Cataracts are complex and quite dangerous disease, which often leads a person to blindness. The pathology itself consists of clouding of the lens capsule, which allows ophthalmologists to cope with this disease using surgery. Modern medicine uses an artificial lens for these purposes, which replaces the damaged one. However, even surgery does not completely solve the problem, since often after surgical intervention secondary cataract develops, which requires repeated surgery. In this case, laser discission of secondary cataracts is often performed. Let's tell you more about this treatment method.
Symptoms of the disease
The main sign of recurrent disease is blurred vision. Visual acuity, as a rule, decreases gradually, and in most cases the patient begins to see a halo around the light source.
Causes of secondary cataracts
Doctors are inclined to believe that secondary cataracts develop because when the lens is removed, not all cells of the lens epithelium may be removed, which subsequently begin to multiply, which leads to a gradual deterioration of vision. According to statistics, the probability of secondary cataracts occurring after surgery varies between 42–90%. This may be due to age (in children and people with diabetes, the disease develops more often). In addition, the appearance of secondary cataracts depends on the type of surgery performed and the material of the lens.
Treatment of secondary cataracts
But a more progressive method of combating this disease is a procedure called laser dissection. The first such operation was carried out more than thirty years ago and since then has been extremely popular. The advantage of discision over other methods of vision correction is the minimum side effects and possible complications.
This operation is prescribed in the following cases:
- significant decrease in vision due to clouding of the lens capsule;
- visual impairment, which reduces the patient’s quality of life;
- severe vision loss due to too much bright light or poor lighting.
Contraindications for laser discision should also be considered. These include conditions such as:
- inflammation of the iris;
- the presence of scar tissue or swelling on the cornea, which does not allow the doctor to see the intraocular structure;
- macular edema of the retina.
Features of surgery
This surgical intervention is performed with extreme caution in cases where the patient has a rupture or detachment of the retina.
Laser dissection of secondary cataracts is carried out only under local anesthesia, which means the patient does not feel discomfort. Before the procedure begins, medications are dropped into the eyes to dilate the pupils. These may be the following drugs: 2.5% Phenylephrine, 1.0% Tropicamide, and 2% Cyclopentolate. Pupil dilation is necessary in order to better see the posterior capsule. And to prevent a possible increase inside eye pressure V postoperative period, the patient is prescribed 0.5% Apraclonidine. The patient will be able to go home after the operation literally in 2 hours. Bandages and stitches are usually not applied after this operation. To avoid inflammation, patients are advised to take eye drops with steroids.
Complications after surgery
In most cases, there are no complications after this operation, although sometimes the following conditions may occur:
- inflammation or swelling of the cornea;
- retinal detachment or tear;
- displacement of the intraocular lens;
- macular edema of the retina.
It is important not to forget to take Apraclonidine, which will not allow intraocular pressure to rise, and also use local steroids Lotoprednol or Prednisolone for a speedy recovery. Health to your eyes!
Laser discillation is a procedure that aims to treat secondary cataracts after artificial lens surgery. What are its indications and are there any contraindications to its implementation? Details in our article.
In this article
Such a deviation as clouding of the posterior capsule of the lens eyeball leads to a significant deterioration in visual acuity. In modern ophthalmology, when removing a cataract, specialists leave a capsule into which an artificial lens is implanted. It is important to understand that secondary cataracts begin to progress not on the implanted lens, but on the remaining capsule. The anomaly is very common in patients in the postoperative period; according to statistics, it occurs in approximately 40% of patients 2-5 years after surgery.
Today, to eliminate the disease, the laser method of corepraxy of the posterior capsule of the lens is used - the formation of a new pupillary opening. This is a fairly quick, yet highly effective and low-traumatic procedure.
These processes are completely unrelated to the doctor’s error during the operation. The appearance of secondary cataracts is associated precisely with the body’s response at the cellular level, when the epithelium turns into functionally inferior fibers, irregularly shaped, losing their transparency. Cloudiness can also be caused by fibrosis of the capsule.
Risks of manifestation of opacification of the posterior capsule of the lens
Experts identify several factors that may influence the progression of secondary pathology visual organs. Among them:
- The age category to which the person belongs. Thus, it has been established that in children after laser surgery the anomaly occurs much more often than in adults. This is explained more high level tissue regeneration, which causes cell migration of the epithelium. It is these processes that cause division in the capsule remaining after removal of the primary cataract.
- Shape of the intraocular lens (IOL). As practice shows, the square shape of such a lens gets along in the patient’s body much faster, which significantly reduces the risk of damage to the capsule.
- The material from which the IOL is made. Ophthalmologists emphasize that if the intraocular lens is made from a material with a high percentage of acrylic and is implanted into the posterior capsule of the lens, secondary cataracts occur much less frequently. Silicone IOLs, on the contrary, cause pathology quite often.
- Diabetes mellitus and a number of concomitant visual diseases.
Signs of a secondary anomaly
After the end of laser surgery to replace the lens, it is impossible to determine whether the disease has re-developed. Time period initial stage The development of opacification of the posterior capsule with secondary cataracts can range from 2 to 10 years. Only after this interval can appear obvious signs eye disease and loss of objective vision. So, clinical picture pathology varies significantly depending on the area of deformation of the lens; if this occurs in its periphery, vision deterioration may not be observed at all.
Cloudiness of the posterior capsule of the lens with the occurrence of secondary cataracts is most often detected during a routine examination by the attending ophthalmologist. If persistent visual impairment has been established, even if it was restored during laser surgery, treatment is prescribed. Also, a number of manifestations include the presence of a veil, halos and glare in poor lighting, double vision of the objects in question, distortion of color perception, and the development of myopia (myopia). Clouding of the posterior surface of the lens can appear on one or both visual organs.
Elimination of opacification of the posterior capsule of the lens in secondary cataracts
Treatment of the pathology of the anomaly occurs with the help of capsulotomy - freeing the central optical zone of the visual system from clouding, which allows light rays to penetrate into the eye and increase visual acuity. Less commonly, this procedure is performed mechanically using special surgical instruments, more often laser method. This is due to the fact that the latter procedure is practically non-traumatic and very fast, it lasts several minutes.
While surgical intervention involves excision/dissection of the clouded film. Most often, the hole diameter is 3 mm. The disadvantages of the surgical method are that subsequently there may be infectious infection eye, swelling of the cornea, hernia when the integrity of the membrane is violated.
Laser dissection of the posterior capsule for secondary cataracts - features
Removal of cloudiness from the posterior capsule of the lens is carried out using laser beams. This method is characterized by the highest degree of reliability, which is achieved by precise focusing and low energy consumption of the beams on average 1 mJ/pulse. This procedure with intervention with a laser device is called discision (cleansing) of the posterior capsule.
During this procedure, by burning in the back surface of the capsule, the specialist makes a hole through which the cloudiness is removed. The operation lasts only a few minutes, and if it is successful, the patient does not need to stay in the hospital for more than 1-2 hours. During the process, the patient will not experience pain or other discomfort; the specialist will first subject him to local anesthesia.
Laser dissection of the posterior capsule of the lens of a secondary cataract involves the following steps:
- The ophthalmologist applies special drops to the corneal surface of the visual organs that dilate the pupils and also prevent an increase in eye pressure;
- Several shots of laser beams are fired, which causes the appearance of a transparent window in the lens capsule, and the secondary cataract is eliminated.
After the procedure, the patient is not given any bandages. The rehabilitation period passes quite quickly (on average one month) and painlessly. During this time, the person needs to undergo several routine examinations, follow the instructions of the ophthalmologist and use the prescribed hormonal drops. Studies show that if all recommendations are followed, the risk of recurrent complications is very small, it is only 2%.
Who is prescribed discision and to whom is it contraindicated?
If secondary cataracts occur, the procedure is indicated for patients with:
- damaged posterior wall of the capsule, causing a significant decrease in vision;
- bad social adaptation with decreased vision;
- problems seeing objects in bright light or, conversely, poor lighting.
Laser surgery should not be performed on people with:
- scar tissue on the cornea;
- inflammatory processes;
- mesh swelling;
increased pupil thickness from 1 mm.
Cataracts of the eye are not a death sentence; they can be successfully treated with a simple operation to replace the lens. Surgical treatment cataracts are great success ophthalmology, which enabled patients to see the world around them again.
But, unfortunately, no one is immune from complications that may arise after it. One of the most serious consequences of pseudophakia (replacing the lens with an artificial lens) is secondary cataract, but with the development of modern medicine, this is not at all fatal.
Treatment of secondary cataracts after lens replacement
After lens replacement surgery, some patients are at risk of developing late complications called secondary cataract. The disease is characterized by the same symptoms as the primary form, that is, a person’s vision slowly but surely deteriorates, objects lose clarity, their outline becomes double and blurry. The “water haze” before the eyes returns to the patient again. This happens due to clouding, now, not of the lens itself, since an artificial lens is in its place, but of its posterior capsule.
There are several ways treatment of secondary cataracts, developing after lens replacement. Until recently, elimination of postoperative relapse could only be accomplished through surgical intervention. But this method gradually became obsolete, due to a number of negative consequences that could occur during surgery:
Due to these reasons, ophthalmologists refused to carry out surgical interventions. With the advent of the ophthalmic laser, treatment has reached a new, progressive level.
Traditional medicine also offers several recipes. Of course, it is unlikely that they will help get rid of the disease, but it is possible to slow down the development process:
Before treatment folk remedies Make sure you are not allergic to any of the ingredients and be sure to consult your doctor.
At the initial stage of secondary cataract, successful therapeutic treatment is possible with the help of hormonal and herbal preparations.
Laser dissection of recurrent cataracts has been successfully used for the last 30 years. The method was developed by an ophthalmologist - a woman who for a long time studied physics. The procedure has proven to be safe and effective way getting rid of relapse eye disease. It does not require general anesthesia.
Intraocular incisions made with a laser are hundreds of times less traumatic than incisions made with surgical instruments. And the risk of damage to the cornea or intraocular lens is minimized. Distinctive features laser discision method are outpatient treatment, fast rehabilitation and low morbidity. Indications for the procedure are as follows:
- Serious impairment of visibility, especially in the dark and in bright light;
- Significant opacification of the posterior capsule, which interferes with normal life.
The operation is contraindicated in cases of iris swelling and inflammatory processes eyes.
The treatment procedure is extremely simple:
- A drug is applied to the cornea to prevent increased eye pressure.
- Patients are instilled with a drug that dilates the pupils, after which most of them note a slight improvement in vision.
- In the back of the lens, using laser pulses, a hole is made, through which the clouded part is removed. The local action of laser beams allows you to leave unharmed, healthy tissue capsules.
- Immediately after the procedure, it is necessary to use anti-inflammatory drops and stabilize the metabolism in the lens.
The operation is performed using local anesthetic, without bandages, stitches and hospitalization of the patient. Two hours after the procedure, the patient is sent for outpatient observation. Most people who have undergone laser surgery notice an improvement in their vision immediately after the operation.
Unfortunately, during laser treatment, there is a small percentage of complications:
A number of other complications of laser discision, such as retinal detachment, increased intraocular pressure, has minimal chances of development.
Causes of secondary cataracts
Until now, doctors cannot name the exact cause of secondary cataract. But the main factor in the development of relapse is the remains after the primary operation, on back wall capsules, epithelial cells, removed lens. Subsequently, they begin to multiply, which leads to repeated clouding and deterioration of vision.
In addition to this reason, there are several more, to a greater or lesser extent, that contribute to the recurrence of cataract development:
The use of antibacterial drops is a good prevention of secondary cataracts.
What you need to know about secondary cataracts?
The disease begins after surgical treatment lens The first symptoms are blurred vision. The reason for the development is epithelial cells primary cataracts that remain on the posterior membrane of the lens after surgery.
It is treated with laser method without anesthesia and incisions. The procedure takes a few minutes. It consists of removing remaining cells and preventing their proliferation. Rehabilitation period no intervention required.
If your vision has deteriorated after surgery, it is recommended comprehensive examination eyes.
Among eye diseases that lead to blindness, the leading position is occupied by cataracts, or clouding of the lens. Good modern medicine I learned to solve this problem with surgical intervention, namely cataract extraction. This operation is carried out in outpatient setting, takes little time and is completely safe for humans.
However, despite all the apparent simplicity, the operated person is not immune from relapse of the disease. Statistics show that approximately 50% of adult patients consult doctors with complaints of secondary cataracts. In children, this relapse occurs in 90% of cases. To solve this problem, discision of secondary cataract is prescribed. What kind of operation is this and how is it performed? Everything needs to be sorted out.
Reasons for the development of secondary cataracts
Do not think that primary cataracts are treated with a laser. Doctors use a scalpel to remove the cloudy lens. It is with a scalpel that the clouded lens is removed, and an artificial one is inserted in its place. However, in this case, particles of the affected lens may remain in the eye, which over time begin to multiply and spread throughout the posterior capsule. They then lead to secondary cataracts, which require repeated surgery.
Symptoms of secondary cataracts
The most important sign of the development of secondary cataracts is a gradual deterioration of vision. As a rule, the patient in this case complains of the appearance of “floaters” or fog before the eyes, as well as a halo around the light source.
If the diagnosis confirms the development of secondary cataracts, ophthalmologists decide to discise the posterior capsule.
What is the Discipline Procedure?
Laser dissection is the most progressive method of treating recurrent disease. It is carried out using a laser ophthalmic device (YAG). Through the subtlest laser beam, an experienced specialist acts on the growing cells, destroying them and creating an optical opening. As a result of such manipulations, the patient regains full vision.
How is the operation performed?
Before surgery, the patient is given local anesthesia, thanks to which the process does not cause him absolutely any discomfort. In addition, drugs are applied to the cornea to dilate the pupils (Phenylephrine drops 2.5% or Tropicamide 1.0%). To prevent increased eye pressure, the drug Apraclonidine 0.5% can be administered.
Complications of the surgical intervention are unlikely; most often, the patient will be able to leave the clinic within 2 hours after the intervention. Moreover, you will not have to wear any bandages or stitches after this procedure. In order to avoid inflammation, the patient needs to put drops in his eyes for some time after surgery. steroid drugs. And after a week, it is important to visit the doctor again and make sure that the treatment was successful. As a rule, secondary cataracts are treated in one session and only in isolated cases are two operations required.
Absolute contraindications to dissection
- the presence of swelling or scars on the cornea of the eye, due to which the surgeon cannot examine its structure;
- clouding of the cornea of the eye;
- development of uncompensated glaucoma;
- inflammation of the iris.
Relative contraindications for this operation include only a period of less than 6 months from the removal of the primary cataract.
Postoperative complications
As a rule, in 90% of cases, discision of secondary cataracts is performed successfully without any negative consequences. In rare cases, this intervention may result in:
- swelling or inflammation of the cornea;
- displacement of the intraocular lens;
- retinal edema;
- retinal rupture or detachment.
In these cases it is required additional help ophthalmologists. I wish you health and clear vision!
Secondary cataract- opacification of the posterior capsule of the lens, which can occur and develop within 5 years after the initial operation. People often make the mistake of thinking that the appearance of secondary cataracts is due to the unprofessionalism of the surgeon who performed the operation. This statement is incorrect, since in the vast majority of cases, secondary cataracts appear solely due to the characteristics of the body. The opacification develops gradually and occurs due to the proliferation of epithelium on the posterior surface of the lens capsule.
One of the main signs of the development of secondary cataracts is a gradual deterioration of vision. Often patients complain of the appearance of “floaters” in front of the eyes, blurred vision and the appearance of halos around bright light sources. In general, the symptoms are similar to those observed with ordinary cataracts of the eye.
Laser dissection of the posterior capsule of the lens is considered an effective method for treating secondary cataracts.
Laser intervention (discision) is highly effective. When performing a dissection, a hole is made in the posterior wall of the capsule, either with a laser or surgically. Through this hole, the clouded tissue of the lens capsule is removed. As noted above, it is the method of posterior capsule discision that is the most effective and main method of treating secondary cataracts of the eye in modern ophthalmology.
Patients respond very positively to laser dissection of the posterior lens capsule. The operation does not require a hospital stay, but is performed on an outpatient basis. It should also be noted that the entire procedure is painless and does not bring any significant discomfort to the patient.
As a rule, complications do not arise after this type of intervention, vision is restored quickly, and the patient returns to his normal activities.
Diagnose secondary cataracts and, if necessary, carry out all necessary treatment You can by visiting our ophthalmic surgery center in Krasnodar “IRIS”. Our clinic has all the necessary equipment to perform discision of the posterior lens capsule. With prices for this procedure you can find it directly on our website in the section, you can also get more detailed information by calling us at: +7 861 212-9-212
