01.03.2018 Cataract is a pathology in which there is a clouding or discoloration of the lens. She is herself common reason blindness all over the world. Cataract surgery is sometimes the only way to preserve vision.

Lens

This part of the eyeball is a transparent, biconvex structure. Together with the cornea, it helps to refract light rays, which are focused on the retina, changing its shape, and adjusting the focal length.

They account for more than 90% of the total dry mass of the organ. Other components that can be found are sugars, lipids, water, several antioxidants, and low weight molecules. The lens of the human eye selectively absorbs ultraviolet and short wavelength light, and this absorption increases steadily with age. As a result, the light spectrum reaching the retina is constantly changing.

With the aging of the body, various structural and metabolic changes are observed in it, which leads to a gradual decrease in the transparency of the media, turbidity, presbyopia and an increase in the scattering and aberration of light waves, as well as to a deterioration in optical properties.

The lens consists of a nucleus, cortex and capsule. It is considered the second refractive medium after the cornea due to its position, curvature and refractive properties, which in an adult in the natural environment are about 20 diopters. This function is controlled by the innervation of the autonomic nervous system and the ciliary muscle.

The capsule is composed of type IV collagen, laminin and fibronectin. It is a smooth transparent membrane capable of allowing small molecules to pass both inside and out.

Causes of cataracts

The first signs of turbidity are observed at the age of 40-50 years. At the moment, the exact etiology and pathogenesis of karatogenesis are still not known. The theory of free radical oxidation is popular in ophthalmology.

"Free radicals" are molecules that have a free electron. They easily enter into biochemical reactions and cause a very strong oxidative stress lens fiber cells. Free radicals disrupt the synthesis of DNA and RNA, interfere with the synthesis of protein microstructures, reduce the energy balance, and destroy cellular enzymes.

The main metamorphoses that occur with aging:

• Reducing the diffusion of water into internal microstructures;
• Crystalline rearrangements due to the accumulation of high molecular weight agents and insoluble proteins (denatured alcohol);
• Accumulation of end products of the glycation reaction (AGE), lipids, a decrease in the content of reduced glutathione and the destruction of ascorbic acid.

Free radicals in the body are formed mainly by ultraviolet radiation and smoking.

Violation metabolic processes and the appearance of areas of opacity is sometimes associated with a change in the chemical composition of the intraocular fluid. The trigger is a strong physical exhaustion after transferred viral and infectious diseases, anorexia, anemia, radiation exposure, acute and chronic poisoning(for example, mercury).

Pathologies that increase the risk of catarrhal changes include diabetes, high blood pressure, obesity, and skin conditions such as atopic dermatitis (a type of eczema). They are sometimes associated with parathyroid tetany, which occurs due to atrophy or thyroidectomy of the parathyroid glands.

Congenital types of the disease, occurring at birth or early childhood are caused by inherited disorders (Down syndrome) or infections (such as rubella or herpes).

Clouding develops after injuries, burns, and previous interventions. Radiation or electromagnetic radiation can stimulate the exfoliation process, which leads to a violation of the structure of the lens fibers and the oxidative systems of the organ.

A person has the following clinical symptoms: "Blurred" vision, night vision worsens, color perception is weakened, hypersensitivity bright light and diplopia. In this condition, optical or contact correction... At the last stage, the pupil becomes milky white.

Cataract treatment

To slow down development pathological process held conservative therapy, in advanced cases, cataract surgery is indicated. The surgeon completely removes the pathologically altered lens. It is replaced by an artificial lens of optimal strength.

Cataract surgery in Moscow at the Fedorov clinic is performed in outpatient... Hospitalization in a hospital is used only in difficult cases, for example, in the presence of concomitant diseases, such as severe bacterial or viral infection, glaucoma, or retinal detachment.

Before manipulation, a person goes through a complete ophthalmological examination, in which the specialist determines what type of IOL he needs to implant. Since the procedure involves replacing the patient's biological lens with an artificial implant, choosing the correct optical power is critical.

Previously, the specialist collects a thorough history, asks the patient whether there have been any allergic reactions before, what medications he takes and whether there are problems with blood clotting. Consultation of specialists is carried out: cardiologist, therapist, dentist. It is necessary to make an electrocardiogram, fluorography.

A few days before the intended manipulation, ophthalmic drops with an antibiotic are prescribed according to a certain scheme. They are necessary in order to reduce concentration. pathogenic bacteria on the outer surface of the eye and prevent the development of intraocular infections.

The duration of the surgery is usually no more than 30 minutes or one hour. Anesthesia is selected individually, taking into account somatic pathology. In most cases, it is used local anesthesia or in combination with intravenous administration certain sedative medications. During the procedure, the patient does not feel pain, “light flashes”, red laser lights are possible.

Cataract surgery

Intracapsular extraction consists in microsurgical removal of the pathologically opaque body directly together with its capsule. In this case, the ophthalmic surgeon makes an incision relatively big size, then gently removes the biological lens.

This is an outdated technology as it is considered more traumatic. It requires the imposition of intraoperative sutures and long-term visual rehabilitation.

The extracapsular method involves extracting the opaque masses together with the anterior capsule, rear part persists and acts as a barrier between the anterior and posterior segments, and also serves as a site for implantation. This technique is less traumatic in comparison with the intracapsular one, however, at present it is used quite rarely, in view of the appearance of improved techniques.

Ultrasonic and femtolaser phacoemulsification

During an operation, the surgeon makes a very small hole in the shell. Using a very fine stream of sterile saline and water, it gently separates solid and white bodies from surface structures. A hollow titanium needle of the phacoemulsifier is inserted into the bag. Its peculiarity is that it emits ultrasonic waves of a certain frequency. They fragment the nucleus into tiny particles. The resulting emulsion is simultaneously aspirated through the hole at the end of the needle. After the capsule bag is completely empty, an additional viscoelastic substance is injected into it to maintain the space, and implantation is performed. The prosthesis cannot be seen or felt. The main advantage of phacoemulsification is considered to be that very small micro-incisions are made. They heal on their own almost immediately and do not require stitches.

Phacoemulsification is less invasive, has less complications and results in faster and more stable visual rehabilitation. Since there are no age restrictions, it is even used in children. Contraindications: diabetes mellitus, corneal dystrophy, conjunctivitis.

Small incisions have two main advantages. First, the cornea is less injured. Secondly, the manipulation is performed in a closed environment with less fluctuations in intraocular pressure. Injection of a bolus of cefuroxime into the anterior chamber significantly reduces the risk of postoperative endophthalmitis.

Modern types of prostheses are compact. They are foldable and small in size, and therefore they can be inserted through micro-incisions, and inside they can be straightened and fixed.

Most ophthalmic surgeons in their practice do not use ultrasonic cleavage of the nucleus, but laser. The advantage of this emulsification method is a high fragmentation rate and finer crushing. In addition, as practice shows, the intraoperative use of ultrasound during phacoemulsification can lead to damage to the endothelial cells of the cornea due to mechanical trauma from high frequencies and thermal damage.

Femtolaser phacoemulsification is used to create the finest incisions in the cornea, anterior capsulotomy and nuclear fragmentation. The laser performs capsulorhexis more precisely, improving the centering of the intraocular implant. This procedure is expensive and requires special equipment.

For fragmentation during femtolaser surgery, the so-called hybrid model is recommended: the central core 3.0 mm is liquefied, and the periphery is fragmented into 4-8 incisions.

This method allows the surgeon to easily remove the central area and provides access to the peripheral areas, reducing the energy and duration of ultrasonic phacoepilation.

Rehabilitation period

Recovery visual function does not occur immediately on the operating table, in most cases within a few days. The ophthalmologist must warn the patient in advance that at first the image will not be clear. Lacrimation and slight reddening of the sclera are possible. To accelerate healing and prevent complications, drops with antibiotics, anti-inflammatory drugs, hormones, as well as "artificial tears" are prescribed.

Discomfort and slight itching are possible for 2 days. Sensitivity is restored within 24 hours.

After the prosthetics, a sterile bandage is put on. It protects against dust particles, UV rays and pathogenic bacteria. It is very important to avoid splashing water and soap on your face for two weeks.

In the early postoperative period no need to be strict bed rest, a person should lead a normal life, but it is worth limiting watching TV and reading books. Special glasses must be worn for several weeks to protect the eyes.

Cataract is an eye disease in which normally a transparent lens becomes opaque - it becomes cloudy. The main role of the lens healthy eye- refraction of light rays, which ensures their hit on the retina. After transmitting information and analyzing it by the brain, a person clearly sees the objects around him. Clouding also leads to deterioration and distortion of vision. Cataract formation is a gradual process that, as we age, affects all people to one degree or another.

Reliable etiological factor the development of cataracts is unknown. From the point of view of pathophysiology, there is a change and aggregation of the protein structures of the lens, which leads to a violation of its transparency. It is extremely rare that cataracts manifest themselves in early age, this scenario is most often associated with congenital enzymatic defects, genetic diseases or systemic congenital infections. Severe traumatic injuries, surgical interventions, intraocular inflammatory processes can also be a trigger for the development of cataracts, as well as ionizing radiation, smoking and diabetes. However, it is the patient's age that is still the main reason for the development of ocular cataracts.

Cataract symptoms, indications for surgery

Cataracts always form gradually, without reddening of the eye or painful sensations... Expressed outward signs absent. The exception is a heavily running process.

A person who develops a cataract sees the world as if through a dirty glass - a cloudy veil forms before the eyes. The symptomatology of lens opacity has various variations:

Blurred vision, which was already mentioned above.

Severe glare, especially in bright sun or at night from vehicles with headlights on.

Colors become dull, dull.

Frequent replacement of glasses is required or contact lenses due to progressive deterioration of vision. However, as the cataract progresses, fitting glasses or lenses no longer helps to cope with poor vision.

Doubling before the eyes.

Previously, it was believed that for the operation of cataract it is necessary to wait for its "maturation". That is, the development of an advanced stage of the disease. Now, thanks to the development of microsurgical technologies, the approaches to cataract surgery have changed dramatically. The very fact of the presence of a cataract is not an indication for its removal until clinical manifestations do not begin to significantly affect daily life... Wonder if you can without outside help and severe discomfort drive a car, work and do housework?

Expectation of surgery for cataract within reasonable limits does not complicate the work of the surgeon and does not increase the risk of complications. Attending physician after thorough examination always advise optimal terms surgical intervention.

After the patient has made the decision to carry out the operation, he needs to undergo a standard preoperative examination and a number of diagnostic procedures. First of all, a specialist ophthalmologist conducts a thorough examination of the organ of vision. It is necessary to make sure that vision loss is associated specifically with cataracts, especially in the presence of such concomitant diseases as diabetic retinopathy, glaucoma or macular degeneration.

Visual acuity, intraocular pressure are measured, color perception and contrast sensitivity are assessed, the fundus is examined. If necessary, appointed ultrasound procedure, optical coherence tomography, or fluorescence angiography.

In addition to studying the ophthalmological status, an assessment is equally important. general condition the patient. During the preoperative preparation, the patient is assigned:

General and biochemical analysis blood

General urine analysis.

Assessment of coagulability if indicated.

Electrocardiography.

Fluorography or chest x-ray.

Research for HIV, syphilis and markers of hepatitis.

Sanitation of the oral cavity.

In the presence of concomitant cardiovascular and other diseases, a consultation of specialized specialists is carried out.

After a comprehensive examination and in the absence of contraindications, the date of the operation is assigned. The surgeon tells in detail about the course of the operation for cataract, possible risks and complications, after which the patient signs informed consent on surgical treatment.

Hospitalization and lens prosthetics

The patient is admitted to the clinic on the eve of the date of the operation. If necessary, he is repeated some laboratory and instrumental research... It is necessary to tell your doctor about the drugs that you are constantly taking, especially anticoagulants and antiplatelet agents. The specialist will give appropriate recommendations. On the day of the operation, you need to be on an empty stomach, refrain from eating and drinking.

Anesthesia during the surgical treatment of cataracts is used exclusively local - eye drops with local anesthetic... Thanks to minimally invasive technologies, the operation is practically painless. 1-2 hours before the operation, the patient is instilled with mydriatics - medications dilating the pupil, which is necessary for the surgeon to work properly.

The operating field is treated with an iodine-containing antiseptic, an eyelid dilator is used to prevent involuntary blinking of the eyelids. The patient lies on his back. Under visual control through a microscope, the surgeon performs a self-sealing corneal puncture, the width of which does not exceed 2-3 mm. It is because of this that suturing at the end of the operation is not required, which significantly speeds up recovery process... Then a viscoelastic drug is injected into the eye cavity, which plays a protective role for adjacent intraocular anatomical structures.

The next stage is capsulorhexis or incision of the anterior lens capsule. The posterior capsule is not removed during the operation - it serves to fix the intraocular lens. Capsulorexis provides the surgeon with access to the cloudy lens. Then a phacoemulsifier into the eye, the titanium needle of which emits ultrasonic waves, which leads to the grinding of the lens substance to a state of suspension. This process is called phacoemulsification. The mass obtained after crushing is removed by aspiration.

Then, through the previously performed access, an intraocular lens, an artificial lens, is rolled into a tube. Such an artificial lens is already straightened directly in the eye and fixed in the correct position. At the end of the operation, the eye is covered with a protective bandage.

Taking medications after cataract surgery

Depending on the clinic and the patient's condition, the latter is allowed to go home on the day of the operation or the next day. In this case, the doctor appoints the date and time of the next follow-up visit, and also gives recommendations on behavior, regimen, restrictions and the use of drugs. All appointments must be strictly observed, this is the key to a quick restoration of vision.

In the postoperative period, the following medications are usually prescribed:

Non-steroidal and steroidal anti-inflammatory eye drops. For the first few days, patients feel pain, burning, itching, and pronounced redness of the operated eye. To relieve discomfort, let us take painkillers according to the generally accepted dosage regimen.

In the early postoperative period, it is necessary to wash the eyelids with antiseptic solutions - furacilin and chloramphenicol. The goal is to prevent infection.

Antibacterial eye drops are essential to prevent adherence bacterial infection... A drug is selected wide range, active against many microorganisms.

Drops for lowering intraocular pressure. Prescribed under the supervision of the latter, the decision on the appointment and cancellation is made only by the doctor.

Complex local funds containing preparations to regenerate the cornea and eliminate excessive dryness.

All medicines are prescribed only by the attending physician. In the event of adverse reactions, it is important to immediately consult a specialist.

Rules for the use of eye drops

The vast majority of drugs in ophthalmology are prescribed locally in the form eye drops... Therefore, it is important for patients to know how to properly bury their eyes so as not to harm themselves and to ensure adequate drug delivery to the target.

Download and print the rules

Some rules:

Before starting the manipulation, it is important to thoroughly wash your hands with soap and water.

You need to bury it while lying or sitting on an armchair / couch, with your head tilted back well.

It is better if an assistant will bury the eyes.

It is necessary to gently pull back the lower eyelid and drip the drug into the conjunctival sac.

The pipette should not touch the eye, eyelid or conjunctiva.

After instillation, it is advisable to lie down / sit quietly for several minutes, press the lower eyelid with a clean, if possible sterile, gauze napkin.

Complications in the postoperative period

Cataract surgery is one of the most frequently performed and safest surgical procedures in the world. However, after this operation there is a risk of complications. Here is some of them:

Dislocation of the intraocular lens.

Endophthalmitis - inflammation of the eyeball.

Increased photosensitivity.

Photopsy.

Macular edema.

Retinal disinsertion.

Vitreous hemorrhage (hemophthalmos).

Intraocular hypertension and the development of glaucoma.

The formation of a secondary cataract is a process in which, due to cell division, a clouding of the posterior capsule of the lens is formed. The symptomatology resembles that of a common senile cataract. Treatment consists of laser exposure.

Almost all complications respond well to treatment with timely diagnosis... That is why it is important to visit the doctor at the appointed time. With a worsening of the condition and the appearance of pain, sharp deterioration vision against the background of positive dynamics, an urgent need to visit a specialist.

Rehabilitation period

The timing of vision restoration after IOL implantation for cataract is individual. Some patients notice improvement as early as 1-2 days. Total duration recovery period is approximately one month, during which the following recommendations must be observed:

Observe bed rest for the first day.

Avoid mechanical impact on the operated eye (do not press or rub the eye).

Avoid direct sunlight, wear sunglasses.

Limit the use of eye makeup for 2-3 weeks.

Make sure that shampoos and detergents do not get into the eyes during hygiene procedures.

Avoid intense physical activity lifting weights over 10 kg.

Taking care of yourself contributes to the rapid restoration of vision and minimizes the risk of complications.

Cost of cataract surgery, public and private clinics

Cataract surgery can be performed free of charge in government agency health care. There are quotas for such interventions; their number depends on the region. More often, free interventions are carried out social categories citizens - pensioners, disabled people of all groups. However, in such a situation it is necessary to wait for your turn. If the patient wishes to implant himself an imported lens, it must be purchased for a separate fee.

For a fee, cataract surgery can be performed without waiting in line. The cost varies from the category of complexity of the intervention, the degree of maturity of the cataract, the type of artificial lens, the reputation and equipment of the clinic. Ophthalmological clinics there are many, but not all of them have a good reputation. You can get acquainted with the cents on their websites on the Internet and from patient reviews. On average, the cost of a cataract operation is 45,000-100,000 rubles, depending on the authority of the clinic and the surgeon, the model of the artificial lens and the complexity of the operation. The following clinics in Moscow have won trust:

Clinic them. Svyatoslav Fedorov - named after the founder of ophthalmic microsurgery in Russia. Long-term traditions and scientific activity make the Fedorov Clinic one of the most demanded among patients.

Eye Diagnostics and Surgery Center. Has won the trust of patients thanks to modern equipment and experienced specialists, which allows cataract surgery to be performed in the most difficult cases, including concomitant pathology.

Research Institute of Eye Diseases. Helholtz. He is known for his good attitude towards patients and good treatment results. It is one of the very first Moscow eye clinics.

The number of people suffering from cataracts is increasing everywhere. It is important to understand that surgery is the only way to return good vision people with this ailment.

Video: cataract, the course of the operation, rehabilitation

Cataract is a disease that often affects older people. V old age vision begins to lose sharpness, there is clouding, blurring. The only one efficient method cataract treatment - removing it surgically, however, the operation may be postponed for long months and even years. Thanks to folk remedies and medicines, you can slightly improve your eyesight.

How to treat cataracts

First of all, you should understand what constitutes an eye disease. Initially, the protein accumulates in the lens and prevents the passage of light. This causes blurred vision, a decrease in the transparency of the lens structures. There are several types of cataracts:

1. Age. Appears closer to old age.
2. Congenital. The disease can be caused by infection, injury, or abnormal development of the fetus in the womb.
3. Secondary. It develops as a result of complications of other diseases (after diabetes). Poisoning with toxic substances alcoholic beverages, exposure to ultraviolet light or taking medications such as corticosteroids or diuretics can also contribute to vision problems.
4. Traumatic cataract.

What will be the treatment of cataracts depends on the degree of vision loss and the impact of the disease on the quality of human life. Doctors advise to resort to surgery only in a situation where there is a threat of developing blindness, or there is a suspicion of diabetic retinopathy, macular degeneration. In other cases, you can be treated medication and folk methods.

Treatment of cataracts without surgery with drugs

Surgical intervention is the only sure cure for the disease. However, the researchers found that an organic substance called lanosterol also promotes protein absorption. Eye drops, which include this component, - effective medicine from cataracts. However, it is very difficult to find it in our country.

There are others pharmacological preparations which you can buy at the pharmacy. They are able to cure disease because they nourish eyeball trace elements, amino acids, relieve inflammation. Cataract treatment without surgery includes the use of medications approved. It is recommended to use the following drugs produced by domestic and foreign firms:

• Oftan Katahrom;
• Quinax;
• Taufon;
• Vitafakol.

Cataract - treatment with folk remedies

Many patients are interested in the question: how to treat cataracts without surgery folk remedies? Our grandmothers used ordinary foods rich in useful substances... They should be consumed several times a day. In addition to following this diet, you need to do lotions for your eyelids at home. Treatment of the disease with folk remedies requires integrated approach... Most effective means:

1. Carrot. It contains riboflavin, vitamin A, which improves vision.
2. Spinach. It is rich in beta-carotene, antioxidants.
3. Green tea, garlic, lemon, pumpkin help to increase the sharpness of vision. All of the above foods should be added to the diet.
4. Honey. It must be mixed with aloe juice and water in a 2: 1 ratio. The prepared mixture should be used as eye drops.
5. Potato. Potato sprouts are poured with a glass of vodka and insisted for 15 days. The finished medicine should be taken 1 tsp. 3 times a day on an empty stomach (one hour before meals).

How to treat early cataracts

On early stage the development of the disease, the person does not notice the changes. The manifestation of symptoms is an unpleasant surprise for many people. However, action should be taken as soon as possible. For the treatment of the initial stage of the disease to be effective, you need to wear ophthalmic, bifocal glasses, lenses, do gymnastics for the eyes, and improve the quality of lighting. Doctors also prescribe cysteine. If the disease begins to progress, it is worth considering surgery.

Removal of cataracts

Surgery is the only way to get rid of blurred vision. There are several ways to eliminate the disease:

• extracapsular extraction (removal of the lens nucleus);
• phacoemulsification (extraction with a needle);
• intracapsular extraction (removal of the lens together with the bag);
• ultrasonic phacoemulsification (operation without sutures).

The first three options are conservative methods therapy. With them, there is a risk of complications (intraocular infection, retinal detachment) and bleeding. The latter is the most gentle way. Cataract surgery with lens replacement is performed as follows:

1. First, a small incision (about a millimeter) is made in the lining of the eye with a scalpel or laser.
2. A circular opening is then cut at the front of the thin membrane (capsule) to gain access to the retina.
3. The lens is crushed into small pieces using a laser or ultrasound.
4. Replaced with a transparent implant (intraocular lens).
5. Thanks to the operation without stitches, rehabilitation is very fast.

Prices for cataract surgery

It is difficult to name the exact price of the operation, because it depends on several factors: the complexity of the process, the model of the artificial lens, the pricing policy of the clinic, the reputation of the surgeon, etc. The cost of eye cataract surgery in a private center ranges between 25 and 150 thousand rubles. In a public hospital, treatment is free of charge, according to the compulsory medical insurance program, but the choice of the lens remains with the college of doctors.

Video: prevention, symptoms and treatment of cataracts

How is cataract surgery performed?

How is cataract surgery performed?

On the day of the operation, the patient comes to the clinic, where, after a preliminary conversation, medications are instilled into his eyes. Their goal is to expand the pupil as much as possible, which will make it possible to perform manipulations in front of the eyes without much difficulty. At the same time, drugs are administered against the possible spread of infections and inflammations.

Immediately before entering the operating room, a person changes into sterile clothing. A special hat is put on his head, behind which all his hair is hidden. After that, the person falls into the hands of the anesthesiologist, who measures him blood pressure, pulse. If health is assessed as "satisfactory", then an anesthetic near-eye injection is performed or special drops are buried. The choice is based on individual characteristics and contraindications. In some cases, it is administered intravenously sedatives that help the operated person to calm down. After that, a pressure eye patch is applied, which helps to evenly distribute the drugs.

As a rule, during the operation, the patient is in creation and, accordingly, can talk to the surgeon. But this is not recommended, since speech is accompanied by movement of the head, which can lead to eye injury. If a child lies on the surgeon's table, then he is immersed in anesthesia. At the end of the preparatory stage, the person enters the operating room, where he is placed on a soft table. A sensor is attached to one of the fingers of the hand, informing doctors about the level of blood pressure and pulse. Then everything happens quickly enough:

1. The eye is treated with an antiseptic.
2. A sterile bandage is applied to the patient's head, in which an opening for the operated eye is provided.
3. The surgeon makes a 2.5 mm micro-incision in the cornea with a diamond instrument.
4. Viscoelastic is inserted through the hole, which protects the structure of the eye from damage due to ultrasound.
5. An ultrasonic probe is inserted, which in a matter of seconds converts the diseased lens into an emulsion. It is removed along with the capsule.
6. An artificial lens is installed in place of the lens.
7. The mass of viscoelastic is taken out.

The total time of all manipulations is 20-25 minutes. No stitches are applied - the incision is self-sealing during subsequent recovery weeks. Upon completion of the operation, the patient is under the supervision of doctors for some time (2-3 hours), after which he goes home.

As you know, cataracts are characterized by clouding of the lens, and this leads to a loss of visual acuity and subsequently to complete blindness. Unfortunately, drug therapy is not able to fully get rid of pathology, therefore, surgical methods are most often used. There are several of them and each has its own peculiarity, advantages and disadvantages. It is worth knowing that only the attending specialist selects the technique, because it depends on individual characteristics. This may be the stage of development of the disease, the presence of concomitant pathologies, and so on. The cost of cataract surgery largely depends on the method chosen, the level of the clinic and the qualifications of the doctors. Regionality is also taken into account. For example, in the capital, an operation can cost 2 times more than in a small town.

Intraocular lenses (IOLs) designed for cataract implantation improve visual acuity. They are produced by many manufacturers, but the types are the same for all. So, lenses can be like this:

1. Monofocal IOLs have no contraindications and are considered safe. The lenses have the same refractive power in any area of ​​the surface, providing excellent visibility of objects. The only drawback is the need to wear glasses when reading.
2. Multifocal lenses are the most popular and innovative lenses, as they have different refractive power. Because of this, a person can equally clearly see images both in the distance and nearby. Therefore, further vision correction is excluded. The disadvantage is the inability to be used by people who have high degree sensitivity to light.
3. The accommodating IOL also has no contraindications and is in demand and effective. These lenses can independently adjust to the visual image and mimic the activity of the natural lens. The lens is fixed to the eye muscle, while the refraction changes in the same way as in the fixing apparatus. Therefore, a person is able to see equally accurate images at different distances.
4. An aspherical lens is capable of correcting any distortion. These IOLs have no contraindications and consequences.

Cataract surgery is based on removing the affected area of ​​the lens and implanting a flexible lens. But for this they are used completely different techniques, which differ from each other in the methods of penetration, dissolution of the affected organ and the instruments and equipment used.

This method is the most widespread and demanded, as it is considered safe and effective. During the operation, a 2 mm incision is made. A microscopic probe equipped with ultrasound is introduced into it, which changes the structure of the lens, turning it into an emulsion. And only after that it is removed. A flexible intraocular lens is then inserted. Distinctive feature phacoemulsification is that the method can be applied at any time. If, for example, with some other methods, surgery is possible only after the full maturation of the pathology, then there is no need to wait for this period. It turns out that the maturation process can last up to 10 years, as a result of which vision gradually decreases. At this time, the patient usually loses his ability to work because of this and there is a risk of acquiring blindness. The rehabilitation period is minimal.

This method surgical intervention is the pioneer in catarrhal surgery, therefore today it is considered a little outdated. Extracapsular extraction cataract operation is used quite rarely, only if necessary, since it is traumatic. During the operation, the ophthalmologist makes an incision in the cornea under general anesthesia... But before that is carried out preparatory stage: special drops are instilled into the affected organ, which disinfect and dilate the pupil.

Then the anterior capsule is opened and removed, after which the nucleus of the lens is removed and the capsule bag is cleaned, the lens is installed. When will she accept correct position, a seam is applied. Thus, the back capsule remains in place. The disadvantage is that rehabilitation period too long, and the patient must avoid physical activity for the rest of his life. Possible complications: capsule seal, secondary form cataracts.

During cataract surgery, the lens can be replaced using a cooled metal rod, that is, by cryoextraction. In this case, the capsule and the lens are removed at the same time. The doctor makes an incision in the cornea, after which the edge of the lens is exposed. The cryoextractor fixes the affected organ and pulls it out. Next, a flexible lens is installed and sutures are applied. Complication: risk of prolapse vitreous and retinal detachment thereafter. The rehabilitation period is average.

Laser operation

Laser surgery for cataract removal with lens replacement is used less often, as the technique is new, effective and the most expensive. In many ways, it is similar to phacoemulsification, only in this case, not ultrasound, but a laser with a certain wavelength is used.

Cost of cataract surgery and contraindications

Contraindications:

1. Hypertension.
2. Diabetes.
3. Some pathologies of the cardiovascular system and the brain.
4. Chronic illnesses.

The cost of an operation to replace the lens for cataract varies from 20,000 to 80,000 rubles. Accordingly, the primary cataract has a lower cost, and the secondary form is high.

Recovery period

After cataract surgery, rehabilitation can have different periods, but its essence is the same:

1. At the first time after surgery, the patient should take painkillers and those drugs that the doctor prescribes.
2. It is strictly forbidden to lift a load over 3 kg during this period.
3. You can not make sudden movements and inclinations.
4. Give up heat and hot procedures.
5. The eyes can only be touched with sterile wipes (for example, with lacrimation).
6. You need to go out in sunglasses.
7. To eliminate the risk of swelling, it is best to drink less fluids.
8. You can not eat spicy and salty foods.

Is it possible to cure cataracts without surgery

Conservative methods of treatment do not bring the same results as surgical ones. The point is that everything medical drugs aimed only at a temporary improvement in the condition and stopping the development of pathology. Therefore, cataract treatment is impossible without surgery. Especially if it's not initial stage development.