Decreased 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 way of life the very next day.
The lens of the eye and its diseases
Inside the eyeball under the 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 muscular apparatus is responsible for the “tuning” of this mechanism. It can compress the lens, changing the curvature of its surfaces.
The natural lens has no nerve endings, is not supplied with blood, but consists of epithelial cells. The vitreous body and the fluid that fills 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 isthe name "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 do not depend on age. Without proper 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. She is used in other cases as well.
Indications for intervention
Replacement of the lens is most often required when it becomes cloudy - a cataract. With this disease, objects around become fuzzy. Sometimes it is accompanied by myopia or, conversely, farsightedness. The condition is constantly progressing, therefore, requires an operation.
The intervention also helps with other age-related disorders, for example, in the case of presbyopia of the eyes. This disorder is characterized by farsightedness due to the process of sclerosis of the lens. It loses its elasticity and becomes hard. Patients with presbyopic eyes have difficulty reading fine print.
Another indication for lens replacement is astigmatism. In this disease, the curvature of the lens is disturbed, as a result of which the ability to focus on objects deteriorates. Patients are forced to constantly squint to see the world around. The operation is resorted to in case of ineffectiveness of other methods of treatment.
In recent years, the operation to replace the lens of the eye is practiced for myopia. She performsas an alternative to glasses. However, in most cases, vision can be restored 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
Surgery is not recommended for the following conditions:
- inflammation of eye structures;
- retinal detachment;
- recent heart attack/stroke;
- small eyeball;
- pregnancy and lactation.
Some of the presented contraindications are relative. For example, in case of infectious and inflammatory diseases of the eye, surgical intervention is possible, but after stopping the pathological process. In case of pregnancy, the lens replacement procedure is recommended to be postponed until the end of lactation.
Implant choice
Implants that are inserted in place of the 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 differ in shape, material of manufacture, light-refractive features. The main selection criteria are stiffness, the number of tricks and the ability to accommodate.
Depending on the flexibility, lenses can be soft or hard. The latter option is cheaper, but has lessfunctionality. The soft lenses roll up nicely, allowing you to make a small incision during surgery.
According to the ability to accommodate, accommodating and non-accommodating prostheses are distinguished. The former are able to change their curvature, due to which, after the operation to replace the lens of the eye, the patient can completely abandon glasses. They are much more convenient, but more expensive and not produced in every country.
Depending on the number of tricks, prostheses are:
- monofocal;
- difocal;
- multifocal.
Each artificial lens has several foci or points at which the picture has maximum accuracy. Bifocal prostheses are the most commonly used. They have 2 focuses, which allows you to see the object accurately near and far. However, objects between these two points are blurred. Multifocal instances allow you to focus 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
When preparing for an operation to replace the lens, which one is better to place an implant can be suggested by the doctor at the consultation. At the same time, he must take into account the patient's disease and the presence of concomitant he alth problems. When choosing, special 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 ifthe operation is carried out under the compulsory medical insurance policy.
- American. Patients most often prefer firms from the USA. The most popular company is Crystalens. It produces multifocal and accommodating prostheses. However, the opinions of doctors about these products are contradictory. Most of them believe that this is more of a well-known brand than a high-quality product.
- British. The British company Rayner was the very first to produce artificial lenses and carry out 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 artificial lenses from Human Optics and S. They are distinguished by the presence of an aspherical edge and a high degree of color rendering. 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 range has been replenished with toric lenses, which are recommended for cataracts complicated by astigmatism.
A wide range of artificial lenses allows you to choose for each patient the most appropriate option that meets his needs.
Types of transactions
There are several options for the operation to replace the lens. The specific method and treatment regimen is selected by the doctor, taking into account the characteristicsdiseases, he alth status of the patient.
- Extracapsular extraction. During the procedure, the doctor makes a small incision at the junction of the sclera and cornea. The damaged lens is removed through it, a prosthesis is implanted in its place, and then sutures are applied. The patient must remain in the hospital under observation for some time after the operation. Stitches 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 he inserts an ultrasonic probe that turns tissues into a 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 technology for replacing the lens is increasingly being used. It involves the use of a laser machine, through which an incision is made on the surface of the eyeball. The use of this technique reduces the likelihood of complications, but the cost of the procedure increases significantly.
Preparing the patient for the procedure
Before the lens replacement surgery, the patient's vision and general he alth are checked without fail. You will need to undergo an additional examination, which includes blood and urine tests, a physical examination. In some cases, specialist advice is required. For 5days before the date of surgery, the patient is recommended to instill antibacterial agents in the eyes to avoid infection of the soft tissues. Sometimes additional antihistamines are prescribed.
Recently, psychologists and other specialists work with patients on the eve of the procedure in many hospitals. They explain step by step how the operation will take place, how to behave in this case.
Features of the operation
Let's consider the progress of the procedure using the example of ultrasonic phacoemulsification. This is the most common way to replace the lens for 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 lies down on the couch. He is given local anesthesia and the eyelids are fixed with a special dilator. Then an incision is made in the cornea, opening and removal of the anterior lens capsule. After that, the doctor proceeds to crush the lens core itself. The capsule bag is cleaned from the remnants of the lens mass and the implant is installed. Such an operation to replace the lens for cataracts is good because the incision on the retina is microscopic. It does not require stitching, and after the procedure it tightens itself.
At the final stage, the doctor applies a sterile dressing. In the absence of visible complications, the patient is sent home.
Recovery period
Vision after the procedure begins to improve noticeablywithin a few hours. You can fully feel the positive effect in about a month.
According to medical reviews, the replacement of the lens of the eye is a rather complicated operation. In order for the healing process to proceed without complications, after its implementation it is necessary to follow the following recommendations:
- In the first days after the installation of the prosthesis, you should refrain from physical exertion, drinking alcohol.
- It is necessary to wash the eye daily with bottled water, instill the drugs prescribed by the doctor.
- It is recommended to protect the operation site from mechanical damage, and apply a bandage at night.
- When going outside, it is better to wear dark glasses. The thing is that the artificial lens transmits more light, which can 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 normal life 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. Occasionally, patients may still experience the following problems:
- tissue infection;
- retinal detachment;
- eye inflammation;
- 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 the occurrence of bleeding require medical attention. However, discomfort and burning during the first day are normal reactions of the body to the operation.
Can we 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, the patient, as a rule, expects total blindness. If earlier the operation was prescribed only for mature cataracts, today it is increasingly recommended for young patients who have already begun to have irreversible changes.
It is possible to do without surgical intervention 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 the wrong treatment or lack thereof can be much worse.
Reviews of doctors and patients
What do doctors say about lens replacement surgery? 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 practicallyAll patients experience improvement in vision. Approximately 80% of those who applied for help had a positive result even after 7 years. Slight deterioration in the functions of the visual apparatus is observed only in 20% of cases.
Patient testimonials confirm the statistics. However, not everyone sees a positive effect the very next day. For some time, a feeling of discomfort and the effect of a “white veil” before the eyes may persist. In this case, doctors recommend that patients wait until the end of the rehabilitation period and not panic ahead of time.
Another significant advantage of the procedure is the fact that it can be done free of charge under the CHI policy. However, a quota will be required. This means that the patient must meet a series of requirements and wait for their turn. Seniors and disabled people usually go first.
If the choice of the patient falls on an expensive implant, treatment, which is not included in the program of the insurance company, you will have to pay for the operation yourself. 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 will be able to order a lens on your own, since the companies mentioned in the article work only with wholesale buyers.
Among the negative reviews, opinions about a long period of rehabilitation often appear. For some patients, doctors do not allow driving and playing sports for several months. OtherIt is strictly forbidden to work in production, associated with an increased load on the eyes. Such warnings are well justified. If the patient does not adhere to them, the risk of postoperative complications may increase several times.
Conclusion
Lens replacement surgery is a fairly effective and relatively painless procedure. It allows you to save vision and performance in people with severe visual impairment. With the right approach to therapy and attentive attitude to one's own he alth, the positive effect of the procedure will not be long in coming. In addition, if you follow all the doctor's instructions, you can minimize the likelihood of complications.
