With nearly 600 000 operations a year, cataract surgery is the most common surgical procedure performed in Germany across all medical disciplines; it is also one of the procedures with the lowest risks and generally very successful.
It not only gives back patients their clear vision; the procedure can also reduce or even eliminate additionally existing visual defects. By aligning the optical effect of the artificial lens, patients will in some cases only need weak reading glasses after the operation. And for patients dreaming of a life without glasses, there is also the option of implanting multifocal lenses.
The surgery is performed on an outpatient basis under local anaesthesia. To begin with, the eye is numbed with drops. In case of very nervous patients, it is also possible to perform the operation under a general anaesthetic to avoid complications due to their restlessness. The procedure is pain-free and takes no longer than 10 minutes per eye. Only one eye is operated at a time – mostly the more severely affected eye is treated first. Generally, the second eye is operated one to two weeks later.
Before and after the operation
If the procedure is performed under local anaesthesia, you needn’t take any further special precautions before the surgery. However, if the surgery is performed under general anaesthesia, you should strictly observe the instructions of your doctor with regard to food and drink abstention starting six hours before the operation.
Directly after the operation, you will have the opportunity to recover a bit under observation until you feel fit enough to go home. It is not allowed to drive a car directly after the operation and you should also not attempt to go home alone by public transport. Best, you arrange to get picked up by your family or friends or call a taxi.
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Fragmentation of the clouded lens
Cataract surgery consists of two steps. In step one, the clouded lens is removed (this is referred to as phacoemulsification). In step two, the artificial lens (intraocular lens) is inserted.
Removal of the clouded lens via suction
The phacoemulsification technique, requires an only millimetre-long incision. The lens capsule is opened. The nucleus of the lens is then broken-down using ultrasound and sucked off.
Insertion of the foldable artificial lens
Via a small incision (approx. 2 to 4 mm), a small, folded artificial lens (IOL) made of soft material can now be inserted into the now empty capsular bag of the lens. The lens will gently unfold inside the eye, where it is fixed into place with small, elastic brackets. In general, the incision is performed so that it does not need to be closed with a suture, but will heal by itself.
Natural lens and modern IOLs
It is scientifically proven that blue light – as well as UV light – can damage the retina. The natural lens has developed a protective mechanism against this, by adopting an increasingly yellow colour after the age of four in order to reduce the risk if retinal damage.
Modern IOLs such as e.g. the AcrySof artificial lens have been developed taking the natural lens as model and are therefore equipped with a UV and blue light filter. The lens will therefore also act as protection for the retina after a cataract operation.