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What is Cataract Surgery?

Previously, we performed cataract surgery creating corneal incisions with a metallic blade so that a phacoemulsification machine would fragment a cataract into small pieces sending bursts of ultrasound through a handpiece. These fragments were then aspirated through the incisions.

perfect wound architecture

Today, using Catalase we can remove a cataract utilizing the most modern technology and the unparalled experience of our ophthalmologists achieving more precise, safe and reproducible results. Catalase or Femtosecond Laser Cataract Surgery as it is known in the USA is available only in the most advanced ophthalmology centers around the world.

Catalase utilizes a femtosecond laser to create corneal incisions with the perfect wound architecture with the correction angulation to ensure a self-sealing incision, less trauma to corneal tissue without the need for metallic blades and decreased risk of infection. The femtosecond laser then proceeds to create a capsulorhexis opening (a 5 mm aperture to open the capsular bag where the cataract lies so that it can be removed). Then, the laser makes laser cuts in the cataract to fragment it into several pieces allowing it to be aspirated through a handpiece. Utilizing Catalase makes this procedure safer with less risk of capsular tearing and subsequent vitreous prolapse, retinal inflammation, among other possible complications. Visual results tend be better with more exact intraocular lens centration.

  • The risk of postoperative astigmatism and extreme fluctuations in intraocular pressure are minimized with Catalase.

  • Patients do not need to suspend their everyday activities because visual rehabilitation is extremely fast.

Who will benefit from phacoemulsification?

Most people suffering from cataracts will benefit from this procedure. Best results are obtained with early cataracts. It is preferable not to wait until the cataract is ripe and vision is excessively low since the cataract will be too hard for the phacoemulsifier. Surgery is indicated as soon as vision is not adequate for daily activities.

In order to help you with costs it is necessary to fill out the following questionnaire so that the doctor can review your information and give you an approximation:

Questionnaire

Is phaco-emulsification safe?

In the hands of a good surgeon phacoemulsification is extremely safe due to these advantages:

Small incision (3mm): Sutures are not needed due to the very small incision that is self-sealing. This reduces the risk of astigmatism and foreign body sensation after surgery. It also eliminates fluctuations in intraocular pressure during surgery, which in turn reduces risk of hemorrhage.

Topical anesthesia: All that is required is anesthetic eye drops. No need for injections or general anesthesia.

Immediate recovery: No admissions to the clinic or bandages are needed. The patient may restart daily activities immediately.

Eye structures are intact: The small size of the incision does not affect eye structure. Eye resistance to trauma is the same as it was before surgery.

Just as any other surgical procedure, Catalase has risks. One out of a hundred people may have some sort of complication. In almost every case there is a solution to the problem. Severe complications are extremely rare.

Multifocal or Accommodative Intraocular Lenses

These lenses are used in patients with bilateral cataracts, or who require eyeglasses for both far and near vision that will need cataract surgery in both eyes within a short time. This type of lens can correct both near and far vision so that after surgery patients will not require eyeglasses for the majority of their activities. Approximately 90% do not require either far vision or near reading glasses to read the newspaper, a restaurant menu or even a phonebook. There are multiple types of multifocal lenses in today's market. Multifocal lenses can be divided into BIFOCAL and TRIFOCAL lenses. Bifocal lenses allow near (reading and handheld devices such as a phone) and distance vision (more than a yard in distance). Trifocal lenses allow near, intermediate (computer) and distance vision.

How should I prepare for Catalase?

Our ophthalmologist will make sure there are no associated pathologies that can interfere with the prognosis by doing an extensive examination of your eyes, including pupil dilation.

A measurement of your eye length and corneal curvature is crucial for calculating the power of the intraocular lens to be implanted. Blood work and a thorough evaluation by our internal medicine department will be done to make sure you are ready of surgery leading to a successful outcome.

What should I do during surgery?

During surgery you will be lying on the operating bed. The operating microscope will be in front of you and you will always see the microscope's bright light. Your face will be covered with sterile drapes and oxygen will be provided under them. You should never touch these drapes. A small device will hold your lids open.

During the procedure you should keep your eye as still as possible. The best way to do this is by looking at a single point throughout surgery. Usually the operating microscope's light is a good reference point. You will feel the hands of the surgeon on your forehead. You will occasionally feel cool liquid over your eye that may spill down your cheek. This is the solution needed to keep your eye properly hydrated.

What should I do after surgery?

No bandages are required so you walk out of the operating room on your own although vision will be blurry for two or three days. It is important to avoid touching your eye with any pressure the first couple of days after surgery.

Normally there will be some foreign body sensation, similar to having an eyelash in your eye. Eye drops will be prescribed for several weeks. Two weeks after surgery you will be able to perform any activity without risk.

Toric Intraocular Lenses

These lenses are used in cataract patients who have astigmatism and wish to correct the underlying astigmatism at the time of surgery.

Is Catalase painful? How long does it take?

Catalase is performed under topical anesthesia (anesthetic eye drops). No injections or general anesthesia are required. The patient is awake during the procedure feeling no pain at all. Phacoemulsification takes about 15 minutes per eye.

What results can I expect?

Over 90% of patients achieve vision better than 20/30 after phaco, unless there is some kind of a retinal condition. Reading glasses are the rule after cataract surgery (in many cases they were also required before surgery due to presbyopia), unless you choose to have implanted multifocal intraocular lenses which permit simultaneous far and near vision. (See Multifocal Intraocular Lenses)

Will a second procedure be necessary?

In a small percentage of patients, the capsule may become opaque some time after surgery, compromising vision. A perforation in the capsule is required to restore corrected vision. This is called a capsulotomy, performed with a Yag Laser. 

The capsulotomy is an outpatient procedure and is painless. No anesthetic is necessary and rehabilitation is immediate.

Key Points Summary
  • Modern Surgical Techniques: Utilizes phacoemulsification to remove cloudy lenses and replace them with clear artificial lenses.
  • Quick and Safe Procedure: Performed under local anesthesia, typically taking less than an hour.
  • Rapid Recovery Time: Most patients experience improved vision within a few days.
  • High Success Rate: One of the most common and successful procedures in medicine.
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Copyright Š 2024 Tijuana Eye Center. All Rights Reserved.Todos Los Derechos Reservados. ATENCION AL PUBLICO EN GENERAL Permiso COFEPRIS 203300201A0987 LS 17AM020040034 Responsable Sanitario Dr. Juan P. Rodriguez P. 4452528 Escuela Superior de Oftalmologia del Instituto Barraquer de America.

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