Cataract

CATARACT

A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil. Cataract can be classified into,

Age-related: These form as you get older.
Congenital: This is what doctors call it when babies are born with cataracts. They may be caused by infection, injury, or poor development in the womb. Or, they can form in childhood.
Secondary: These happen as a result of other medical conditions, like diabetes, ultraviolet light, or radiation, or from taking medicines such as corticosteroids or diuretics.
Traumatic: These form after an injury to the eye.

Treatment :

Cataract or lens surgery is the most common eye operation.
Cataract removal can be performed at any stage and no longer requires ripening of the lens.
It is generally agreed that surgical intervention is indicated when there is “functional “visual impairment.

Lens surgery techniques :

Phacoemulsification :

Present technique of cataract removal happen through incisions ranging from 3.2 mm down to less than 1.0 mm.
Combined with foldable lens implantation, the major advantage of phaco is the small incision.
Current techniques (MICS) use phaco through self sealing clear corneal incisions measuring 1.9-3.2mm.
phaco offers the surgeon the possibility to break the nucleus into smaller pieces and even into a fine emulsion of material, all of which can be removed through the probe .As a result, it is now possible to minimize trauma to the structures of the eye, and to have minimal impact on its shape as a consequence of modern cataract surgery.

Femtosecond laser-assisted cataract surgery :

The newest of the cataract surgery techniques involves a combination of techniques, using femtosecond laser-assisted phaco, where the femtosecond laser can cut precise corneal incision, an accurate sized and truly circular capsulorrhexis and partial fragmentation of the lens nucleus permitting less ultrasonic energy release.

Refractive lens exchange

stands as a viable procedure today for both myopia and hypermetropia, with the abilities now to control astigmatism and reduce presbyopic symptoms. Multifocal IOLs and trifocal IOLs are aimed at the intraocular correction of presbyopia.

Characteristics of Multifocal Lenses: Trifocal IOLs

Trifocal lenses work by bending the light entering the eye from near, intermediate and far distances, and focusing this light onto a single focal point on your retina. This enables you to focus on objects at different distances simultaneously, providing near, intermediate and distant vision through one lens. These modern IOL types reduce, or may eliminate, the need for glasses or contact lenses. Just like prescription glasses, your IOL will also be adjusted to your individual needs to give you the best vision possible.

Clear vision at all distances :

Trifocal lenses are the most advanced intraocular lenses (IOLs) available today, providing clear vision for close, intermediate and far distances, without gaps in between. They are designed to enable a high degree of independence from glasses for patients leading an active life and wishing to do without visual aids.

How Trifocal Lenses Work :

Trifocal Lenses in Daily Life :

Unlike monofocal and bifocal lenses, trifocal lenses also provide comfortable intermediate vision, which is important for various daily activities, such as computer work.

With trifocal lenses, you can perform a range of activities in everyday life without glasses. This includes daily tasks such as:

Reading
Cooking, cleaning, ironing
Working at the computer
Shopping
Watching TV
Driving
Working in the garden
Playing sport or doing exercise

Advantages of Trifocal Lenses :

The biggest advantage of trifocal intraocular lenses is the possibility to see clearly at all distances without glasses. As a result, you may no longer need to wear glasses when pursuing your daily activities.

Trifocal IOLs allow for the treatment of pre-existing vision disorders, such as myopia or hyperopia. With a toric version of the trifocal lens, pre-existing astigmatism can be corrected as well. Trifocal intraocular lenses are also effective for treating age-related vision changes such as presbyopia, which affects nearly everyone after the age of 40. When you treat your cataract with a trifocal IOL you can take care of your presbyopia at the same time.

In short, ideal candidates for trifocal lenses are patients who would like to be completely independent from glasses or contact lenses.

What you should know :

Like with all innovative technologies, there are also a few things to consider when choosing a trifocal lens. If you suffer from eye diseases, such as glaucoma, diabetic retinopathy, diabetic macular oedema, or macular degeneration, you may not be a suitable candidate for bifocal or trifocal lenses. These diseases, even in early stages, may be incompatible with premium intraocular lenses. If you suffer from one of these diseases, you can discuss alternative options with your ophthalmologist.

Light phenomena :

One side effect connected with multifocal IOLs is a higher degree of visual disturbances and light phenomena (dysphotopsia), which are caused by the lens focusing light from multiple distances. These are normally perceived as

Glare in certain low lighting situations
Halos around light sources at night

Most people with multifocal lenses find these phenomena only mildly disturbing and get used to them over time. However, there is also a small group of patients who do not adapt to this type of IOL lenses well or are very bothered by the side effects that may occur. Decreased contrast sensitivity : Another consequence of the multifocality is a slightly less perfect image quality. This is due to the lens splitting light from different distances on the retina. Therefore, patients have to compromise a little on the image quality to gain the multifocal effect.

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