation you need to sharply identify the area you want to see later. You will need glasses for other areas after the procedure.

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On the other hand, with the multifocal lens you can see equally well from all distances, so you may not have any after the cataract operation. glasses Need. However, the image is generally less contrast and can still be blurry in some areas. In addition, glare from light is increased with this type of lens, for example when driving at night.

Good to know:
Depending on the lens you choose for cataract treatment, you may incur the costs of the operation: statutory health insurance companies only pay the full cost of your cataract operation if you receive a monofocal lens. With all other types of lenses, the material, and in some cases, the insert also is more expensive. You have to pay these additional costs out of your pocket.

In any case, it is advisable to carefully weigh the advantages and disadvantages of different types of lenses. If, despite the advice of your ophthalmologist, you are still not sure which lens is right for you, you can get a second opinion from a specialist before your cataract operation.

By the way, the type of lens alone is not critical to the outcome of the operation in cataracts. Most importantly, the lens adapts to your eye optimally and has the right strength. In order to calculate this, your ophthalmologist will carefully examine and measure your eyes prior to the cataract operation.

Cataracts: What happens after the operation?

Cataracts undergoing surgery require careful follow-up treatment. To protect the operated eye, it is covered with a bandage after the operation. Your eye doctor will tell you how long you should wear an eye pad.

For the first few days after a cataract operation, the eye that has had surgery may be a little itchy and/or sore. However, avoid touching or rubbing the eyes vigorously. Sometimes a temporary sensation of a foreign body arises in the eye. But most of the time, these complaints go away soon.

The eye medication that will be prescribed to you for the post-operative period is especially important in the follow-up of the cataract treatment: in any case, use eye drops and/or ointments as instructed.

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In addition, after cataract surgery, it is essential that the doctor regularly examines the operated eye. These follow-up appointments are recommended:

  • Mostly daily in the first days after the operation
  • In the next two months at longer intervals
  • In the event of complications occurring in a short time
  • To set the first visual aid about three weeks to three months after the operation
  • Approximately once a year after being provided with appropriate visual aids

Most daily activities can be done as usual a few days after the cataract operation. How long you have to take sick leave after a cataract operation and when you can drive again depends on your visual acuity after the operation.

Optometry: If necessary, new visual aids can be adjusted a few weeks after the cataract operation as soon as possible.  (Source: Getty Images / IPGGutenbergUKLtd)Optometry: If necessary, new visual aids can be adjusted a few weeks after the cataract operation as soon as possible. (Source: IPGGutenbergUKLtd / Getty Images)

It is true that vision often improves on the first day after the operation. But the final visual acuity is not achieved until a few weeks after the cataract operation. At this stage, as soon as possible, it is possible to adjust the lenses to correct visual acuity if necessary.

Can problems arise after cataract surgery?

Treating cataracts with surgery is very safe. However, problems can arise after that. The most common complication after cataract surgery is the so-called cataract: then the capsule of the posterior lens remaining in the eye becomes cloudy, vision deteriorates again.

Secondary cataracts usually occur three to six months after cataract surgery, and sometimes years later. It can be treated with a laser. Other potential problems after cataract surgery are:

  • retinal swelling
  • Lens shift
  • retinal detachment
  • Intraocular inflammation

Most of the complications that can arise after cataract surgery are not permanent. However, they can cause temporary discomfort or slow the healing of an eye that has had surgery. Sometimes they also need treatment with medication or another eye surgery.

Already know?
The artificial lens used to treat cataracts usually lasts a lifetime. It cannot wear out or deform. This means that the lens does not usually need to be exchanged after the first operation.

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