Cataract Surgery Environment

Cataract Definition

Cataracts are the congenital or degenerative opacification of the eye's natural crystalline lens – the eye's lens, which is primarily responsible for the ability to focus images up close, like a zoom.

Cataract Symptoms

The main cataract symptom is a slow, progressive, and painless loss of vision, loss of contrast, and intense glare (halos and flashes around lights). The only treatment is surgical; it involves removing the lens and replacing it with an intraocular lens. Cataracts are the leading cause of treatable blindness worldwide. From the age of 65, approximately 20% of people develop cataracts, and the probability increases to 50% from the age of 75.

The main risk factors are excessive exposure to ultraviolet rays, smoking, malnutrition, excessive use of corticosteroids, and certain systemic diseases such as diabetes. There are different types of cataracts, with senile cataracts being the most frequent and related to aging. Other less frequent types are congenital and traumatic cataracts. The ophthalmologist decides with the patient, based on the examinations performed, the necessity and timing of cataract surgery.

Cataract surgery is one of the most advanced techniques in the world, and Portugal is no exception. This procedure lasts an average of 30 minutes but can take up to 2 hours, depending on the technique the ophthalmologist chooses to use. The most common procedure is phacoemulsification. In this procedure, local anesthesia is used, so the patient feels no pain during the surgical procedure. The lens, which is opaque, is dissolved by ultrasound and then removed in several small pieces. In general, no stitches are necessary, allowing for a rapid recovery of vision.

The success rate of the operation is quite high, and complications are extremely rare. However, an increase in intraocular pressure and corneal edema (swelling), generally transient, may occur immediately after the operation. Infections are rare and occur in 1 out of 1000 surgical interventions. Another rare complication is retinal detachment.

Cataracts and New Drugs or Medical Devices

A multicenter study recently presented in Chicago at the 2014 meeting of the AAO (American Academy of Ophthalmology) proves the safety of the first implantation into the lacrimal canal of a device with dexamethasone, a corticosteroid indicated to treat inflammation and pain after cataract surgery.

One of the biggest risks of cataract surgery is contamination of the eye after the procedure, related to failures in the administration of eye drops. Therefore, according to him, the device will guarantee better vision for those undergoing the procedure. The doctor explains that a contaminated eye can lose irretrievable cells.

The most common errors reported by participants are:

• Instillation of more than one drop of eye drops in each eye, resulting in wasted medication;
• Stopping treatment by blinking several times after instillation;
• Contamination of the dispensing nozzle by contact with the finger or eye surface;

Each of these defects can compromise the outcome of the surgery;

Cataracts and Patient Experience

Post-cataract surgery: Recovery after cataract surgery is usually short and uneventful, provided you are in good health and do not have any other serious eye problems. Statistics show that the chances of obtaining a good outcome and clearer vision after cataract surgery are excellent.

Most patients after cataract surgery experience cloudy, blurry, or distorted vision. Some adaptation time is normal, and during this time, some patients even report having "wavy" vision or distortions. Many patients also suffer from red eyes due to the temporary damage to blood vessels on the surface of the "white" of the eye (sclera) during cataract surgery. As the eye heals, the redness should become less visible within a few days.

Cataracts and Guttata Cornea

The cornea is the part of the eye located in front of the sclera and is made up of a layer of transparent cells. In this disease, the endothelial cells are destroyed, and in their place appear these small accumulations of fluid which, over time, cause inflammation of the cornea, causing it to lose its transparency. Treatment of this eye disease varies depending on its cause and severity; often associated with cataract surgery, treatment of guttata cornea may involve a corneal transplant.

Cataracts and Sustainable Development

The Sustainable Development Goals represent humanity's main strategy to ensure its future, and science and technology are two of the indispensable tools that can help achieve these goals. Nanotechnology, that is, the applied knowledge of the minuscule, now plays a key role in this strategy, alongside other branches of knowledge. The application of nanotechnology to cataract surgery is among the solutions and strategies necessary for the survival of the human species in a proper balance with the nature of which it is a part.

New Implants in Cataract Surgery

Michael Snyder's technique consists of conventional cataract surgery with implantation of an intraocular lens on which an iris prosthesis is placed. The iris prosthesis is made of flexible silicone and is injected and implanted inside the capsular bag, just like intraocular lenses, so it does not cause intraocular inflammation or increased intraocular pressure.

Conclusion

With a functional success rate of over 95% in different countries, cataract surgery involves removing the opaque crystalline lens and implanting, through tiny incisions, an artificial lens (intraocular lens), thus allowing for the correct focusing of images captured by the eye. The procedure is performed quickly and painlessly in the surgical center, under sedation with local anesthesia. It lasts 15 to 20 minutes, and the patient remains at the clinic for approximately three to four hours. In most cases, vision recovery occurs within the first 24 hours, and the result is easily noticeable.

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