Description

This article is from the Vision and Eye Care FAQ, by grants@research.canon.com.au (Grant Sayer) with numerous contributions by others.

5.7 Cataracts

Cataracts are opacifications of the crystalline lens of the eye, causing a
loss of transparency. The crystalline lens is the "focussing" mechanism
of the human eye. The change in light transmission is due to accumulation
of water and/or denaturation of the lens protein. A variety of factors
cause cataracts, eg diabetes, eye trauma, age related changes. The
predominant symptoms of cataract are an increasing loss in vision. There
can be associated fluctuations in the vision depending on water changes in
the lens. The rate at which the cataract changes varies depending on
physiological factors.

The surgical procedure is described below (contribued by Dr W.Wan M.D):


There are two standard techniques for modern cataract surgery:
phacoemulsification (PE) and nucleus expression or planned extracapsular
cataract extraction (ECCE). There are numerous variants on these,
especially PE, which may get advertised as no-stitch, one-stitch, clear
cornea, topical, etc. In general: 1) PE is technically more difficult to
learn, however, once you learn it, most surgeons feel it is a better
technique in their hands; 2) the incidence of complications is dependent
on the surgeon and the patient population, not the particular technique
used (PE was previously thought to have a greater incidence of
complications, but this was primarly due to a learning curve; for a given
surgeon, the complication rate will be lowest with the technique that he
is best with); and 3) PE is generally quicker than ECCE, but again this is
very surgeon-dependent.

My personal preference is for PE 95% of the time; ECCE is reserved for
cases where it may be better than PE based on the type of cataract, the
patient, the surgical goals, and occasionally the type of equipment
available. (If you want to know how I decide which are in that 5%, you
need to go to ophthalmology residency!) PE generally offers quicker visual
recovery, and arguably quicker healing and overall rehabilitation, better
wound stability, and less risk of disastrous complications such as an
expulsive hemorrhage during surgery. However, the bottom line is, good
surgeons get good results with either technique, pick a surgeon who gets
good results and let him decide what technique is best for you in his
hands. (Even then, of course, keep in mind that although it is 95%
successful, cataract surgery IS surgery, and complications can occur.)


The indication for removing the cataract in a second eye is the same as
the first: If the decreased vision in that eye is bothering the patient.
(Unless there is some other eye disease, e.g. glaucoma or inflammation
being caused by the cataract, or it is preventing management and treatment
of some other eye problem in the interior of the eye, which would be
unlikely if it is mild.)


Other internet resources that provide information on cataracts
URL: http://cpmcnet.columbia.edu/dept/eye/rad/intro.html
(Eye Radiation and Environmental Research Laboratory)

URL: http://www.west.net/~eyecare
(EyeCare Connection homepage with information on cataracts)

URL: http://128.173.80.71/lensnet.html
(Lens and Cataract Researcher Internet Directory)

URL: http://www.ascrs.org/
( American Society of Cataract & Refractive Surgery - patient FAQ on cataract)

 

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• Index
• next: 5.8 Uveitis:

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