Cataract Surgery, Here's What You Need to Know

Cataract surgery is a surgical procedure performed on cataract sufferers, which is a disease that occurs due to cloudy lens of the eye and disturbs the view. Cataracts can occur in one or both eyes. This disease often occurs in the elderly, but in some cases, it can also occur in newborns or children. Under normal conditions, the lens of the eye will be clear because it matches its function, which is to pass light into the retina. If someone suffers from cataracts, the lens of the eye will feel cloudy and turbidity will increase slowly. The presence of cataracts makes it difficult for sufferers to carry out daily activities due to disturbed vision. Until now the process of the emergence of cataracts in a person has not been known with certainty. Besides being caused by aging, cataracts can also occur due to genetic diseases, enzyme disorders, and infections. Lens blurring can develop faster if there is an eye injury or inflammation of the eye tissue (intraocular inflammation). Cataracts can also occur when you are young, especially if someone is often exposed to ultraviolet light, undergoing radiotherapy, suffering from diabetes, or smoking.

Indications for Cataract Surgery

Cataract surgery is done if the patient has been diagnosed with cataracts. Cataract symptoms that usually appear are:

• Vision loss.
• Blurred vision.
• Difficult to distinguish colors.
• Difficult to see bright objects.
• Nearsighted.
• Double vision.

Warning for Cataract Surgery

Cataract surgery is usually quite safe for patients to undergo and rarely causes complications. However, cataract surgery can still pose risks such as:

• Inflammation and eye infections.
• Swelling of the eyes.
• Decreased eyelid.
• Bleeding.
• Artificial lens detached.
• Cataracts reappear due to cloudy capsule behind the eye lens.
• Retinal detachment.
• Glaucoma.
• Blindness.

The risk of complications due to cataract surgery will increase if the patient has other eye diseases. If there are other eye diseases, such as glaucoma or macular degeneration that cause visual disturbances, cataract surgery usually cannot improve the patient's full vision.

Preparation for Cataract Surgery

Before cataract surgery, the patient will undergo an ultrasound examination of the eye to measure the shape and size of the eyeball. The aim is to estimate the size of the artificial lens that will be placed in the eye of the patient during cataract surgery. Patients are also required to notify the eye doctor regarding the drugs being consumed and other illnesses that are being suffered. If you are taking blood-thinning medication, the doctor will ask the patient to stop taking the drug for a while. Based on eye ball measurements, the doctor will tell you the types of lenses that the patient can choose, such as lenses for seeing near objects or distant objects. The doctor will also tell you about the risks and benefits of cataract surgery, as well as the possibility of wearing glasses after the operation. The types of eye lens implants that can be mounted on the eyes of cataract patients are:

• Monofocal lens. This is the type of artificial lens that is most often used in cataract operations. Monofocal lenses only have a focal point at a certain distance and cannot treat astigmatism (cylindrical eyes) due to the uneven shape of the cornea. Patients who use monofocal lenses are usually required to wear glasses to help vision or correct astigmatism. In addition to correcting astigmatism, the doctor can adjust the shape of the cornea mechanically during surgery.
• Torik lens. This is an artificial lens that can overcome the astigmatism suffered by cataract patients. Toric lenses can also help patients see objects remotely, but must still use glasses to carry out certain activities, such as reading and writing. In order for the maximal torque lens to be used, the lens must be fitted to certain specifications in the patient's eyes.
• Multifocal lens. This lens can help patients see objects with different distances, both close, middle, and far. However, multifocal lenses cannot treat astigmatism so astigmatism patients still need glasses. Multifocal lenses can also cause excessive glare for patients and reduce the color contrast seen by patients.

Patients will usually be asked to fast the day before undergoing cataract surgery. Patients will also be asked to be accompanied by family members so that the recovery process after the patient's surgery can be assisted by the family.

Cataract Surgery Procedure

Cataract surgery is done by destroying the cataract lens with a special instrument. After the lens is destroyed, the cataract lens is removed from the eyeball and replaced with an artificial lens (IOL). In some cases, the lens that has been removed does not need to be replaced by an IOL. To facilitate surgery, the doctor will shed a special drug whose function is to widen the pupil. After the pupils have dilated, the doctor will provide local anesthesia to the eye so that the eye area will numb during surgery. If the patient is tense or anxious before undergoing surgery, the doctor can give a sedative. During the cataract surgery procedure, the patient will remain conscious and open his eyes until the operation is complete. Cataract surgery can last for 45-60 minutes. Cataract surgery techniques that are usually performed on cataract patients include:

• Phacoemulsification. This technique is done by destroying the cataract lens using sound waves (ultrasound). The dilated pupils make small incisions at the front of the cornea. Through this incision, a special instrument is inserted into the eyeball until it reaches the lens. After that, sound waves emitted from the device to destroy the cataract lens. Lenses that have destroyed cataracts are then removed from the eye through suction. Next, a new lens is placed in the location of the old lens. The incision made in the cornea of ​​the eye is closed, and if necessary, sewn with special stitches.
• Laser technique. The principle of cataract surgery with laser techniques is almost similar to phacoemulsification. The difference is in the method of making an incision and the destruction of the lens that is experienced. In the laser technique, the doctor will use a laser beam to make an incision in the cornea of ​​the eye. After the incision is made, the laser beam will be used to destroy the lens of the cataract. Lenses that develop cataracts are then removed by aspirating and new lenses will be placed in the old lens case. After completion, the incision will be closed again, and if necessary, sewn using special stitches.
• Extracapsular cataract surgery. This technique is carried out by lifting one intact lens and leaving the lens behind the capsule, the same as phacoemulsification or laser, to become an IOL attachment. This technique is usually used if the cataract that occurs is dense enough, so it cannot be destroyed. The incisions made are usually more than phacoemulsification incisions, and postoperative recovery takes longer.
• Intracapsular cataract surgery. This operation is done by making a large incision, then lifting the entire lens with the capsule from the eye. After that, a new lens is placed in the eye in the same location as the old lens or in a new location, usually in front of the iris.

Cataract surgery has a fairly high success rate. Most patients who undergo cataract surgery report that their vision can return to normal and not blurred. If the patient has cataracts in both eyes, the doctor will first perform cataract surgery on one eye. After the eye has healed, surgery on the other eye will only be done.

After Cataract Surgery

After cataract surgery, patients are usually allowed to go home, but may not drive alone. The patient's vision will improve within a few days, marked by a clearer color, even though the first days after the operation will feel blurred. Patients who have undergone cataract surgery can experience cataracts again called secondary cataracts. Secondary cataracts occur due to lens capsules which are not removed during cataract surgery experiencing calcification and interfere with the patient's vision. Secondary cataracts can be overcome by performing cataract operations again, by lifting the capsule. After the cataract surgery is complete, the patient will feel discomfort and itching in the operated eye. Avoid scratching or rubbing the eyes because it is feared it can cause unwanted side effects. To protect the eyes, the doctor will put an eye bandage on the patient a few days after the operation. The doctor will also schedule patient control times so that patient recovery can be monitored closely. The doctor will give eye drops that must be used during the recovery period to avoid infection and inflammation. The next few days, discomfort or itching will usually disappear from the eye, and the eye has recovered about 8 days after cataract surgery. If the patient requires glasses after cataract surgery, the doctor will prescribe eyeglass lenses.

• The patient should immediately inform the doctor if during the recovery period experiences the following: Red eye.
• Pain that does not go away, even though pain medication has been given.
• Light eyesight.
• Vision loss.