Cataract Surgery

The right time for your cataract surgery is when your cataracts have begun to interfere with your quality of life, and glasses or contact lenses no longer satisfy your visual needs.

The most common procedure of cataract surgery is the so-called phacoemulsification:

First, the eye is locally anesthetized with eye drops. The eye is opened through a small incision (microincision). A part of the lens capsule is then removed. The cloudy lens is liquefied and aspirated by high-frequency ultrasonic vibrations (phacoemulsification). In the remaining clear empty capsular bag the new intraocular lens can now be inserted.

This state-of-the-art surgical technique has the advantage that the small incisions close tightly. Only in exceptional cases do they have to be additionally secured with delicate sutures.

Intraocular lenses consist of acrylate or silicone. Modern lenses are folded for implantation, so they can be implanted through a very small incision into the eye. The optically effective part (optic) of the intraocular lens has a diameter of six millimeters. Haptics ensure a secure fit in the lens capsule. The body tolerates these artificial lenses very well – the implants can remain in the eye for one’s entire life.

• At the end of cataract surgery you will be given a transparent protective eye shield. This usually covers the eye until the next day and should also be worn at night in the first week after surgery. This is important in case you accidentally rub your eye.
• Use the prescribed anti-inflammatory eye drops as instructed.
• You can do fitness exercises immediately. Sports with the possibility of an eye injury should be avoided in the first two weeks.
• Careful washing of the face with closed eyes and clean water is possible after surgery. However, be careful not to rub your eyes and avoid direct eye contact with contaminated water, shampoo or soap.
• Driving a car is only permitted after a postoperative ophthalmological check with a visual acuity test.
• Because of the risk of infection from germs in the soil, you should refrain from gardening for the first two weeks after the operation.
• You should avoid sauna and swimming pools in the first two weeks after surgery because of the risk of infection.

After surgery, you should definitely keep the follow-up appointments with your ophthalmologist. The likelihood of severe complications after surgery is very low. However, if you:

• notice a visual deterioration
• feel pain
• the eye is very red or
• you see significantly worse

contact your ophthalmologist immediately or go to an ophthalmological emergency department.

Vision usually improves in the first days after cataract surgery. The final visual acuity can be achieved in the weeks following surgery.

Modern intraocular lenses make it possible to correct ametropia such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism and cataract surgery simultaneously. There are also special lenses that correct presbyopia and enable a life almost without glasses.

The selection of the best lens is based on the individual design of your eye and your personal needs and wishes regarding your vision. I would be happy to consult you and choose the most suitable lens for you.

In some cases, a gradual deterioration in vision can occur after months or years – a secondary cataract (posterior capsule opacification, PCO) has developed. Cells left in the capsular bag during surgery can slowly proliferate and grow onto the posterior capsule where they form the opacification of the posterior capsule. When reaching the visual axis, vision is cloudy again. PCO is effectively treated by a short, painless procedure using a laser (Nd:YAG capsulotomy). After that, good vision is possible again.

Using standard intraocular lenses, we also have the option of correcting myopia (nearsightedness) or hyperopia (farsightedness) during cataract surgery. After the operation, in most cases you do not need glasses for distance vision, but reading or computer glasses are usually required.

Modern special lenses can also improve astigmatism and even presbyopia.

This enables us to fulfill the increasing needs and demands of our patients to significantly improve their vision and become independent of glasses. After all, a life without glasses or becoming almost eyeglass-independent means regaining a high level of quality of life.

A monofocal intraocular lens is a typical standard intraocular lens. With this lens, vision without glasses is usually only possible either at a distance or in some cases at a close distance. Glasses are still required for the other distance.

Alternatively, there is the possibility of implanting a multifocal intraocular lens. With this lens you have the chance to see clearly without glasses – both in the distance, the intermediate and in the near.

EDOF intraocular lenses (extended-depth-of-focus lenses; lenses with an extended depth of field) can also enable eyeglass-independent vision at several distances, in this case distance and intermediate ranges.

Toric intraocular lenses can correct a pre-existing corneal astigmatism.

The newest development in modern cataract surgery is the femtosecond laser, which is used in femtosecond laser-assisted cataract surgery (FLACS) and performs high-precision cuts in the eye controlled by a computer. Femto cataract surgery with this new technology is done in two steps, one performed by the laser and one performed manually by the surgeon.

The femtosecond laser can be used to for opening of the lens capsule (capsulotomy), division of the lens (lens fragmentation) and corneal incisions. Even arcuate incisions to correct astigmatism can be achieved by the laser. After these steps the surgeon then aspirates the pre-fragmented lens using low-level ultrasonic energy and implants the intraocular lens.