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08.02.2019 08:23:58
Visual impairment is a typical age-related phenomenon. There is often a cataract behind it. But lenticular opacity can occur in children as well. Irrespective of the causes of cataracts, high-quality treatment is possible through the use of innovative techniques of laser therapy. Christoph Eckert is Director of 24 ophthalmological centres in Baden-Württemberg and Bavaria. He has answered our questions.
Dr. Eckert: This has not been fully found out. In science, till now there is agreement only on that the aging process causes a decrease in the water content of the crystalline lens. Because of this, it becomes cloudy. Therefore, in medicine, we are talking about age-related cataracts.
Dr. Eckert: We can already say that many elderly people are prone to it. 50% of people over 60 years old suffer from cataracts. In people over 70, this number is about 90%. But in general, cataracts can occur at any age. The reasons for this are, of course, different. These can be a metabolic disorder or a disease, such as diabetes. Strictly speaking, they include everything that causes disorders of blood circulation. Besides, some medications, such as Cortisone, can cause this process. Narcotic drugs are also ranked among the factors that accelerate the progression of the disease manyfold.
Dr. Eckert: It can be found even in small children. Cataracts can be congenital. It may also occur in the first years of life. Metabolic diseases, viral infections and genetic factors are possible causes.
Dr. Eckert: Usually, surgery is inevitable. In this case, the hardened lens is replaced with an intraocular lens. This ordinary intervention is performed in Germany more than a million times a year. The intervention can be carried out by means of a laser or a scalpel.
Dr. Eckert: I will explain in simplified terms. In the case of a scalpel, a microscopic incision is made on the cornea along its edge. This incision is necessary for inserting special instruments into the eye. Then the hardened lens is destroyed by using ultrasound, and the particles are aspirated. Finally, a rolled-up lens is inserted into the eye, where it unfolds. Meanwhile, laser-assisted surgery is performed more and more often. The procedure is the same, but safer. In addition, the surgeon can carefully straighten the lens, which leads to better results after surgery.
Dr. Eckert: The probability of this is negligible. The surgery can lead to capsular rupture or retinal detachment. Side effects are possible, but they are short-term. These include itching, reddening and increased tearing. A secondary cataract may also develop, and it occurs a little more often.
Dr. Eckert: A secondary cataract refers to the opacification of the posterior lens capsule. It is caused by small cells that remain in the eye after surgery. If their number increases, the lens may become cloudy. However, this can be very easily eliminated via laser polishing. It is painless and takes only a few minutes.
Dr. Eckert: A cataract is not an emergency, at least in adults. Children, however, should be operated on as quickly as possible to prevent amblyopia. Adults have enough time to get information about the surgery and to choose between a scalpel and a laser. Despite this, it is important not to put off the surgery for too long. The more time passes, the more laser intervention will be required to remove the hardened lens. The risk of complications increases as well. In addition, intervention in the case of a progressing cataract is more difficult to perform.
Dr. Eckert: We are talking about successful operations when the desired refraction is achieved. Refraction is the optimum optical power of the lens. Approximately 99.9% of operations are successful. The patient can see everything clearly and sharply again. If after surgery it is not possible to achieve the desired number of dioptres, it is called low ametropia. Later this can be corrected through the use of laser corneal surgery or glasses.
Dr. Eckert: No. But the results of new research indicate that lifestyle and, above all, nutrition affect the occurrence of cataracts. Eating large amounts of fresh food, primarily rich in vitamin C, reduces the likelihood of cataract occurrence.
