How long does cataract surgery last - how is the lens replaced? Lens of the eye - surgery to replace it with an artificial one according to scientific technology of surgery to replace the lens

Surgery to replace the lens of the eye is a serious and technically complex surgical procedure. During the procedure, the patient is conscious. The success of the operation largely depends on how accurately the patient follows the ophthalmologist’s recommendations. Despite certain difficulties, lens replacement is the only radical method of treating cataracts and other diseases of the visual system.

The operation is performed by ophthalmologists. The main indication for its implementation is cataracts, that is, clouding of the lens. The disease mainly affects older people, as the lens loses its transparency due to the aging process. Moreover, some medications, ophthalmological diseases, bad habits and much more can speed up this process.

Cataracts develop slowly. In the initial stages, patients feel a veil before their eyes; as the pathological process progresses, it becomes denser. Visual acuity deteriorates, people with cataracts become more sensitive to light.

How is the operation performed? Do I need to follow any restrictions after surgery? We will get answers to these and other questions in this article.

Indications and contraindications

Replacement of the eye lens is necessary in the following cases:

cataract;
lens luxation;
intolerance to glasses and lenses;
astigmatism;
presbyopia;
myopia;
deterioration of accommodation processes;
age-related farsightedness.

Attention! Many experts recommend simultaneous surgical treatment of glaucoma and lens replacement.

There are a number of contraindications to refractive lens replacement:

inflammatory processes in the visual apparatus;
the anterior chamber is too small;
retinal detachment;
diabetes;
hypertension;
progressive farsightedness, accompanied by a small size of the eyeball;
suffered a stroke or heart attack.

Age-related changes in the lens are the main indication for surgery

Selection of artificial lens

Before choosing a prosthesis, you should first decide on several points:

at what distance the patient performs the work;
how often does he need to move his gaze from one point to another;
whether the patient agrees to wear corrective means in the form of glasses or contact lenses.

To make an informed decision, you should first pay attention to the physical properties of intraocular lenses. Artificial lenses differ in many ways:

form;
material;
light refractive ability;
rigidity;
presence of filters.

Depending on the number of foci, intraocular lenses are divided into the following types:

Multifocal. With their help, the patient is able to focus his gaze on objects that are at near, medium or far distances. Such lenses make it much easier to return to your normal lifestyle and professional activities. If previously after surgery it was necessary to wear glasses, then multifocal lenses eliminate this need. Multifocal lenses have small optical zones, which affects the clarity of vision.
Monofocal. This type provides clear vision at only one distance - either near or far. Monofocal lenses provide clear vision, but they require the additional use of glasses or contact lenses.
Bifocals allow the eye to focus on nearby and distant objects. If they are used, there is no need to use corrective agents.

An ophthalmologist will help you choose the right prosthesis after a comprehensive examination.

Specialists can also use a toric lens. This type of lens allows you to combat myopia, farsightedness, and astigmatism. On the outside of the lens there are guidelines that will help the surgeon position the lens in the best way.

Preparation and performance of the operation

Cataract removal with lens replacement is a serious procedure that requires preliminary preparation. The period between diagnosis and surgery should be as short as possible. The doctor must be informed about existing diseases. In addition, you must inform the specialist about the medications you are taking.

Eight hours before the operation, the patient should avoid eating. Most often, elective surgery is performed in the morning. At night, you can take some kind of sedative, for example, motherwort.

Refractive lens replacement is performed on an empty stomach

In some modern clinics, on the eve of surgery, a psychologist works with patients, as well as a surgeon who introduces the patient to the stages of prosthetics, and also stipulates the patient’s actions during the operation. Sometimes patients are asked to look at one point, not blink, and follow all commands. It is important not to panic, but to calmly and quickly respond to the specialist’s demands.

To avoid infection, drops with an antibacterial effect are instilled into the patient several days before surgery.

Attention! The duration of the operation is twenty to thirty minutes.

The procedure is performed under local anesthesia and lasts within thirty minutes. If there are no complications, the patient is sent home the next day. The surgeon makes a micro-incision in the wall of the eyeball and removes the cloudy film. The removal of the lens is carried out using a laser beam. After which he replaces the cloudy film with an intraocular lens. If cataracts affect both eyes, the operation is performed first on one visual organ and only after a while the procedure is repeated.

Rehabilitation period

The recovery period for vision lasts about a month. The doctor will explain in detail what should not be done after the operation. The first stage of the recovery cycle lasts seven days. During this period, the patient already begins to notice significant improvements in the functioning of the visual apparatus, but the body still reacts sharply to the manipulation. The second stage lasts for a month. Patients are advised to use drops, wear glasses, and not strain their vision. And the final stage, lasting five months, is characterized by complete restoration of the functioning of the visual apparatus.

During rehabilitation, it is important to regularly visit the ophthalmologist and adhere to certain restrictions, namely:

do not lift heavy objects;
In the first days, it is important to control the amount of fluid consumed. You will have to give up soda and alcoholic drinks;
exclude sports;
refuse to visit the bathhouse and sauna;
wearing a bandage in the first two weeks;
use of antiseptic eye drops;
daily rinsing of the eye with sterile water;
refusal to drive a car;
When taking a shower, you need to make sure that splashes of water do not get into your eyes;
avoid bending over, especially in the first days after surgery;
do not press or rub the operated eye;
do not take hot baths;
It is recommended to wear glasses during the first week. They will need to be washed with soap every day;
exclude strength training, running, jumping, gymnastics, cycling;
It's better to sleep on your back. It is strictly forbidden to sleep on the side on which the eye was operated on;
try to limit your stay in smoky or dusty rooms;
limit computer work and TV watching;
In the first few days you should not wash your hair.

During the period while the eye is recovering, visiting baths and saunas is strictly prohibited.

Attention! Bed rest is optional. The main thing is to avoid intense physical activity.

Fast and proper rehabilitation includes the following areas:

proper nutrition. The basis of the diet should be foods rich in vitamins and microelements. Try to eat more vegetables and fruits;
use of eye drops. Patients may be prescribed disinfectants, anti-inflammatory agents, as well as drops of combined action;
compliance with the regime;
selection of corrective means – lenses or glasses;
timely consultation with an ophthalmologist.

Possible consequences

Let us highlight the complications that may arise after surgery:

secondary cataract, accompanied by deterioration of visual function;
hemorrhage;
infectious process;
increased IOP;
rupture of the posterior capsule;
iris loss;
uveitis, iridocyclitis;
astigmatism;
retinal detachment;
corneal edema;
diplopia – double vision;
blurry vision.

Important! After lens replacement surgery, secondary cataracts may develop.

Sometimes patients complain that after surgery they have double vision and their eyes turn red

Separately, I would like to say about secondary cataracts, which can appear after surgery. What is this connected with? The fact is that during surgery, a specialist cannot completely remove all epithelial cells of the lens. As a result, they begin to affect the implanted lens, leading to its clouding. This complication may take several months or even years to develop.

The disease manifests itself in the form of decreased visual acuity, distortion and blurring. To correct this condition, direct surgery or laser treatment is performed.

In order to avoid the development of secondary cataracts, it is very important after surgery to use metabolic agents that slow down the process of lens opacification. Patients should undergo regular follow-up with an ophthalmologist.

In the early postoperative period, suprachoroidal hemorrhage may appear. Most often it occurs in older people who have been diagnosed with glaucoma, as well as cardiovascular diseases. When the posterior capsule ruptures, the vitreous body is lost, the lens is displaced, and bleeding also develops.

Lens replacement can also cause Irvine-Gass syndrome. The risk group for this complication includes people with uveitis, diabetes mellitus and wet AMD. To combat the complication, corticosteroids, angiogenesis inhibitors, and nonsteroidal anti-inflammatory drugs are used.

In the complex structure of the human eye, the lens is one of the most important parts, responsible for the refraction of light rays and the formation of images on the retina. Changes in its structure or deformation lead to deterioration of vision and require immediate, most often surgical, intervention.

Eye lens replacement surgeries have long become an everyday event in ophthalmological practice, this is the result of the high development of modern medical science and medical technologies - despite the apparent simplicity and speed of execution, the operation is a serious, technically and technologically complex process that requires high professionalism of the doctor and appropriate medical equipment. Operations are performed exclusively in cases where changes in the structure or shape of the eye lens are not amenable to therapeutic or laser correction.

Replacing the lens is the only real way to get rid of cataracts and a number of other eye diseases.

Indications for surgery

Lens replacement surgery is performed only when indicated, after appropriate diagnostics of the visual system. Such indications include:

Cataract

Lens opacification is a pathological change most often found in older people. With cataracts, objects visible to the eye lose their clear outlines, blur, and the eye reacts painfully to bright light. Myopia or farsightedness often develops. The disease is constantly progressing, only timely surgery will restore vision.

Presbyopia

This pathology is also common in older people. Patients complain of farsightedness, which develops as a result of sclerosis of the lens - tissue hardening. The lens hardens, its elasticity and ability to change its curvature decrease.

Astigmatism

The lens is deformed, its shape and curvature are disrupted, and as a result, the inability to focus on an object. The disease is characterized by blurriness, vagueness of the image, the need to squint to look at a particular object, and problems with orientation in space.

Myopia

Decreased visual acuity. The eye has difficulty distinguishing objects located in the distance, and fatigue quickly accumulates when reading, working at a computer, or driving a car. The operation is prescribed only for high degrees of myopia in combination with other eye diseases, when it is impossible to cope with laser or optical vision correction.

The operation is not performed in the following cases:

Inflammatory or infectious eye diseases (keratitis, conjunctivitis, blepharitis).
The size of the eyeball or its anterior chamber is too small. This may interfere or make it impossible to carry out the necessary manipulations.
Retinal detachment. There is a risk of disease progression after surgery.
Any inflammation in the active stage.
Suffered over the last six months: heart attack, stroke, diabetes, multiple sclerosis, cancer.
Pregnancy and lactation.

Progress of the operation

Held full vision diagnostics(click to open the page in a new window) and assessment of the general condition of the body - clinical tests of urine and blood. In some cases, consultation with specialists may be required.

The essence of the operation is to replace the natural eye lens with an artificial implant, intraocular lens (IOL) - artificial lens

Lens replacement surgery is usually performed on an outpatient basis.
The patient is given local anesthesia.
The doctor opens the anterior chamber of the eye with several punctures, and the contents of the lens are removed with a special suction.
A tube is inserted into the eye chamber, which contains a rolled-up implant - an artificial lens. In the chamber, the artificial lens is straightened and placed in place.
Eye chamber punctures are minimal in size, so no stitches are required.
The eye is washed, a healing drug is applied and a sterile bandage is applied.
The patient can go home.
The entire procedure takes 15-20 minutes and is absolutely painless.

Improvement in vision is observed immediately after surgery:

Clear outlines of objects
The image does not double, there are no “spots” in front of the eyes.
Bright colors
Visual acuity improves

The full effect of the operation is achieved within a month.

Lens replacement surgery can be carried out in different ways; the technique and treatment regimen in each specific case are selected taking into account the characteristics of the patient and the nature of the disease.

In modern ophthalmology, lens replacement surgery is most often performed using the phacoemulsification(click to open page in new window).

The use of modern techniques and equipment reduces the risk of complications from surgery to a minimum, but in rare cases, some patients may experience:

swelling and inflammation of the eye
intraocular bleeding
artificial lens displacement
increased intraocular pressure
retinal detachment
secondary cataract
opacification of the posterior part of the capsular bag
double vision due to the difference in the characteristics of the artificial and natural lenses

Therefore, before deciding on surgery, specialists at the First Eye Clinic conduct a thorough and comprehensive examination of patients in order to take into account and evaluate all possible consequences in advance.

According to medical statistics, the effectiveness of eye lens replacement operations is about 98%, and minor vision deterioration a few (5-7) years after surgery is observed in less than 20% of patients.

The risk of getting a complication after surgery is many times smaller than the risk of completely, irreversibly losing vision by refusing surgery.

No medications (drops, ointments), no means of “traditional medicine” (tinctures, ointments, spells) are even theoretically capable of stopping, much less completely curing, progressive cataracts.

Our clinic treats its patients very carefully - postoperative care is provided, recommendations are issued, and all necessary medical care is provided in the event of a complication.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Lens replacement surgery is a serious and technically complex surgical procedure. During the procedure, the patient is conscious and, moreover, must strictly follow the doctor’s recommendations. Its success or failure largely depends on this. Replacing the lens helps solve only problems associated with this organ. Often after surgery, new diseases are discovered that prevent complete restoration of vision.

But, despite all the difficulties, lens replacement is the only radical treatment for cataracts and a number of other pathologies. This allows people with serious eye diseases, most often the elderly, to regain visual acuity and the joy of being able to see all the colors of the world around them, read, and watch TV.

Indications for surgery

The lens is replaced mainly when it becomes cloudy - cataracts. This is a common pathological change that occurs in old age. With this disease, objects become blurry and unclear. Myopia or, conversely, farsightedness often intensifies and develops as the perception of close objects improves. The condition is constantly progressing, only timely replacement of the lens for cataracts allows vision to be restored.

The operation can also help with other age-related changes, in particular with presbyopia of the eye. In this case, patients complain of farsightedness, which is associated with the processes of sclerosis of the lens. It becomes harder, loses its elasticity, and therefore the ability to change its curvature. Patients find it difficult to manipulate objects close at hand, and at the same time they have difficulty reading small print.

Lens replacement may be indicated for astigmatism. Its shape and curvature are disrupted, resulting in a reduced ability to focus on an object. Patients report symptoms such as blurred images and the need to squint in order to see an object. The operation is used when other methods are ineffective due to the progression of the disease.

In recent years, lens replacement has also been practiced for myopia. The operation is an alternative to glasses or contact lenses. In most cases, this disease can be treated with laser correction or other minimally invasive methods. The operation is performed only in case of a high degree of myopia, aggravated by other diseases (anisometropia - violation of symmetry in the refraction of the eyes, sclerosis of the lens, etc.).

Contraindications

The operation is not performed in the following cases:

Inflammation of the eye structures.
Small size of the anterior chamber of the eyeball. He may not allow all the necessary manipulations to be carried out.
Destruction, retinal detachment. In this case, there is a risk of disease progression after surgery.
Small eyeball, if the decrease is caused by progressive farsightedness.
Any inflammation in the active stage.
Recent heart attack or stroke.

Choosing a prosthesis

Physical properties

Artificial lenses or intraocular lenses can be distinguished by shape, material, refractive (light refractive) characteristics, and the presence of a certain filter. The main criteria are rigidity, number of focuses and ability to accommodate.

According to flexibility there are:

Soft;
Hard lenses.

The latter are somewhat cheaper, but much less functional. Soft lenses are easy to roll, minimizing the incision for implantation.

According to their ability to accommodate, prostheses can be:

Accommodating;
Non-accommodating.

The former are able to change their curvature, like the real lens of the eye, which allows the patient to completely abandon glasses after surgery. Such prostheses are much better and more convenient, but they are more expensive and are not produced in all countries.

Depending on the number of foci of vision, the following lenses are distinguished:

Monofocal;
Difocal;
Multifocal.

Each artificial lens has several foci, i.e. points at which the image has maximum clarity. The most common are bifocal dentures. They have two focuses, which allow you to see an object clearly at two fixed distances (near and far). Objects located between these points appear blurry. Multifocals make it possible to focus your gaze at 3 or more distances. The fewer the number of focal points, the more often the patient will have to use glasses or contact lenses.

Company manufacturer

Often it also comes down to the choice of country of origin. Lenses will differ in price, quality, and reliability. Modern patients undergoing surgery in the Russian Federation can choose the following prostheses:

Prosthesis price

The cost of prostheses can range from 20,000 to 100,000 rubles. Companies that are still little known on the market, such as Human Optics, usually offer products cheaper than companies such as Alcon. Accommodating and multifocal lenses are the most expensive. For paid treatment, their price is usually included in the cost of the operation. Ordering lenses yourself is quite difficult; companies usually work only with wholesale buyers.

Important! Prices may vary at different private medical centers! When purchasing a prosthesis from public hospitals, customers deal directly with sales representatives. When performing an operation under compulsory medical insurance, it is possible to return part of the funds spent on the purchase of an artificial lens (about 25%).

Progress of the operation

Before surgery, the patient will undergo a series of standard tests. Typically, hospitalization occurs the day before the intended procedure. Recently, in hospitals and clinics on the eve of surgery, a psychologist or medical specialist works with patients, who explains in detail all the stages of prosthetics and tells them how to behave. Sometimes patients are advised to practice looking at a certain point without blinking and following the surgeon’s commands.

Immediately before the procedure, the patient is given drops of anesthetic or given an injection. He lies face up on the operating table. The doctor opens the anterior eye chamber, making several punctures. After this, using a special suction, the contents of the lens and all cellular elements are removed.

progress of eye lens replacement surgery

A tube is inserted into the chamber, in which the prosthesis is folded. In the chamber, the artificial lens expands. The eye is then washed, bandaged, and the patient is admitted to the recovery room. In rare cases, in elderly people, due to anxiety, pressure surges during surgery and tachycardia are possible. All vital parameters are monitored during the procedure. If the doctor has any concerns, the patient is sent to intensive care.

Important! It is necessary to react as calmly as possible to all the surgeon’s words and performed manipulations, and to avoid excitement.

Recovery period

The most important month is the first month after lens replacement. During the postoperative period it is necessary:

Often it is not possible to completely return to a normal lifestyle within 4-5 weeks, so restrictions are extended for several months. The main criterion is the patient’s condition, the rate of eye fatigue, and discomfort.

For the entire subsequent “life with a prosthesis,” restrictions on visiting the bathhouse and overexertion remain. Many patients note that the operated eye becomes more susceptible to infections - conjunctivitis, etc.

Vision change

Patients may notice the following improvements after surgery:

The outlines of objects have become clearer.
The double vision and spots before the eyes disappeared.
All colors look more vibrant.
Improved visual acuity.

Important! Positive changes do not always occur immediately after surgery. Sometimes the brain needs time to adapt to new information coming from the eyes. Sometimes you need to wait until the swelling that often occurs after surgery subsides.

Possible complications

Unpleasant consequences can arise either through the fault of the surgeon or due to the patient’s failure to comply with all instructions, or as a result of the individual characteristics of the body, previously unidentified pathologies (for example, immunodeficiency).

The most common complications include:

Corneal edema. It is not a dangerous symptom. In the vast majority of cases, it goes away on its own within the first few days after surgery.
Secondary cataract. Sometimes deposits form on the lens, causing it to become cloudy. This largely depends on the material used. The greatest likelihood arises when choosing lenses made of polymethyl methacrylate. Removal of deposits is quite easy using a laser; in this case, secondary lens replacement is not required.
Retinal detachment. This layer of the eye is very sensitive and susceptible to any external influences. Therefore, surgery can provoke dissection or increase its degree.
Infection during surgery. This risk is not very high because sterile instruments are used during surgery. Antiseptic drops are used for prevention; even if inflammation develops, it is usually successfully treated with a course of antibiotics.
Increased intraocular pressure. This complication is a consequence of lens displacement, incomplete removal of fluid to flush the anterior chamber of the eye during surgery, etc. If left unattended, this problem can eventually lead to glaucoma. With timely diagnosis, as a rule, it is solved by using special medications in the form of eye drops (Azopt, Betoptik, etc.).

The procedure for receiving free medical care, the cost of the procedure

Since 2012, lens replacement can be done free of charge, under the compulsory medical insurance policy. It is carried out according to a quota, which means that the patient must meet a number of parameters and will have to wait for his turn for the procedure. Pensioners and disabled people go first.

In order to obtain the right to undergo surgery, its positive result must be predicted by ophthalmologists. When replacing a lens, age is not an obstacle to entering the quota, since the procedure does not use general anesthesia, which is difficult for older people to tolerate. An argument for refusal may be the presence of concomitant eye diseases that may impede the restoration of vision.

Important! Patients are provided with only a Russian-made artificial lens free of charge; foreign analogues must be paid for independently.

Paid transactions have a wide range of prices. In Moscow clinics they are carried out for 40,000 - 120,000 rubles (for one eye). The cost is influenced by the chosen prosthesis, the reputation of the clinic, and the experience of medical specialists. The most popular medical centers in the capital are Excimer and the Eye Surgery Center. They have branches in a number of Russian cities.

Many patients experiencing vision problems sooner or later have important questions, such as: is a lens transplant necessary for cataracts, how safe is it and can surgery be avoided?

Is surgery necessary?

The decision on the need for a lens transplant surgery is made only by a qualified ophthalmologist after a comprehensive examination of the patient. Infrequently, there are cases when an already established diagnosis of “cataract” is not later confirmed, therefore, so that there is no doubt about the need for surgery, it is imperative to undergo a full ophthalmological examination.

When is an eye lens transplant needed?

Cataracts, which are manifested by clouding of the lens, can occur due to various reasons. The most common of them are age-related changes. Surgery may also be required for cataracts that arise as a complication of diabetes mellitus, after autoimmune diseases, eye trauma, irradiation of the body, or severe stress.

How risky is the operation?

Since any surgical intervention causes understandable apprehension and fear in patients, it is necessary to immediately clarify that the operation of eye lens transplantation is considered one of the most high-tech and when performed by an experienced surgeon, the risks are practically minimized. Phacoemulsification is the most common technique in the world for removing clouded lenses. It is considered the “gold standard” of ophthalmology and is the safest.

Stages of phacoemulsification surgery

The process of phacoemulsification surgery typically occurs as follows: First, the doctor uses a drop of anesthetic to numb the eye. Then, a micro-incision is made on the cornea (no more than 2.6 mm), through which an ultrasound device is brought to the lens of the eye, which destroys the nucleus and brings it out. Next, the capsular bag is cleared of remnants of the lens and an intraocular lens is inserted inside using a disposable injector. The lens is an artificial lens, it is inserted in a folded form, but inside the eye it straightens on its own and is fixed in the capsule. The micro-incision does not require stitches as it is self-sealing.

Features of artificial lens

The new lens - an intraocular lens, is made of a flexible polymer biocompatible with the tissues of the eye. Placed in a folded capsule bag, it unfolds easily inside and is immediately ready for use. Due to the high biocompatibility of the polymer, its rejection by eye tissues is impossible.

Postoperative examinations

At the end of the eye lens transplant surgery, the patient can go home. Vision returns almost immediately, so in most cases, accompanying persons are not needed. There is also no need to stay in hospital. After replacing the lens of the eye, the patient must come for postoperative examinations according to the schedule established by the operating surgeon and be observed free of charge.

Postoperative rehabilitation

Complete postoperative rehabilitation of the patient takes approximately two to three weeks. During this time, the operated eye should not experience visual stress. Physical activity on the entire body should also be limited, otherwise there are no restrictions. 5 days after the operation, the patient can already be fitted with reading glasses.

Application of special drops

In the postoperative period (2-3 weeks), the patient is prescribed the use of special drops that prevent infection from entering the operated eye, relieve inflammation, and moisturize. They are provided free of charge and must be used as prescribed by a doctor.

It is imperative that you follow the postoperative recommendations: do not scratch your eyes, do not make sudden movements, do not lift heavy objects. Also, in the first postoperative month after lens transplantation, visiting baths, swimming pools, saunas and using cosmetics is undesirable.

Choosing an artificial lens

Today, the market offers a huge number of varieties of models of artificial lenses - intraocular lenses, many of which, in addition to their direct function, are capable of correcting the patient’s vision pathologies. The most popular and in demand are artificial lenses from manufacturers in the USA. For transplantation, it is better to choose those models that are certified as having passed clinical trials and approved for use by the Ministry of Health. The patient can express his wishes when choosing a lens manufacturer, but all optical parameters of the intraocular lens must be recommended by the ophthalmic surgeon.

Femtosecond laser

Along with the traditional technology of phacoemulsification of cataracts, in medical centers, the patient may be offered surgery using a femtosecond laser. This is the latest development in ophthalmic surgery, due to which the most important moments of the operation are performed automatically, eliminating the human factor.

An important feature of surgery using a femtosecond laser is the destruction of the cloudy lens without damaging the cornea. The beam is focused on the lens capsule, after which it splits the lens into small particles. This achieves a reduction in the number of intraocular manipulations, eliminates the destructive effects of ultrasound on the eye and minimizes the possible risk of complications. Operations using a femtosecond laser are an order of magnitude more expensive than conventional phacoemulsification, but this price is quite justified in cases of complicated cataracts, diabetes mellitus, corneal dystrophies, and after complex eye injuries.

One of the leading ophthalmological centers in Moscow where all modern methods of surgical treatment of cataracts are available. The latest equipment and recognized specialists are a guarantee of high results.

"MNTK named after Svyatoslav Fedorov"- a large ophthalmological complex "Eye Mycosurgery" with 10 branches in various cities of the Russian Federation, founded by Svyatoslav Nikolaevich Fedorov. Over the years of its work, more than 5 million people have received assistance.

– a serious, technically complex microsurgical operation; after the intervention, new pathologies sometimes arise that interfere with the normal restoration of vision. To avoid negative consequences, it is necessary to choose a high-quality lens and strictly follow the ophthalmologist’s recommendations during rehabilitation.

Laser eye lens replacement

Indications and contraindications for surgery

The main indication for eye lens replacement is cataracts; the pathology is often diagnosed in old age; the disease progresses rapidly and is characterized by a blurry, indistinct image.

Indications

For what pathologies is eye lens prosthetics performed:

presbyopia– when destroyed, the lens becomes hard, cannot change curvature, and farsightedness develops;
astigmatism– the shape and curvature of the lens changes, the image becomes blurred, the person has to constantly squint, the operation is performed in the absence of a therapeutic effect from other methods of therapy;
severe forms of myopia, burdened by other ophthalmological problems, when the eye can hardly see.

With astigmatism, vision is impaired and the image becomes blurred.

Installation of an artificial lens is the only effective way to remove cataracts in old age.

Contraindications

The operation is not performed for inflammation of the eyes, a miniature size of the anterior chamber of the eye, or retinal detachment. Contraindications for lens replacement are progressive forms of farsightedness, exacerbation of any chronic disease, recent stroke, heart attack.

Lens Selection

Artificial lenses (intraocular lenses) have different indicators and characteristics, which affects their cost, properties and quality. You can see what different prostheses look like in the photo.

Types of eye lens

This is what an installed eye lens prosthesis looks like

Before undergoing surgery, give up alcohol and smoking a week before the procedure.

How to prepare for prosthetics:

7-10 days before surgery, stop wearing glasses and contacts.
Stop drinking alcohol and smoking for 5 days.
The day before the intervention, take a shower and wash your hair.
On the day of the operation, you should not drink or eat anything, or use cosmetics, perfumes, or deodorants.

Before admission to the hospital, patients undergo a general and biochemical blood test, a test for HIV, hepatitis, syphilis, coagulation, a clinical urine test, an ECG and fluorography. A person needs, the final conclusion is given by a therapist.

Artificial lenses are made from biocompatible materials, so there have been no cases of prosthesis rejection.

How is the operation performed?

The person is hospitalized a day before the operation, has a conversation with the patient, and the surgeon explains in detail the stages of prosthetics and explains the rules of behavior. The intervention is carried out on one eye, and some time after, a second operation is prescribed.

The process of replacing the lens of the eye

Stages of refractive lens replacement:

Surgical procedures are performed under local anesthesia - the patient is given an injection of an anesthetic drug, or an anesthetic is instilled into the eyes.
The surgeon makes several punctures and opens the anterior chamber of the eye.
Phacoemulsification is carried out - the solid core is liquefied with ultrasound or evaporated with a laser.
The eye cavity is cleaned with a special suction.
A rolled-up lens is placed in a special tube and inserted into the eye chamber, where the prosthesis is straightened.
The lens is centered and strengthened with arms.
The eye is washed with an antiseptic and a bandage is applied.

During the operation, blood pressure and pulse are constantly monitored; the entire procedure lasts 20–30 minutes; if there are no complications, the patient is sent home after 24 hours.

During the operation, the person is conscious, he must strictly follow the surgeon’s instructions - the outcome of the procedure depends on this.

Postoperative period

Rehabilitation after eye microsurgery takes place at home; the patient must regularly visit an ophthalmologist; the bandage will have to be worn for 7–14 days.

After the operation, it is necessary not to remove the bandage for some time.

Pain and stinging are observed for a week; non-steroidal anti-inflammatory drugs are prescribed to relieve discomfort.

How to behave after prosthetics:

Wash your eyes daily with Furacilin solution and use antiseptic drops.
The operated eye should not be scratched or put pressure on it.
During the week after surgery, reading and watching TV should be no more than half an hour a day.
Intense physical activity, heavy lifting, drinking alcohol, smoking, bending are strictly contraindicated.
Sleep exclusively on the side opposite the operated eye, or on your back.
You cannot visit the sauna, bathhouse, swimming pool, or use cosmetics for 1–2 weeks.
When taking a shower or bath, water should not get on the bandage.
You can only go outside wearing dark glasses.
It is necessary to reduce the daily intake of salt, spicy foods, animal fats, and drink less water and tea.

After a few weeks, the doctor will evaluate your vision and select glasses or contacts if necessary. You should discuss the ability to drive a car and the timing of your return to work with your ophthalmologist.

The first time after the operation, the person sees poorly, all objects have blurred contours - this is how the body gets used to the prosthesis, and gradually all the unpleasant sensations disappear. Visual acuity is restored after 4–5 weeks, but some restrictions are lifelong.

Possible complications

Negative consequences after surgery arise due to the surgeon’s fault, when the doctor’s commands are not followed correctly during prosthetics, or when rehabilitation rules are violated.

Consequences:

corneal edema– disappears on its own in 4–6 days;
cataract recurrence– deposits appear on the lens, the eye sees dimly, everything unnecessary is removed with a laser, lens replacement is not required;
retinal detachment;
swelling of the macular area– occurs in diabetics, with glaucoma;
displacement of the prosthesis– repeated intervention is required;
hemorrhage in the anterior eye chamber– occurs when the lens is not installed correctly, when there is heavy strain on the eyes during rehabilitation, drug therapy is performed, or re-operation is performed;
development of infectious processes– the problem rarely occurs; it can be treated with antibacterial eye drops.

During the postoperative period, corneal edema may occur, but it will go away on its own within 4-6 days.

The most dangerous consequence– increased intraocular pressure, occurs against the background of displacement of the prosthesis, with incomplete removal of fluid from the eye chamber during the intervention, and develops without timely treatment. To normalize indicators, special eye drops are used - Betoptik, Azopt.

Where do they make it and how much does it cost?

Lens replacement is carried out in public and private ophthalmology clinics, the average price of a prosthesis is 25–110 thousand rubles. When purchasing lenses in public hospitals, the patient can get back approximately 25% of the cost of the prosthesis if they have a policy.

For paid treatment, the price of lenses is included in the cost of the operation; on average, treatment of 1 eye will cost 35–140 thousand rubles, depending on the level of the medical institution and the qualifications of the doctor.

The basis of the artificial lens is polymer raw material, which does not corrode, is not affected by negative external factors or enzymes of the human body, so the service life of the lens after installation is unlimited.