Cataract is the loss of transparency of the natural intraocular lens. The loss of transparency of the intraocular lens can cause decreased visual quality, contrast loss, color perception change, night vision disorders, sensitivity to light or rapid eyeglass prescription changes. Cataract can be seen at any age and can have many causes. In adults, it can develop due to advancing age, trauma, medication use, diabetes and eye diseases. In children, metabolic diseases, genetic diseases, medication use, infections during pregnancy and trauma can cause cataract development.

There is no effective medical treatment that stops the development of cataract or regresses cataract. The treatment of cataracts is surgical. The intraocular lens that has lost its transparency is surgically removed and replaced with an artificial intraocular lens.

When Should I Have Cataract Surgery?

The timing of cataract surgery varies according to the patient’s age, additional diseases and needs.

In childhood, surgery should be performed as soon as possible in the presence of cataracts that significantly reduces visual quality. When cataract surgery is delayed in children, additional diseases such as amblyopia or strabismus may develop.

In cataracts that develop in adults without an additional disease, the timing of surgery depends on the patient’s visual acuity level. Surgery can be performed when the patient’s visual acuity level begins to restrict daily activities. If the patient does not feel any restrictions, surgery can be postponed.

If the presence of cataracts negatively affects another intraocular disease such as glaucoma or uveitis, or if it creates difficulties in the treatment of other eye diseases, cataract surgery should not be postponed.

Which Intraocular Lens Should Be Used in Cataract Surgery?

Intraocular lens type choice varies according to the patient’s age, additional diseases, profession and needs. There are many types of intraocular lenses. The main ones are;

Monofocal Lenses

Monofocal lenses are used to obtain sharp vision in a single focus. The focal point is usually adjusted for clear vision at distance and use additional glasses for close distances. It is primarily preferred in patients with any eye disease, in patients in occupational groups where contrast sensitivity is important, and in patients with a high risk of surgical complications.

Advantages

• High visual acuity in single focus
• High contrast sensitivity
• Safe use in patients with additional eye diseases

Disadvantages

• Additional glasses required for near-distance vision

EDOF (Extended Depth of Focus) Intraocular Lenses

In addition to obtaining sharp vision in a single focus like monofocal intraocular lenses, it is also used to obtain a clear image at medium distance. Although the medium distance performance is good, additional glasses may be required for near distance.

Advantages

• Clear vision without glasses at far and medium distance
• High contrast sensitivity

Disadvantages

• Additional glasses required for near-distance vision

Multifocal Intraocular Lenses

Multifocal intraocular lenses are used to provide glass-free vision at far, medium, and near distances. Multifocal intraocular lenses are preferred in patients who do not have any eye disease and want to see without glasses at far-medium-near distances after surgery. Multifocal intraocular lenses are not used in the presence of any eye disease. Multifocal intraocular lenses are not preferred for long-distance drivers or pilots.

Advantages

• Seeing without glasses at far, medium and near distances

Disadvantages

• Can only be used in eyes without additional eye diseases
• Decrease in contrast sensitivity
• Glowing or halo in lights in the dark

Toric Lenses

Toric Intraocular Lenses

Toric intraocular lenses are used to eliminate astigmatic disorder in patients with astigmatism who do not want to use glasses after surgery. Both monofocal and multifocal intraocular lenses have toric options.

Refractive Lens Exchange (RLE / PRELEX)

Refractive lens exchange is a method that can be preferred in patients with high refractive error and whose eyes are not suitable for laser surgery. High myopia, astigmatism or hyperopia can be corrected with this surgery. The surgery technique is basically the same as cataract surgery. The patient’s natural lens in the eye is surgically removed and replaced with an artificial intraocular lens. Depending on the patient’s needs, vision can be achieved without glasses only at far distances or at far, middle and near distances.

Cataract / RLE Examination and Intraocular Lens Selection

• A detailed eye examination including anterior and posterior segment of the eye 
• Detailed measurement of the parameters for intraocular lens calculations
• Calculation of the appropriate intraocular lens power
• Selecting the type of intraocular lens 
• Explaining the benefits of surgery and possible surgical risks to the patient in detail

Cataract / RLE Surgery Process

Before Surgery

• Unless your doctor tells you otherwise, you do not need to stop your daily medications
• You do not need to stay in the hospital
• The surgery is generally performed with local anesthesia, fasting is not required before surgery.
• If the surgery is to be performed with general anesthesia, tests related to general anesthesia are performed before the surgery.

Surgery Day

• Application of eye drops for pupil dilatation
• Application of anesthesia to the surface of the eye with eye drops
• The average surgery time is 15-20 minutes
• The patient does not feel any pain during the surgery

After Surgery

• Eye drops will be used for 1 month after surgery
• Patients can do most of your daily activities within 3 days after surgery.
• Swimming in the sea or pool, heavy lifting and heavy sports activities can be done after the 2nd week.
• There are control examinations on the 1st day, 1st week and 1st month after surgery.
• Additional control examinations can be done as needed.