Minimally invasive cataract surgery
About 3,000 cataract surgeries are performed annually in Poland per one million inhabitants. Worldwide, 20 million people of all ages suffer from it, and it is the most common cause of – fortunately reversible – blindness (about 48%). In Poland, however, the number of sufferers is estimated at about 800,000 people.
It is estimated that about 35-40% of patients presenting for cataract surgery have coexisting astigmatism from 0.75 to 3.0 diopters, and 15-29% of patients have astigmatism greater than 1.5 diopters. The combination of cataracts (eye disease) and astigmatism (visual impairment) is a very difficult experience for elderly patients. They have significantly impaired daily functioning: even navigating the immediate environment is a challenge.
Restrictions on treatments reimbursed by the National Health Fund
What is important from the patients’ point of view, then, is that the premium procedure – implanting artificial lenses that simultaneously correct the entire visual defect – is not available as part of the procedures reimbursed by the National Health Fund. Therefore, patients often choose to have the procedure in a private facility, where they have this option.
During cataract surgery, not only short- or farsightedness can be corrected, but also astigmatism and presbyopia . Implantation of toric lenses, i.e. those that, in addition to the spherical defect (short/long-sightedness), also compensate for the non-spherical defect (astigmatism), makes it possible to remove the cataract and correct the visual defect during one surgery.
Cataract surgery is the only way to treat it
During cataract surgery, the cloudy natural lens of the eye is removed and a modern artificial lens is implanted. The intraocular lens is implanted once for life, so its proper choice is crucial to the quality of vision after surgery.
One of the modern methods of treating cataracts is phacoemulsification.
The more thorough the initial examination, the better the outcome of the surgery. A major influence on the course of the surgery is an accurate diagnosis of the eye. It is made by imaging the individual structures of the eye, including the retina and optic nerve, i.e. using OCT eye tomography. The resolution of OCT is 10 times greater than that of ultrasound. It is a result that can be compared with the histological image of the retina. The test is non-contact, performed on an outpatient basis. It takes a few minutes, but a lot of experience on the part of the evaluating physician is required to properly assess the results.
It is recommended that contact lens wearers take a break from contact lenses for two weeks before the test.
On the day of cataract surgery, the patient is given eye disinfectant drops, the hair and body are covered, and the skin around the eye where the operation will be performed is disinfected. The eye is immobilized with the use of a special scleral. Using a surgical microscope, the doctor makes a small incision on the outer edge of the eye to access the natural lens.
The lens is located in the lens capsule, which the surgeon opens through a circular incision (capsulotomy). To remove the natural lens of the eye, it is first broken up with ultrasound and then sucked out. 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).
Remember: as part of treatment at a private facility, patients have a choice of many types of lenses, which can, on occasion, correct vision defects such as myopia, hyperopia or astigmatism, as well as presbyopia.
