What is a Cataract?

When we talk about cataract we refer to the crystalline lens -the natural lens inside the eye- when it becomes opaque. It is located behind the pupil and works like the lens of a camera, allowing light to pass into the eye and focusing the images on the retina, which in turn sends them to the brain through the optic nerve, and it is there where vision is finally produced. To perform this function optimally, the lens must be completely transparent.

Symptoms

The most common are:

• Blurry vision
• Double vision
• Difficulty seeing at night
• Photophobia (discomfort caused by light)
• Perception of opaque or yellowish colors
• Need for more reading light
• Presence of halos in night vision
• Improved near vision for no apparent reason
• Need for frequent changes in prescription glasses or contact lenses

Causes

• Age is the most common cause of cataracts, usually presenting from the age of 60.
• Other factors include:
• Genetics
• Eye or metabolic diseases, such as diabetes
• Trauma
• Overexposure to the sun without ultraviolet eye protection (UV)
• The consumption of certain drugs, such as steroids
• May be present at birth

Treatment

Definitive treatment for cataracts remains surgical treatment. This procedure consists of extracting the opaque lens, replacing it with the lastest generation artificial IOL, which may have different focusing abilities for distant, intermediate and/or near vision.

Intraocular Lenses

Traditional IOLs can induce small optical imperfections called higher order aberrations. These can affect the quality of vision, especially in low light conditions. Advanced technology, aspheric intraocular lenses more closely resemble the shape and optical quality of the eye's natural lens, so they can provide sharper vision. There are several types of aspheric lenses:

• Monofocal aspheric lenses that correct cataract, myopia and hyperopia. They allow a single point of focus, for example, for far distance vision. For intermediate distance (60 to 70 centimeters vision) and near distance (33 to 40 centimeters vision) the patient will have to wear glasses after cataract surgery.
• Toric aspheric lenses that correct astigmatism, as well as hyperopia and myopia. These lenses give good focusing vision for far distance but for intermediate and near distance the patient will have to wear glasses after cataract surgery.
• Trifocal aspheric intraocular lenses that correct cataract and presbyopia, that is, the patient will be able to see in the distance, in intermediate and near vision, without having to use glasses or glasses (or use them in the minimum of occasions) after surgery.
• Extended focus aspheric intraocular lenses (EDOF) correct the cataract allowing good far distance vision, intermediate distance object vision and functional vision for moderate sized near objects, but the patient will need glasses when viewing small objects and reading small print.

Before performing cataract surgery, several studies are performed on the patient in order to determine the focusing power that the intraocular lens must have for the patient to see well after surgery, and studies to determine which type of intraocular lens is the most suitable according to the characteristics of the patient's eyes. In other words, not all patients qualify for any of the intraocular lenses mentioned above.

Femtosecond* Laser

The most advanced technique applied in cataract surgery is the femtosecond laser (a femtosecond is one billionth of a second [10-15]), which allows the procedure to be customized to each patient's eye. Although all human eyes share the same anatomical structure, each eye varies in size, distribution of spaces between internal structures, corneal curvature and other key features, so each eye must be carefully measured and mapped. The use of laser produces less inflammation in the intraocular tissues, so visual recovery is faster. In addition, it achieves higher visual quality with advanced technology lenses because it allows the intraocular lens to be implanted and located within the eye in a more centered and stable manner..

The femtosecond laser allows a higher level of predictability and precision that usually cannot be achieved with traditional phacoemulsification surgery. Its application is painless and extremely fast. At present, we are the only ophthalmologic center in the Dominican Republic and one of the few in the world to use this technology in cataract surgery.

Today we can achieve that after cataract surgery many people can see well without the use of glasses or glasses. However, in some patients there may be ocular reasons that make it necessary to wear glasses for very specific activities and, in very few cases, to wear them all the time after surgery.

Even though it cannot be prevented, cataract can be detected during a routine eye examination. This is why it is advisable to visit the ophthalmologist periodically.

To remember:

• You can slow the progress of cataracts by wearing sunglasses with UV protection.
• There are no special medications, exercises or diets that prevent or cure cataracts.
• Consider cataract surgery when they stop you from performing your regular activities.
• Thanks to advances in medical technology, cataract surgery is an ambulatory procedure, quick and painless, with minimal risk and prompt recovery.
• Cataract surgery is one of the most frequently performed procedures worldwide.
• Cataracts do not have to limit your lifestyle.

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