Basic methods of treating age-related and aggravated cataracts

Decreased vision in old age can be caused by a change in the transparency of the lens - its gradual clouding. This leads to cataracts.

Age-related cataracts are a common disease after sixty years of age, as they are a consequence of general aging and wear and tear of the body.

However, with mild clouding of the lens, special glasses can help, and blindness can be treated surgically. Let's consider the issues of cataract prevention, nutrition and treatment of lens pathology.

Features of age-related vision

A decrease in the elasticity and transparency of the lens occurs naturally. In the initial form of lens pathology, the quality of vision decreases, but few people worry about this.

However, this is precisely the reason for a visit to an ophthalmologist, because timely detection of pathology can help preserve vision.

The peculiarity of age-related cataracts is that the disease can develop over years.

When the pathology intensifies, a person can only distinguish the outlines of large objects; in a severe stage, the patient distinguishes only the presence or absence of a light source. The patient can accurately point to the light source (lamp, window), but sees nothing else.

Unfortunately, doctors have not established the exact causes of senile lens pathology. However, some unfavorable factors can provoke or accelerate the development of cataracts. These include:

• smoking and alcohol;
• diabetes;
• excessive consumption of heavy foods;
• negative effects of ultraviolet radiation;
• various types of head or eye injuries;
• previous surgery;
• hormonal disorders.

Sometimes cataracts are inherited. That is, if someone in the family had this disease, it may also appear in relatives. Some doctors believe that the provoking factor is poor nutrition and a lack of important microelements in the body.

Age-related cataracts: diagnosis and symptoms

When to sound the alarm, how to determine the onset of pathology? The insidiousness of lens clouding is that the patient does not notice any symptoms. Age-related cataracts mature for a long time from the inside, without indicating themselves in any way.

Most people begin to notice that objects lose their clarity of shape and their vision becomes “blurry.” The patient begins to distinguish between artificial and daylight, because the reaction of the eyes becomes different.

This is expressed in the fact that in bright sunlight and insufficient artificial lighting, visual acuity drops sharply.

Another characteristic feature of the manifestation of cataracts is “blinding” by bright artificial light - a person cannot see normally in intense lighting. Gradually, the color distinction of objects is lost - they become faded.

The patient has difficulty reading newspapers, watching television programs and working at the computer. Sometimes objects begin to appear double, and when looking at street lamps or turned on car headlights, a rainbow sphere appears around them.

Diagnosis of lens pathology is carried out using a visual examination, patient complaints and hardware examination. Depending on the symptoms, senile cataracts are divided into several stages.

The stages of senile cataract are as follows:

1. initial cataract;
2. immature;
3. mature;
4. overripe.

Initial stage - pre-cataract

The initial stage is characterized by the appearance of spots or “floaters” before the eyes. There is hydration of the lens due to loss of elasticity of the orbital vessels. Decreased vision at this stage is observed if the pathology has reached the pupil.

A characteristic symptom is myopia, distant vision is impaired. The danger is that the patient thinks that his vision has improved, since there is no need for plus glasses. In fact, this is a manifestation of lens pathology.

This stage can last for a long time without visible changes, however, after that complications begin. Treatment consists of prescribing vitamin eye drops. If this pathology is not treated, the disease will continue to develop and move to the next stage. Diagnosis consists of a vision examination using biomicroscopy.

Immature cataract

This form is characterized by enlargement of the lens and further loss of elasticity. The gray-white cloudiness reaches the pupil and completely covers it.

At this stage of development of the pathology, the patient has difficulty distinguishing objects even close to him. The degree of cataract maturity is determined by the level of vision loss: the worse the patient sees, the deeper the layers of the disease.

An enlarged lens can provoke a new pathology - phacomorphic glaucoma.

Mature cataract

The mature form is already noticeable to others, as the pupil changes color and becomes cloudy due to dehydration of the lens. At this stage, the lens decreases in volume and loses mass. Cataracts do not mature immediately; it takes about two years. In the mature form, the patient loses objective vision, that is, he does not see anything in front of him at all.

Overmature cataract

This is the very last stage of pathology, in which the lens is completely dehydrated: it shrinks, thickens, and becomes overgrown with cholesterol plaques and lime.

Sometimes a so-called “milk cataract” occurs, which is characterized by the presence of a milky liquid lens mass.

In the overripe form, a lens transplant operation or artificial implants are necessary.

Symptoms of cataracts can also be diagnosed in other complex ophthalmological diseases, which only a specialist can determine. Elderly people need to undergo a preventive examination by an ophthalmologist every two years to identify pathology at the stage of formation.

Hardware diagnostics

An ophthalmological examination consists of hardware diagnostics:

• keratotomy;
• Ultrasound biometrics;
• gonioscopy;
• intraocular pressure;
• optical tomography;
• electrophysiological examination.

The examination is prescribed based on the characteristics of the development of pathological changes in the lens and the choice of anesthesia during surgery. Before prescribing surgery, the patient is examined. You should have positive opinions from the following specialists:

• a document from a therapist stating that there are no contraindications to surgery;
• chest x-ray;
• permission of the dentist, neurologist and ENT doctor;
• conjunctival culture tests;
• blood clotting tests and general tests;
• testing for toxoplasma;
• urine analysis;
• Wasserman reaction.

Immediately before the operation, the eyelashes and eyebrows are completely cut off. In the morning the patient does not have breakfast and does a cleansing enema.

Therapy

Treatment of cataracts in older people is carried out when the patient cannot care for himself and clearly distinguish people’s faces.

The ophthalmologist first selects special glasses with enhanced lenses and prescribes drops and medications. However, these measures only slow down the development of lens pathology, but do not eliminate the problem.

Often, older people are prescribed lens correction surgery - ultrasound phacoemulsification.

The lens replacement process lasts no more than 30 minutes. In this case, sound waves break up the clouded lens, remove particles and implant an implant. After this correction, vision is restored, the rehabilitation period passes without complications.

Incisions on the eyeball heal naturally.

Important! After eye surgery, it is prohibited to use cosmetics, wash your eyes with soap, rub your eyes with your hands, or engage in heavy physical labor.

Advantages of ultrasonic phacoemulsification:

• high efficiency indicators;
• fast recovery period;
• no trauma to the tissues of the eyeball;
• the operation takes place without stitches;
• There is no risk of induced astigmatism.

Instead of suturing, sealing is carried out; subsequently, the tissue of the eyeball heals on its own. The incision on the eyeball does not exceed 3 mm. To protect the cornea and iris, dispersive viscoelastics are used, which are applied before the incision.

Artificial lens

Artificial eye lenses are made from modern hydrophilic acrylic compositions. Implantation is carried out into the capsule bag, which is a barrier to contact of acrylic with the tissues of the eye.

In some difficult situations, an artificial lens is implanted in other places of the eyeball - behind the iris, in the pupil itself, etc.

The choice of localization depends on the development of the patient’s pathology.

Sometimes secondary cataracts may appear if implantation is not successful. In this case, the patient undergoes laser correction.

Severe complications after lens surgery include eye bleeding, capsule rupture, deformation of the corneal layer, and the development of infection. However, this is not the rule, but the exception.

In most cases, everything goes away without complications, and the patient regains his lost vision.

Prevention

Is it possible to prevent the pathology of lens opacity, and what needs to be done for this? The lens tissue is devoid of nerves and blood vessels, so inflammatory processes do not appear there.

Instead, dystrophic changes occur caused by a failure of metabolic processes in the body. Disruption of metabolic processes causes aging of the body as a whole, and this cannot be stopped.

However, it is possible to protect the eye, and for this it is necessary to limit contact with bright sunlight: it is dangerous ultraviolet radiation that has a detrimental effect on our eyes.

This means that the prevention of cataracts in old age is:

• good nutrition;
• eye protection from sunlight;
• strengthening immune defense;
• giving up alcohol/tobacco;
• reduction of active physical activity.

In bright sunlight, it is necessary to wear sunglasses so that the lens does not suffer from active ultraviolet radiation.

You should also periodically unload your eyes if you read a lot or work at the computer. Make sure your eyes don't become overtired.

Risk factors for developing cataracts include a high-fat diet—change your eating habits. Arrange fasting days, cleanse the body of toxins, and monitor vascular tone.

Nutrition for cataracts

Nutrition for cataracts in old age is fundamental, and for prevention too. Give preference to the following products:

• green tea;
• seafood;
• buckwheat flour;
• sprouted wheat grains;
• different combination of vegetable juices.

Mulberries and blueberries in any quantity are an excellent means of prevention. You need to eat a glass a day or more.

Honey drops are an excellent means of preventing ophthalmic diseases. Honey is diluted with safe eye drops or boiled water (1:1). Preventive course - 21 days of instillation.

Another means of prevention is the egg method. Boil a homemade egg, cut it in half and remove the yolk. Then the egg halves are filled with granulated sugar, combined and sent to the oven until the sugar melts.

The syrup is poured into a sterile container and dropped into the eyes (diluted with water). The essence of the method is to wash the eyeball from calcium deposits and mucus.

The method is traditional, so it is better to consult an ophthalmologist about its use.

Preventive measures also include herbal infusions. A decoction of marina root is taken orally. To do this, dry raw materials are steamed with boiling water for 4 hours, and then boiled for 5-6 minutes. Drink like tea, but before meals.

Bottom line

Preventing premature aging of the body is the key to the health of the eye lens.

People after 50 years of age (sometimes earlier) need to think about protection from active processes of cell decay, cleansing of toxins, and reconsider their diet and lifestyle.

If a person was engaged in sedentary work, it is necessary to add physical activity. If a person has been involved in heavy physical work, it is necessary to reduce the load.

Source: https://BeregiZrenie.ru/katarakta/vozrastnaya-katarakta/

Age-related (senile) cataracts: symptoms, treatment, nutrition, contraindications to surgery

Senile cataract is a clouding of the lens substance that occurs when reaching old age and is manifested by a decrease in visual acuity. Over time, most people experience blurred vision of the world around them. In many cases, the cause is the appearance of this particular disease.

Most often, senile cataracts are diagnosed in people over 60 years of age. The problem of the growing incidence of cataracts remains quite relevant, since it is the most common cause of blindness.

Stages of age-related cataracts:

• Initial.
• Immature.
• Mature.
• Overripe.

Primary cataract

It is a partial clouding of the lens, located under the capsule or in the cortex. At this stage, the patients’ complaints are not pronounced, since the pathological process does not affect the central part of the lens. It begins to absorb excess moisture, causing the fibers to swell, leading to their delamination at the periphery.

Immature cataract

Most often, the opacities slowly increase, acquiring a grayish or whitish color. Due to the swelling of the fibers, the lens becomes larger in size, and the anterior chamber decreases. At this stage, patients begin to experience deterioration in vision, as the area of ​​opacities falls into the central zone.

Mature cataract

The lens loses moisture, causing it to decrease in size. The pathological process reaches deeper layers, and the opacities become dirty gray in color. At this stage, older people completely lose object vision, since lens opacities block the optical zone.

Overmature cataract

Losing moisture even more, the lens begins to wrinkle. There is an increase in the density of turbid masses in it, and deposits of cholesterol or lime may appear on the capsule. In the case of blinking cataract, the cortex of the lens liquefies and the nucleus descends.

How quickly does cataract progress?

Experts say that in 12% of patients suffering from the disease, the disease worsens in a fairly short time: about 5 years. After time, these people need surgical intervention.

About 15% of patients suffer from slowly progressive cataracts: the pathological process develops over 10-15 years. Most people experience the disease, which gets worse between 6 and 10 years of age.

In many ways, the course of the disease depends on the presence of concomitant pathology, nutrition, and environmental influences.

Causes of cataract development

With age, under the influence of natural processes in the lens, metabolism is disrupted. First, excess water content accumulates, leading to an increase in amino acids and water-soluble proteins. All this leads to swelling, disintegration of fibers and their liquefaction. The lens loses its transparency, first in certain areas, and then completely.

Risk factors for early development of cataracts:

• Hereditary predisposition.
• Presence of concomitant ophthalmological pathology: glaucoma, myopia.
• Taking glucocorticoid drugs, cytostatics, phenothiazines.
• Endocrine diseases: diabetes mellitus, metabolic syndrome.
• Excessive UV exposure.
• Radiation exposure.
• Smoking.
• Poisoning with toxic substances - mercury, thallium.

Manifestations of the disease

Depending on the stage of age-related cataracts, its symptoms will vary. In the early stages, patients complain of minor changes.

The main signs of initial clouding of the lens:

• Split image.
• Blurred vision.
• Deterioration of twilight vision.
• Impaired color perception.

As the cloudiness spreads, the symptoms become more numerous.

Signs of advanced cataract disease:

• Noticeable deterioration in visual acuity.
• Appearance of spots before the eyes.
• Blurred silhouettes.
• Feeling of fog before the eyes.
• The appearance of sensitivity to bright light.
• Improving vision in the dark by dilating the pupil and passing light through the peripheral part of the lens.

At the stage of mature cataract, the main symptom is the complete loss of objective vision: the sick person retains only light perception, as well as the ability to determine the light source.

Overmature age-related cataracts are characterized by the fact that the patient is no longer able to locate light. This stage is dangerous for the development of serious ophthalmological complications: phacolytic glaucoma and iridocyclitis.

Which doctor treats age-related cataracts?

The disease is an eye disease, so the sick person should consult an ophthalmologist. It is this doctor who will confirm the diagnosis and prescribe appropriate treatment. If this specialist is not available at the clinic, the patient has the right to consult with a local therapist. If necessary, he will refer the patient to an ophthalmologist at the eye hospital.

Diagnostics

The doctor conducts the following research methods:

• Determination of visual acuity.
• Examination of the anterior segment of the eye with a slit lamp;

Depending on the diagnostic and treatment situation, the doctor may also carry out:

• Ophthalmoscopy.
• Tonometry.
• Perimetry.
• Ultrasound.
• EPI of the optic nerve.

Treatment

In the initial stages of lens opacification, the specialist recommends conservative therapy to the patient to prevent rapid progression of the disease. The treatment of cataracts includes the use of eye drops that improve metabolic processes.

Most commonly prescribed medications:

• Taufon or Taurine: contain the amino acid of the same name, which prevents oxidation and clouding of the lens protein.
• Oftan Katahrom: normalize oxidative and energy processes. Active ingredients: Cytochrome C, Adenosine and Nicotinamide.
• Quinax: contains azapentacene, which improves metabolic processes and protects the lens from loss of transparency.

To combat cataracts, ophthalmologists recommend using medications according to a special regimen: 1-2 drops instilled into both eyes three times a day in courses.

Contraindications for the use of conservative therapy:

1. Individual intolerance to any component of the drug;
2. Pregnancy and breastfeeding period.

In the case of mature or overripe cataracts, the use of drug therapy is unfounded.

When should surgery be performed?

The main indication is considered to be low visual acuity, leading to limited ability to work and discomfort in everyday life. In case of advanced cataracts, this is the only way to restore vision.

How is phacoemulsification of cataracts performed?

This treatment involves replacing the cloudy lens with an intraocular lens. A fairly small incision is made on the side of the cornea and a small probe is inserted into it. Ultrasound destroys the nucleus of the lens and then removes it. After this, the intraocular implant is inserted onto the capsule, which will support it in place.

The entire operation takes no more than 20 minutes, and the effect is noticeable immediately. Upon completion, the specialist advises the patient to follow certain rules.

Recommendations of an ophthalmic surgeon after cataract removal:

• Lifting weights over 3-5 kg ​​is prohibited.
• Avoid bending down and sudden movements.
• Wear dark glasses in bright sunny weather.
• Do not drink excess water in the first 14 days after the intervention.
• Limit intake of salty, spicy foods.
• Sleep on the non-operated side.
• Avoid driving.
• Do not rub or put pressure on the eye.
• Quitting smoking and alcohol.

This regimen must be followed for about 2-3 months to reduce the likelihood of acquiring postoperative complications.

When it is not advisable to conduct FEC

There are certain contraindications to the operation.

These include:

• Development of an acute infectious disease or exacerbation of a chronic one.
• Condition after myocardial infarction or stroke that occurred at least 6 months ago.
• Inflammatory processes in the organ of vision.
• Malignant neoplasms of the eye area.
• Mental illness or inadequate state of a person.

If there are any, it is recommended to postpone the intervention for some time or cancel it.

Diet

The patient needs to follow proper nutrition for cataracts: he will have to give up a number of foods that provoke the progression of the disease. People who eat large amounts of meat are considered more prone to developing cataracts. To stop the course of the disease, it is recommended to eat food containing nutrients.

List of recommended products:

• Vitamin C: maintains the tone of the eye vessels. There is a lot of it in parsley, strawberries, currants, citrus fruits, and peaches.
• Vitamin E: is an antioxidant, protecting the organ of vision from UV rays and reducing the intensity of the disease. Contained in nuts in large quantities.
• Zinc: affects the absorption of vitamin A and provides support for lens clarity. Red beans, pumpkin seeds, shrimp, and chicken are rich in this microelement.

In old age, it is advisable for a person to eat foods containing small amounts of carbohydrates to reduce the likelihood of developing cataracts. Experts recommend including natural honey in your diet, as it contains microelements and vitamins that are beneficial for the eyes. It is enough to eat 1 tsp per day.

Complications

If cataracts are not diagnosed in time or adequate treatment is not prescribed, adverse consequences may develop.

These include:

• Phacolytic glaucoma.
• Iridocyclitis.
• Subluxation or dislocation of the lens.

Prevention measures

There are general recommendations from specialists that can protect a person from the early onset of the disease:

• Rejection of bad habits.
• Maintaining a balanced diet.
• Regular observation and examination by an ophthalmologist.
• Timely treatment of ophthalmological and general diseases.
• Course use of vitamin drops in the eyes.
• Wearing sunglasses.

The appearance of cataracts in older people is accompanied by deterioration of vision, blurred silhouettes and loss of clarity of objects. By following preventive measures and regular examination by a specialist, a person can delay the development of lens pathology for many years.

If there are no contraindications, if there is significant vision loss, cataract phacoemulsification should be performed. There is no need to be afraid of her. Timely surgery is successful; it is considered one of the most effective and safe interventions on the organ of vision.

Elena Atyutina, doctor
specially for okulist.pro

Source: https://okulist.pro/bolezni-glaz/katarakta/vozrastnaya-katarakta.html

Complicated cataract - symptoms and treatment

Complicated cataract of the eye is a serious disease that is accompanied by clouding of the lens. Many endocrine pathologies and some eye diseases, including traumatic cataracts, can provoke the development of this form of the disease.

Complicated cataracts are characterized by the presence of specific external as well as internal factors, which distinguishes them from age-related nuclear or cortical varieties of cataracts.

Typically, complicated cataracts are unilateral, but in some cases they develop in both eyes. At the same time, the pathology does not develop symmetrically even in the case of bilateral damage. This type of cataract can occur in people of all ages.

It is worth immediately noting that a complicated disease can lead to a significant deterioration in visual acuity and often becomes the cause of the formation of cataracts.

Many people with complicated cataracts, due to decreased vision, experience extreme stress, because a person can no longer continue professional activities, lead a normal lifestyle, travel, and difficulties arise with taking care of themselves at home. At the same time, stress and prolonged depression aggravate the course of the disease.

Causes of complicated cataracts

Biomicroscopy reveals a cup-shaped form of complicated cataract. The color of the pathological infiltrate is usually gray, which is due to a significant amount of calcium crystals, vacuoles, and cholesterol. The area of ​​turbidity itself vaguely resembles pumice.

When examining the lens, it becomes noticeable that the cloudy areas move in the opposite direction to the movement of the eyeball. Cloudiness begins in the back of the lens and develops only when the eye already has some kind of damage, with an accumulation of intoxication products.

It is they, which get into the lens along with the liquid, linger in the narrow space behind the natural lens and give rise to the disease.

The accumulation of infiltrate can be due to both external and internal reasons. First of all, it is worth considering the internal causes of a complicated disease. It is customary to identify a number of diseases, including chronic ones, that become predisposing factors in the development of complicated cataracts, these are:

• Chronic inflammation of the uveal tract.
• Scleroderma.
• Diabetes.
• Myxedema.
• Hypertension.
• Chronic iridocyclitis.
• Malignant eye tumors.
• Chorioretinitis.
• Glaucoma.
• Intrauterine pathologies of eye development.
• Metabolic disorders.
• Immune system pathologies, autoimmune diseases.

External factors leading to the development of complicated cataracts are equally numerous. The most common of them include:

• Traumatic eye injuries.
• Genetic predisposition.
• Iodine deficiency.
• Exhaustion due to poor nutrition.

It is worth noting that age-related changes in the body are also considered predisposing factors for the occurrence of the disease. In women, complicated cataracts occur much more often than in men, and are much more severe and aggressive.

Sometimes complicated cataracts can develop after lens replacement in the case of surgical treatment of progressive myopia, which is caused by tissue damage with impaired blood flow during surgery.

It is necessary to distinguish between complicated and age-related cataracts. These two diseases have different etiologies, and their rate of progression is different.

Types of complicated cataracts

In its development, complicated cataracts, just like age-related ones, go through 4 stages. Each stage has its own specific manifestations. Thus, in the initial form of the disease, factors appear that contribute to the accumulation of infiltrate in the eye. In this case, usually, no serious changes in the quality of vision are observed, although patients may at times notice slight fogginess.

But even at the first stage of development, one can suspect the presence of complicated cataracts, since there are always predisposing factors to it. Therefore, people with glaucoma, diabetes mellitus, or those who have suffered an eye injury in the recent past should undergo ophthalmological examinations as often as possible in order to diagnose complicated cataracts at an early stage.

The second stage of the development of the disease is immature cataract, in which there is serious opacification of the lens, accompanied by a significant decrease in visual ability.

The third stage of the disease is mature cataract, with the presence of a full set of all symptoms of the disease.

At the same time, the layering of infiltrate, which caused clouding of the lens, becomes visible even without the use of special means for examining the fundus. Mature cataracts are visible to the naked eye.

It looks like a thorn or a gray foreign object affecting the iris area. With mature cataracts, the color of a person's eyes changes, becoming milky.

The last stage in the development of this disease is overripe cataract. Often at this stage, patients lose the ability to see completely in the affected eye.

Depending on the location of the infiltrate and other characteristics of the opacities, complicated cataracts can be swelling or posterior capsular.

Cases of swelling cataracts are less common than posterior capsular ones and are characterized by an enlarged, hydrated lens. In this case, the infiltration processes are not pronounced and the lens retains its transparency for quite a long time. The course of swelling complicated cataract is accompanied by an increase in the volume of the lens and a significant decrease in the depth of the anterior capsule.

It is immediately worth noting that in the case of complicated cataracts, there is multiple etiology, which is why the disease progresses differently. This is the reason for its late detection, already at the stage of maturity with all the inherent symptoms. However, the rate of development of the disease, even if it has a similar etiology, can vary dramatically among different people.

Symptoms of complicated cataracts

Clinical manifestations and symptoms of complicated cataracts can vary significantly depending on the causes of the disease. But there are a number of characteristic signs of a complicated form of the disease, these are:

• A milky tint to the affected pupil, which is explained by the formation of a clot of infiltrate, similar in appearance to pumice. Blurred vision due to an increasing amount of infiltrate localized in the cornea. Moreover, as the pathology progresses, the degree of clouding increases, often ending in complete loss of vision.
• Double visible objects. This symptom may not be observed in every case, since it becomes a consequence of destruction of the lens with retinal separation under the influence of crystallizing calcium salts.
• Other vision problems. The majority of patients with complicated cataracts may notice some visual problems already in the early stages. For example, the ability to read text in normal font is lost, and vision deteriorates in low light conditions.

A particularly common cause of complicated cataracts is diabetes mellitus, which usually causes bilateral eye damage.

Examination of the fundus in this case easily reveals areas of opacification located in the anterior and posterior regions of the lens. Often, diabetic, complicated cataracts progress rapidly and are accompanied by thickening of the epithelial wall of the iris.

It is the damage to the pigment epithelium of the iris that leads to a complete change in its color and transparency.

Diagnosis of complicated cataracts

When diagnosing complicated cataracts, a qualified ophthalmologist first examines the affected eye in bright daylight.

If signs of lens opacification and/or retinal dissection are detected, a more in-depth examination is performed using a slit lamp.

Biomicroscopy provides targeted illumination and the necessary magnification, which makes it possible to better visualize the source of damage and its specificity.

It should be noted that mature cataracts are best diagnosed. In the initial stage of complicated cataracts and a minor area of ​​opacification, making an accurate diagnosis requires differential diagnosis with glaucoma, retinal detachment, due to trauma and some other pathologies.

Treatment

In cases where complicated cataracts are diagnosed at an early stage, conservative therapy can be prescribed using eye drops that help normalize blood supply and improve metabolic processes.

In addition, it is recommended to wear contact lenses and be gentle on the eyes, which involves working and reading only in bright light.

But, in most cases, especially if the degree of clouding of the lens is high, surgical treatment is indicated.

There are many methods of surgical treatment of cataracts. Sometimes correction of the surrounding tissues of the cornea and lens is indicated, and in other cases, complete removal of the lens damaged by opacification is performed and its replacement with an artificial analogue - an intraocular lens.

You need to know that after surgical correction of the tissues adjacent to the lens in case of complicated cataracts, without treating the disease that caused it, vision is not always completely restored. If the outcome of surgical intervention is unfavorable, repeated infiltration and new development of opacities are possible.

After surgically replacing the lens with an intraocular lens and undergoing the necessary postoperative rehabilitation, in most cases, vision is completely restored.

Surgery is considered the most effective way to get rid of complicated cataracts and the only way to restore vision.

Cases of postoperative complications in this case are quite rare, because most lens replacement techniques are low-traumatic and involve the use of a special laser. Complicated cataracts treated using modern surgical methods usually do not recur.

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Source: https://catarakta.ru/vidy-katarakty/449-oslozhnennaya-katarakta.html

What is complicated eye cataract: how dangerous it is and how to treat it

Complicated cataract is a clouding of the natural lens of the eye (lens), which develops against the background of existing pathologies in the body.

The pathological process is constantly progressing, capturing new areas of the eye structures, which ultimately leads to loss of vision.

Sometimes it is reversible if you pay attention to the pathology in time and take appropriate measures to stop its development. Such cataracts do not depend on the age of the patient.

Etiology

The natural biological lens of the eye (lens) is an important part of the visual apparatus, which ensures the correct refraction of light rays. On the outside, the lens is surrounded by intraocular fluid, through which it receives nutrition. If negative changes occur in it, this affects the transparency of the lens, provoking complicated cataracts.

Cloudiness forms under the posterior capsule of the natural lens only when the eye is injured and toxins accumulate in it. They enter the lens along with the intraocular fluid, get stuck in the narrow space behind it and provoke the development of pathology.

Causes

Complicated cataracts develop against the background of external influences or due to other diseases of the body, both related to the eyes and having nothing to do with them. You should know that this is a disease, the main cause of which is the toxic effects of decay products resulting from inflammation and malnutrition of the lens.

The following eye diseases lead to the appearance of complicated cataracts:

1. Chorioretinitis. An inflammatory process affecting the retina and choroid of the eye. The pathology develops due to toxoplasmosis, weakened immunity, and cytomegalovirus infection. Cataracts in this case are provoked by general and local intoxication of the body.
2. Fuchs syndrome. Dystrophic changes in the iris, provoked by inflammation.
3. Iridocyclitis. Inflammation of the ciliary body, iris, choroid. It manifests itself as profuse lacrimation, redness of the sclera, changes in the pattern of the iris, and pain. Frequent relapses of iridocyclitis lead to the appearance of cataracts.

Causes not related to eye diseases

Sometimes the causes of complicated cataracts are general pathologies that cause metabolic disorders and general intoxication of the body. These include:

• typhus;
• malaria;
• smallpox;
• anemia;
• anorexia;
• exhaustion of the body;
• hypertension;
• iodine deficiency;
• diabetes;
• pathologies of the thyroid gland:
• rheumatoid arthritis.

Risk factors for the development of complicated cataracts include taking certain medications (corticosteroids, drops with adrenaline or pilocarpine).

Children's complicated cataracts become a consequence of uveitis, which the child suffered from during fetal development.

Complicated radiation cataracts are provoked by exposure to ultrasound, x-rays, and radium rays. This type of disease develops mainly in young people, since in old age the susceptibility of the lens to various types of rays decreases.

Types and symptoms

First, a complicated cataract begins to develop in the posterior part of the lens, which is associated with the unprotected posterior wall by the epithelium. Because of this, decay products can easily penetrate the lens. Initially, a transfusion effect appears at the posterior pole of the natural lens.

Without treatment, the pathology leads to blindness.

It gradually increases in size, is replaced by yellowish opacities and completely covers the area of ​​the posterior capsule. A cup-shaped cataract develops, in which the main surface of the lens and its core still remain transparent, but the quality of vision decreases. The disease develops slowly, moving towards the middle layers of the lens and its core.

There are several types of complicated cataracts, each of which is accompanied by its own symptoms:

1. Initial. The impetus for the development of the disease is the inflammatory infiltrate that accumulates in the eye structures. In this case, a person has no symptoms, except for the occurrence of slight blurred vision that occurs periodically.
2. Immature cataract. A small spot appears on the back of the lens, gradually increasing in size and density. Vision begins to rapidly deteriorate. But the layer of turbidity is still very thin; most of the cortex and core are not affected by pathology. Immature complicated cataract is manifested by increased sensitivity to light, double images, impaired twilight vision, the appearance of cloudy spots in front of the eyes, rapid eye fatigue, decreased contrast of visible objects, a halo around them, and lack of improvement in visual clarity when using corrective optics.
3. Mature form . The layer becomes porous, rough and yellow. The cataract matures and the pupil becomes light gray. At this stage, cataracts can be seen without any instruments. Due to the thick layer of infiltration, a grayish formation similar to a cataract appears on the eye. Vision is rapidly deteriorating.
4. Overripe. A person practically ceases to see with the affected eye as a result of a total layering of the lens over the entire area.

Metabolic disorders affect the back part of the membrane, where there is no epithelium, so toxins easily penetrate through it. This is a posterior capsular cataract. Much less commonly diagnosed are swelling complicated cataracts, in which the size of the natural lens increases while the anterior capsule of the eye contracts.

Incomplete complicated cataract

With this form of pathology, cloudy spots appear on the lens, preventing normal vision. The disease appears at any age, but in older people it progresses more quickly.

Incomplete complicated cataracts of both eyes are rare. Usually the disease is unilateral.

When both eyes are affected, it progresses simultaneously, but development in each organ occurs differently.

Diagnostics

The early degree of pathology can only be detected by an ophthalmologist after a thorough examination. In the later stages of cataract development, it can be seen with the naked eye because the pupil changes color.

First, the doctor conducts a standard examination, and then a biomicroscopic diagnosis using a slit lamp. The pathological infiltrate has a gray-white color, which is caused by the accumulation of a large number of cholesterol deposits and calcium crystals. The cloudy areas are pumice-like and move against the movements of the eyeball.

The slit lamp helps identify lesions

If cataract has developed against the background of uveitis, then an iridescent shine is observed in the posterior pole of the lens. Small local opacities of a whitish-grayish tint are noted. Cataracts complicated by retinal detachment are accompanied by the appearance of opacities under the posterior capsule of the lens.

In addition, ocular pressure is measured, since its constant increase leads to the appearance of anterior capsular and subcapsular foci of opacification. The disease is differentiated from retinal detachment, glaucoma, neoplasms in the structures of the eyes, and diseases of the corneal layer.

Treatment of complicated cataracts

Treatment of complicated cataracts is mainly carried out with surgery. But in some cases, at the initial stage of development of the disease, it can be eliminated or at least the progression can be stopped with the help of eye drops.

Doctors prescribe drops with glutamine, lonosterol, ascorbic acid, cysteine ​​(Taufon, Vitafacol, Vitaiodurol) . These medicinal drugs improve metabolic processes in the lens, eliminate protein compounds that cause clouding of the lens.

If the clouding has reached the second or more stages, the disease can only be treated surgically.

Doctors perform various lens extraction operations:

1. Intracapsular extraction. An operation that is prescribed very rarely due to the high risk of complications in the form of retinal detachment. It involves the simultaneous removal of the lens and capsule.
2. Phacoemulsification. A very quick operation that lasts approximately 15 minutes. Using ultrasound or a laser, the lens is destroyed through a small incision in the eye to an emulsified state, removed and replaced with an artificial intraocular lens. This is a soft lens that is rolled into a tube. It is inserted using a micro-instrument into the place of the lens, and it straightens out. The operation is seamless, the micro-incision heals on its own. On the day of surgery, the patient can already return home.
3. Extracapsular extraction. The lens is removed without the capsule. Extracapsular surgery is most often performed to treat complicated cataracts in children. Microsurgical techniques are used, performing linear extraction and aspiration.

Phacoemulsification of cataracts

After the operation, some complications may occur in the form of swelling, rejection of the artificial lens, and hemorrhages. But they are extremely rare.

Bakhareva Elena Sergeevna, specialist for the website glazalik.ru
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Source: https://GlazaLik.ru/bolezni-glaz/katarakta/oslozhnennaya/