What is cataract?
Cataract is a progressive opacification of the eye lens. In most cases, it is related to aging of the body, although cases of congenital cataract have been reported, as well. It is the most frequent cause of reversible loss of vision.
Operation is necessary when cataract impairs vision to a degree which lowers the quality of everyday life. The procedure is also recommended in the event of closed-angle glaucoma, since removal of cataract may cure this type of glaucoma or prevent its development. Early cataract surgery is also recommended in chronic open-angle glaucoma, since it reduces eye pressure by a few mm, facilitates further monitoring of the disease course, and makes potential future anti-glaucoma surgeries safer.
The only treatment method is removal of the opacified lens and replacing it with an artificial one. The most modern method of cataract surgery is phacoemulsification with the use of ultrasound. Laser-supported manual removal is also used. Thanks to modern methods of removing cataract by means of a small excision (1.8-2.8 mm), the risk of significant intraoperative complications with good surgeons and in uncomplicated cataract is much below 1%. The risk significantly increases with complicated, mature, and hard cataracts, especially when surgeries are performed by less experienced surgeons. Therefore, if the surgery involves a high risk, a prompt operation and selection of an experienced surgeon is recommended. Rehabilitation after uncomplicated initial cataract is very quick, and the risk of complications is minimal. The rehabilitation period with advanced and hard cataracts may be longer, usually due to corneal edema, and may be even a few weeks. In such cases, the number of complications also increases, but if appropriate measures are taken, the risk of vision loss at the best centres is much below 0.1% (once per several thousand surgeries). With less experienced surgeons, the risk may be several times higher.
Patients without other serious ocular problems, like diseases of the retina, optic nerve and choroid, achieve normal vision after the procedure. Additionally, in the case of refractive errors, such as myopia, hyperopia or astigmatism, with the use of appropriate lenses, they may achieve such vision after the surgery which was not previously possible without glasses or contact lenses.
Treatment of cataract at the Eye Surgery Centres of Professor Zagórski.
At our centres, surgeries are performed by experienced surgeons, so the risk is minimal. Professor Zagórski has been performing cataract phacoemulsification for more than 20 years, probably longer than any other active surgeons in Poland. We offer a wide selection of lenses, whose type is for example dependent on the question if the cataract surgery is also supposed to remove one of refractive errors, such as myopia, hyperopia or astigmatism.
The only effective method of treating cataract is a surgical procedure. During qualification, the ophthalmologist selects the lens. The patient receives regional anaesthesia with eye drops. He/she is monitored by an anaesthesiologist during the entire procedure. Then, the operator makes a small incision and using the phacoemulsification method disintegrates the opacified natural lens with the use of ultrasound vibrations, removes the cataract and implants an artificial lens. The procedure of cataract removal takes several minutes and is completely painless. After the surgery, the patient rests in the recovery room.
At OCHO Centres of Professor Zagórski, we place importance on the quality and patient satisfaction; that is why, we use products of renown lens manufactures, such as: Zeiss, Oculentis, Alcon. Lenses are divided into unifocal, unifocal with extended depth of focus, bifocal and multifocal. During qualification, the ophthalmologist and the patient select the best lens which will meet the visual needs of the patient.
In accordance with the Polish law, you cannot pay an extra charge to obtain an above-standard lens if the procedure of cataract removal is reimbursed by the National Health Fund. The National Health Fund offers patients standard unifocal or toric lenses.
After the procedure, the patient is under the care of the medical facility personnel. The duration of the patient’s stay depends on his/her general feeling. The cataract surgery is performed as one-day procedure, so after the surgery the patients rests in the recovery room for about 30 minutes, and then is discharged home with instructions to come back for a control visit on the next day.
Patients whose cataract surgery is performed as part of the National Health Fund, have two mandatory control visits, which are reimbursed. Patients who use commercial services, may have three control visits, where the first one is free of charge.
Our specialists recommend that the patient lead a sparing lifestyle for up to a month after the procedure. This primarily means avoiding excessive muscular exercise, such as lifting heavy objects, doing competitive sport or physical work.
In the first hours after the procedure, vision may be foggy. This is related, among other things, to the application of drugs into the eye. The patient may also experience lacrimation or foreign body sensation. If no additional ophthalmological diseases were found (i.e. the only obstacle to correctly receive visual stimuli was cataract), the vision should return within the first few days. If the operated eye is affected by other ophthalmological diseases, the prognosis of the expected vision is provided during control visits. After the cataract surgery, the patient should see more clearly, and colours should become more vivid.
No. Cataract cannot appear once again on the operated eye. It is possible, however, that opacity of the posterior lens capsule will occur in the same eye. This condition is commonly called secondary cataract. Then, the ophthalmologist may qualify the patient for YAG laser treatment, i.e. capsulotomy. There is a method, however, which may protect the eye against secondary cataract, called posterior capsulorhexis. In commercial procedures, it is possible, with an extra charge, to perform posterior capsulorhexis. Owing to this procedure, it is not possible that posterior lens capsule opacity will appear.
The decision if the patient will see at distance or at near with glasses correction is made during the qualification. In such a situation, when the patient has been short-sighted since childhood and is used to see clearly at a distance, it is usually recommended that he/she remains with the glasses for far distance, while close objects can be seen without correction. The patient may, however, in agreement with the doctor, want to read in glasses, and see at far distance without correction. This decision must be made during qualification, so that adequate lens strength could be ordered.
This decision depends on a few factors. If vision is restored in the operated eye, and the ophthalmologist sees no contraindications to the surgery of the other eye, the patient may proceed to further activities. As part of the National Health Fund, there is a waiting list. A commercial procedure is available depending on the days when a selected operator performs surgeries.
The patient who is afraid to undergo surgery should consult an ophthalmologist. There are indications for prompt operation, in order to secure the eye against stronger complaints or other ophthalmological problems. There is also a group of people in whom the procedure is not urgent, and the patient does not report significant complaints in relation to cataract, which would cause problems in everyday functioning. In such a situation, the ophthalmologist may not qualify the patient for surgery and may postpone its date.
In the period after cataract surgery, the patient should rest and not strain himself. The patient should not lift heavy objects or perform physical work. For about 4 weeks after the surgery, eye drops/ointment should be applied on the operated eye. If the patient sees poorly with the other eye, he/she will need help with those activities. It may also be more difficult for the patient to move around the house, take out things from cupboards or prepare meals. Since it may be necessary to provide support for the patient, the doctor may issue a care leave for a family member during a control visit.
In the private sector, it is possible to perform the cataract surgery of both eyes on one day. After the qualification, the lenses selected by the patient and the ophthalmologist are ordered. The procedure is performed in the same way as the procedure for one eye. A separate set is prepared for each eye. After the surgery of both eyes, with the selection of an advanced lens, the patient has a more effective neuroadaptation process.
During the qualification, the patient receives instructions how to prepare for the surgery. This also includes getting a certificate from a doctor that the patient can safely undergo the procedure. If the primary care physician does not allow taking the procedure, the patient is informed about the next available date, on which he/she is obliged to bring a positive certificate allowing for the procedure.
The time of the patient’s stay at the centre is about 2 hours. In exceptional cases, this time may be prolonged for reasons not attributable to the personnel.
Surgeons with extensive experience work at Ocho. We cooperate with doctors from Poland and from other countries. For cataract surgeries, doctor Marta Latasiewicz flies to Ocho. She specialises in the procedures of vitrectomy and cataract. She takes care of patients with complicated cases. Another surgeon performing procedures of cataract removal is Professor Takhtaev. He is one of the few surgeons in the world, who, in justified cases, perform surgeries of both eyes on one day, and by posterior capsulorhexis completely eliminates the risk of secondary cataract, which is especially important in the implantation of multifocal lenses.
Qualification for the procedure of cataract removal with the calculation of the lens strength
the final cost of the procedure depends on the type of lens that the patient chooses together with the doctor qualifying for surgery