A decrease in visual acuity against the background of clouding of the lens is detected in half of the elderly. To solve this problem, doctors implant an artificial lens. Today, such operations are performed in 30 minutes and allow the patient to return to their usual lifestyle the very next day.
The lens of the eye and its diseases
Inside the eyeball under a layer of the iris is a transparent spherical formation - the lens. It is a biconvex lens, the thickness of which is 4-5 mm. The lens collects a beam of light from the outside, focuses and refracts. The muscle system is responsible for the “tuning” of this mechanism. He can compress the lens, changing the curvature of its surfaces.
A natural lens has no nerve endings, is not supplied with blood, but consists of epithelial cells. The vitreous and the fluid filling the chambers of the eye are responsible for nutrition.
As you know, with age, metabolic processes in the body slow down. The chemical composition of the lens changes, and the lens becomes cloudy. This pathology is called "senile cataract." Similar changes begin after 40 years. However, dysfunctions of the lens can be caused by injuries, infections, metabolic disorders. These types of cataracts are age independent. Without appropriate treatment, a person quickly loses sight. However, you should not be afraid of cataracts, because the operation to replace the lens completely eliminates the problem. In her help resort in other cases.
Indications for intervention
Lens replacement is most often required when it is cloudy - cataract. With this ailment, the objects around become fuzzy. Sometimes it is accompanied by myopia or, conversely, farsightedness. The condition is constantly progressing, therefore, it requires surgery.
Intervention also helps with other age-related disorders, for example, in the case of presbyopia of the eyes. This disturbance is characterized by farsightedness due to the lens sclerosing process. It loses its elasticity and becomes hard. Patients with presbyopia of the eye have difficulty reading the small print.
Another indication for lens replacement is astigmatism. With this disease, the curvature of the lens is disturbed, resulting in a deterioration in the ability to focus on objects. Patients are forced to squint constantly to make out the world around them. Surgery is resorted to in case of failure of other methods of treatment.
In recent years, an operation to replace the lens of the eye has been practiced with myopia. She acts as an alternative to glasses. However, in most cases, it is possible to restore vision through laser correction or other minimally invasive methods. The operation is prescribed only with a high degree of myopia, accompanied by other diseases.
Possible contraindications
Surgical intervention is not recommended in the presence of the following pathologies:
- inflammation of the eye structures;
- retinal disinsertion;
- recent heart attack / stroke;
- small eyeball;
- period of pregnancy and lactation.
Some of the contraindications presented are relative. For example, with infectious and inflammatory diseases of the eye, surgical intervention is possible, but after stopping the pathological process. In case of pregnancy, the procedure for replacing the lens is recommended to be postponed until the end of lactation.
Implant selection
Implants that are inserted in place of a damaged lens are called intraocular lenses. The success of the operation, the quality of life of the patient and the work of the visual apparatus depend on their correct choice. All prostheses vary in shape, material of manufacture, light-reflecting features. The main criteria for choosing are stiffness, the number of tricks and the ability to accommodation.
Depending on the flexibility, the lenses may be soft or hard. The latter option is cheaper, but differs in less functionality. Soft lenses fold well, allowing you to make a small incision during surgery.
The ability to accommodate distinguishes accommodating and non-accommodating prostheses. The former are able to change their curvature, so that after an operation to replace the lens of the eye, the patient can completely abandon glasses. They are much more convenient, but they are more expensive and not produced in every country.
Depending on the number of tricks, prostheses are:
- monofocal;
- diffocal;
- multifocal.
Each artificial lens has several tricks or points at which the picture has maximum accuracy. Bifocal prostheses are used most often. They have 2 focuses, which allows you to see the subject exactly near and into the distance. However, objects between these two points are blurred. Multifocal instances allow you to focus your eyes on 3 or more conventional distances. The smaller the number of tricks, the more often the patient will have to resort to glasses.
Manufacturing companies
In preparation for an operation to replace the lens, which doctor is best to place the implant can prompt the doctor for advice. In this case, he must take into account the patient's disease and the presence of concomitant health problems. Particular attention is paid to the manufacturer of the artificial lens. Patients operated on the territory of the Russian Federation can use the following prostheses:
- Russian. Bifocal implants are absolutely free if the operation is performed according to the mandatory medical insurance policy.
- American Patients most often prefer US firms. The most popular company is Crystalens. She produces multifocal and accommodating prostheses. However, the opinions of doctors about these products are controversial. Most of them believe that this is more of a well-promoted brand than a high-quality product.
- British The British company Rayner was the first to start producing artificial lenses and to perform operations to replace the lens of the eye. She focuses on the optimal shape of her implants, which reduces the invasiveness of the procedure and shortens the recovery period.
- German The most popular are the artificial lenses of Human Optics and s. They are distinguished by the presence of an aspherical edge and a high degree of color rendition. Human Optics appeared on the Russian market only 3 years ago. However, most experts recommend products of this particular brand. Human Optics artificial lenses are manufactured using highly professional equipment. The company offers patients multi - and monofocal implants. More recently, their assortment was replenished with toric lenses, which are recommended for cataracts complicated by astigmatism.
A wide range of artificial lenses allows you to choose the most suitable option for each patient that meets his needs.
Types of operations
There are several options for lens replacement surgery. The specific methodology and treatment regimen are selected by the doctor, taking into account the characteristics of the disease, the patient’s health status.
- Extracapsular extraction. During the procedure, the doctor makes a small incision at the confluence of the sclera and cornea. A damaged lens is removed through it, a prosthesis is implanted in its place, and then stitches are applied. The patient should be in hospital for some time after surgery. Sutures are removed after 3 months.
- Ultrasonic phacoemulsification. The main advantage of this procedure is that the removal of the lens and the installation of a new one is carried out in one step. On the surface of the eyeball, the doctor makes a microscopic incision through which an ultrasound probe is inserted, which turns the tissues into liquid. The liquefied lens is pumped out of the capsule, after which a new artificial lens is installed in its place. The operation itself is performed on an outpatient basis; suturing is not required.
Recently, in medical practice, a new lens replacement technology has been increasingly used. It implies the use of a laser system, through which an incision is made on the surface of the eyeball. The use of such a technique reduces the likelihood of complications, but the cost of the procedure increases significantly.
Preparing the patient for the procedure
Before the operation to replace the lens, the vision and general health of the patient are checked without fail. An additional examination will be required, which includes blood and urine tests, a physical examination. In some cases, consultation with specialized specialists is required. 5 days before the date of surgery, the patient is recommended to instill antibacterial agents in his eyes in order to avoid infection of soft tissues. Sometimes antihistamines are additionally prescribed.
Recently, in many hospitals, psychologists and other specialists work with patients on the eve of the procedure. They step by step explain how the operation will take place, how to behave.
Features of the operation
We will consider the progress of the procedure using ultrasonic phacoemulsification as an example. This is the most common way to replace the lens with cataracts. As a rule, the procedure is performed on an outpatient basis. In especially serious cases, hospitalization of the patient is required.
The patient first lays on the couch. He is given local anesthesia and the eyelids are fixed with a special expander. Then, an incision is made in the cornea, opening and removal of the anterior lens capsule. After that, the doctor proceeds to crushing the lens core itself. The capsule bag is cleaned of the remains of the lens mass and an implant is placed. Such an operation to replace the lens with cataract is good because the incision on the retina is microscopic. It does not need to be stitched, and after the procedure it is itself delayed.
At the final stage, the doctor applies a sterile dressing. In the absence of visible complications, the patient goes home.
Recovery period
Vision after the procedure begins to noticeably improve in a few hours. You can fully experience the positive effect in about a month.
According to medical reviews, replacing the lens of the eye is a rather complicated operation. In order for the healing process to go without complications, after its implementation it is necessary to follow these recommendations:
- In the first days after the installation of the prosthesis, you should refrain from physical exertion, drinking alcohol.
- It is necessary to rinse the eye daily with bottled water, to bury the drugs prescribed by the doctor.
- The operation site is recommended to be protected from mechanical damage, and a bandage should be applied at night.
- When going out, it is better to wear dark glasses. The thing is that an artificial lens allows more light to pass through, which may cause discomfort at first.
- You should refuse to visit baths and saunas, try not to go outside in frosty weather.
Rehabilitation after lens replacement lasts about a month. After this time, most patients return to their usual lives and professional activities. If indicated, postoperative restrictions are extended for several months.
Possible complications
The use of modern techniques allows minimizing the likelihood of complications after replacing the lens of the eye. Sometimes patients may still experience the following problems:
- tissue infection;
- retinal disinsertion;
- inflammation of the eye;
- secondary cataract;
- intraocular bleeding;
- implant mixing;
- increased intraocular pressure.
Some of these disorders require treatment. After replacing the lens of the eye, the appearance of pain, fever or bleeding require medical attention. However, discomfort and burning during the first day are normal reactions of the body to surgery.
Is it possible to do without intervention?
Lens replacement surgery has certain risks of complications. However, in some cases, such a procedure is the only chance to restore vision. For example, with cataracts, laser therapy is ineffective. The pathological process progresses quite quickly. Therefore, without timely intervention by the patient, as a rule, total blindness is expected. If earlier the operation was prescribed only for mature cataracts, today it is increasingly recommended for young patients who have already begun irreversible changes.
Surgery can be dispensed with myopia, astigmatism and presbyopia, provided that the underlying disease does not progress. If the doctor insists on the operation, you should not refuse it. The consequences of improper treatment or its absence can be much worse.
Reviews of doctors and patients
What do doctors say about the operation to replace the lens of the eye? Reviews of doctors, as a rule, are found with a positive color. According to statistics, the effectiveness of surgical intervention in this case is 98%. This means that almost all patients have an improvement in vision. Approximately 80% of those who applied for help maintained a positive result after 7 years. Slight deterioration in the functions of the visual apparatus is observed only in 20% of cases.
Patient reviews confirm the statistics. However, not all the very next day see a positive effect. For some time, a feeling of discomfort and the effect of a "white veil" in front of the eyes may persist. In this case, doctors recommend that patients wait until the end of the rehabilitation period and do not panic ahead of time.
Another significant advantage of the procedure is the fact that it can be performed free of charge under the compulsory medical insurance policy. However, a quota will be required. This means that the patient must come up to a number of requirements and wait for his turn. Pensioners and people with disabilities usually go first.
If the patient’s choice falls on an expensive implant, treatment using which is not included in the insurance company's program will have to pay for the operation on their own. The cost of prostheses can vary from 20 to 100 thousand rubles. Accommodating and multifocal lenses are considered the most expensive. In the case of paid treatment, their price is usually included in the cost of the operation. However, it is unlikely that you can order a lens on your own, since the companies mentioned in the article only work with wholesale buyers.
Among the negative reviews often appear opinions about a long period of rehabilitation. For several months, doctors are not allowed to drive a car or play sports for some patients. Others are strictly forbidden to work in production associated with increased eye strain. Such warnings are justified. If the patient does not adhere to them, the risk of developing postoperative complications may increase several times.
Conclusion
The lens replacement surgery is a fairly effective and relatively painless procedure. It allows you to maintain vision and performance in people with severe visual impairment. With the right approach to therapy and careful attention to your own health, the positive effect of the procedure will not take long. In addition, if you follow all the instructions of a doctor, you can minimize the likelihood of complications.