Most popular and updated trends in cataract surgery

Most popular and updated trends in cataract surgery

Cataracts are one of the most popular eye conditions, and  most of us have a relative that has had this condition, which causes gradual painless drop of vison over months and years , and is caused by opacities in the eye’s crystalline lens. 

The history of cataract surgeries:

Al-Mousili, one of the most popular and renowned eye surgeons during the golden era for Islamic science and medicine evolution, was the first to describe a surgery for cataracts. He was the first to develop a meticulously fine needle that was inserted into the eye and used to absorb the lens opacity. The surgery started developing from here, until the 18th century on the hands of European eye surgeons and continued to evolve to what we know today.

Current modalities and form of cataract surgery:

Prof Dr. Ashraf Soliman states that the most popular and widely accredited methods of cataract removal is performing a surgery using ultrasound waves to fragment the opacity and then absorbing it through tiny microscopic surgical openings (phacoemulsification) in the eye that can be performed by a surgical blade or more recently the cutting edge  femtosecond laser femtocataract.

Phacoemulsification:

Before the surgery commences, the surgeon will place a few anesthetic drops on the surface of the eye to block any pain sensation of discomfort you might feel and mydriatic eye drops to widen the pupil. The eye surgeon then, carefully,  manually peels off the anterior (front capsule of the lens). This step requires great skill, experience , and competence  on the surgeon’s part. The ultrasound probe is inserted into the eye and is used to fragment the lens opacity into quadrants , and then absorbing each quarter on its own. The ultrasound probe produces some heat in the eye , which may adversely affect the cornea, that is why the surgeon’s skill and experience are imperative in the protection of the eye structures during surgery, a new artificial lens is then inserted into the eye to allow the patient to have clear vision post operatively. 

Femtocataract:

The steps are like the ones described above expect that this state-of-the-art surgery does not require surgical blades to create corneal incisions in the eye.  on the other hand, a femtosecond laser is used to create these incisions after taking a detailed accurate map of the corneal surface topography to detect any regular or irregular astigmatism present, and after running these images through a specialized computer algorithm to determine the optimum size and site of surgical incisions to correct these corneal defects to give the patient the maximum visual benefit after the surgery. 

The femtosecond laser is also used to create the opening of the anterior lens capsule making it a regular and reproducible circular  opening. The laser is also used to fragment the lens opacity, decreasing the total ultrasound time, thereby protecting the eye structures from heat damage, and facilitating quick absorption of  cataract.

If the patient suffers from regular astigmatism, a special artificial lens can be implanted in the eye  to correct this refractive error. Alternatively, if the patient has irregular astigmatism, the surgeon can use the femtosecond laser to create partial thickness incisions in the cornea to correct it and improving postoperative visual outcomes

What to expect after cataract surgery?

The surgery itself takes only about 15 minutes, but you may have to arrive 90 minutes prior to the scheduled surgery time for proper preoperative preparation for example imaging, blood work, medication and  eyedrops. In addition, your surgeon might want you stay for a few minutes after surgery to ensure your proper immediate postoperative recovery and to discuss certain instructions and medications that you must strictly adhere to, to ensure proper recovery and surgical success.  Some of these include;

  • Having someone to drive you home after the surgery
  • Eyedrops that must be properly and timely instilled into the eye for a few weeks 
  • Wearing an eye shield during sleep
  • Protecting your eyes from sunlight

Am I eligible to femtocataract surgery?

Certain rules and guidelines govern your surgeon’s decision as to whether or not you are a proper candidate for this kind of surgery, this includes but is not limited to  if you have a significant amount of astigmatism preoperatively that you wish to correct.

عن الطبيب

أستاذ طب و جراحة العيون م. طب عين شمس أستشاري جراحات تصحيح عيوب الابصار و المياه البيضاء و القرنية عضو الجمعية الامريكية لعلاج العيون و تصحيح العيون بالليزر زميل المجلس العالمي لجراحة و طب العيون زميل الكلية الملكية لطب و جراحات العيون بأنجلترا

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About the doctor

A consultant specializing in corneal, cataract and Glaucoma Surgery and Refractive surgery in Egypt, Assistant Professor of Ophthalmology – Ain Shams University, Consultant cornea, cataract, and Glaucoma Surgery and Refractive Surgery, Fellow of the Royal College of Physicians and Surgeons of Glasgow, UK.

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