Cataract

Selected ophtalmology treatments and their medical experts, specialists and clinics in Switzerland - Ticino

A cataract leads to clouding of the eye lens. This results in a blurred field of vision. In the early stages of the disease the prescription of glasses may help. In the advanced stages only surgery can help. This involves replacing the cloudy lens with an artificial intraocular lens.

Advantages

Surgery is the only way to improve your eyesight. When a cataract occurs neither eye drops nor laser offer a cure.

Indications

The most common symptoms of cataracts include:

  • painless blurred vision
  • sensitivity to light
  • need to frequently change spectacle lenses
  • double vision in one eye
  • need for more intense light when reading
  • poor night vision
  • reduced perception of colours which appear yellowish

Procedure

What to expect

The operation is carried out with the patient laying on his back, in a sterile surgical environment and with the aid of a microscope.

Preparation

Before surgery, please advise our specialist if you are taking anticoagulant medicines (Marcumar, Sintrom) or antiplatelet drugs (Aspirin, Tiatral) to be able to suspend two weeks prior to surgery.

Treatment plan

There are different types of interventions:

Hospitalisation
The operation requires a minimum of rest lasting a few hours. The type of hospitalisation required will be adapted to your needs and proposed to you by the doctor in agreement with the anaesthetist

Anaesthesia
The eye may be rendered insensible to pain with either a local injection or eye drops. A general anaesthetic is always possible.  The choice of anaesthetic is made by the doctor who will also consider your choice if this is feasible.

Cataract extraction
This can be made with or without the use of an ultrasonic probe of the crystalline lens.  The casing is not moved and only in exceptional circumstances would a complete extraction of the crystalline lens be made.

Implantation
Of an artificial lens (intraocular implant): the crystalline lens is replaced with a synthetic lens inserted behind the pupil.  The incision may or may not be sutured.

Sclerectomy
The surgery is performed with the incision of the iridocorneal angle and then with the excision of a small piece of the sclera over the canal of Schlemm. The ciliary body, responsible for the production of aqueous humor, is cryo coagulated or scarred by laser light. Later the production of aqueous humor decreases. This method is often used in the case of secondary glaucoma, for example after a venous thrombosis in the eye or in response to a disease advanced diabetic.

Postoperative difficultis
These are rare and unpredictable. They may sometimes lead to an implant in front of the pupil or the necessity to abandon the implant altogether. It may be necessary to take a small fragment of the iris and/or proceed with the ablation of part of the vitreous. The operation could be complicated by a rupture of the capsule (in less than 5% of the cases). The cataract extraction may sometime be incomplete. There may be bleeding but this is reabsorbed within a few days (only in very exceptional cases it can lead to loss of vision or of the eye).

Recovery

Sight improves quickly and a new prescription for glasses be issued after a month.  The presence of other eye injuries may limit sight recovery.  Local treatment is limited to the use of drops, application of ointment and eye protection, the details of which will be prescribed by the doctor. Over the past year in more than 30% of the cases, the operation shows a capsule opacification (secondary cataract) causing a worsening of eyesight. Treatment consists in making an opening in the capsule with either a laser or by surgery.

Risks & complications

Your doctor will discuss with you the possible risks and complications.

 

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