Cataract removal is performed by two methods:
Cataract phacoemulsification is a method of removal of a cataract using an ultrasonic tip and implanting an artificial intraocular lens. The procedure is performed under surface anesthesia applied as a gel or drops into the conjunctival sac. In place of the removed lens, a new one is inserted – a flexible, retractable, acrylic lens that unfolds on its own in the natural lens bag and settles in the right place in the eyeball. The incision is minimal (1.5 to 3 mm).
High-precision femtosecond laser surgery (FemtoCataract) – a method that involves making laser micro-incisions (so-called ports) in the cornea, automated so-called Capsulorhexis, i.e. opening the anterior capsule of the natural lens, fragmenting the natural lens (with a femtosecond laser and removing the cloudy lens through it and then inserting a new lens. The treatment takes 10-15 minutes.
After cataract removal surgery, the eye changes its refractive properties. In the case of cataracts, this means that there is no guarantee that refractive power will be achieved such that the patient will no longer need any glasses. The doctor is able to calculate the power of the lens implanted in the patient’s eye with an accuracy of 0.5 diopters, which makes it possible to correct a coexisting visual defect to at least one distance – usually to the distance.
How the patient should see after the procedure should be discussed during the preoperative examination. The power of the lens can be calculated so that the patient can read up close without glasses or see objects located far away well without glasses – everything is planned according to the patient’s wishes.
If a patient chooses to have a monofocal lens implanted, this means that he will be able to see clearly either up close or far away – for example, he will be able to drive a car without glasses, but to read a book he will continue to need vision correction with glasses. Some nearsighted people who develop cataracts choose to remain in the situation they have been in all their lives: they choose to have sharp close-up vision, and glasses for distance.
But there are those who, on the occasion of cataract surgery, choose to correct their distance vision, thus opting to continue using glasses for nearsightedness, i.e. for reading. The selection of eyeglasses after cataract surgery takes place about six weeks after the procedure, as by then vision should have stabilized. Monofocal lenses are reimbursed by the National Health Fund.
If a patient chooses to have a multifocal lens implanted (trifocal/multifocal or EDOF-extended depth of focus), in addition to cataract removal, he or she can count on very good visual acuity for distance, near (35-40 cm) and intermediate distance (60-90 cm).
This means that after the procedure, he will most likely no longer need any glasses. The exceptions are patients who practice professions that require really falcon-like near vision – such as a watchmaker, tailor or electronics technician, and who in their work do not reach for magnifying or distance glasses, such as professional drivers, pilots, etc.
In order not to disturb the eye for other distances, it is then recommended to use additional spectacle correction for very close distances. These lenses are sometimes also associated with certain visual defects – optical perception is worse at certain ranges.
If the patient has astigmatism, he or she may choose to have a toric single vision lens implanted (eliminates astigmatism, provides sharp vision for distance or near) or a toric multifocal lens (eliminates astigmatism, provides sharp vision for distance, near and intermediate distances, so it gives thepatient the opportunity to become completely independent of corrective glasses).
A multifocal toric lens can eliminate corneal astigmatism, resulting in the fact that correction of vision defects with glasses will no longer be necessary after surgery. A monofocal toric lens will make reading glasses necessary for the patient.
Modern artificial lenses implanted in the patient’s eye can have a UV filter and a blue light filter (blue light filter) built in. It is designed to help protect the retina from dangerous radiation and minimize the need for permanent sunglasses.
For the patient, this means that his/her eye/eyes are under constant protection, but if he/she feels like reaching for sunglasses on a very sunny day, he/she can of course do so for both health and aesthetic reasons.
With so-called white lenses, you need to protect your eyes with filtered glasses on a daily basis, because blue light, which can deteriorate the retina, reaches the bottom of the eye in excessive amounts. These must be glasses with good quality optical glasses and tinted at the optical point. Under no circumstances should you prefer to reach for random glasses from the supermarket!
A good solution is photochromic glasses, i.e. glasses in which the glasses react to the intensity of light. The photochromic molecules contained in the glasses react to the sun’s energy and change their position, and the result of this change is a change in the tint of the glasses’ lenses. This ensures that the optimal amount of light always reaches the eyes.
The decision on which lenses are most suitable is made during a consultation with a doctor. Absolute medical indications are taken into account , as well as the patient’s individual needs related to his lifestyle, professional duties and passions.
