ELZA’s role in Cataract Surgery

Members of ELZA have performed research on intraocular lens technology and were consultants to industry for the market introduction of blue blocking lenses in Europe in the years 2002-2005. Also, ELZA has access to the most modern variant of cataract surgery, performed with a femtosecond laser.


Facts about cataract


Cataract is a progressive cloudiness of the human lens, and can be corrected via surgery. A healthy lens is clear, but as a cataract develops, the lens of the eye gradually becomes hard and cloudy, allowing less light to pass through and making it more difficult to see.

Nevertheless, on a global level, it remains the number one reason for blindness. This is simply due to the fact that in poor countries, most people cannot afford the surgery that would give them back sight.


Historical considerations



Cataract surgery has accompanied mankind throughout history. Two famous examples are ““The march of the blind“ by Pieter Brueghel, painted in 1568, and illustrations showing how cataract was removed in the Middle Ages.



What are the symptoms ?


The left image shows the visual quality in a patient before the development of cataract.

Typical visual impression in early (middle) and in advanced cataract (right)



Early symptoms include increased glare, an increased need for intense light to read, and a prolonged adaptation time when changing the environmental lighting. At later stages, visual acuity gradually decreases and, theoretically, if not operated, would lead to legal blindness, sinply because the lens in the eye has become intransparent.


How are cataracts treated ?


Cataracts are treated by removing the cloudy, natural lens, and by replacing it with an artificial intraocular lens (IOLs).



There are different types of IOLs:

Monofocal IOLs have one point of focus, either distance or close up.

Multifocal IOLs provide two or more points of focus and are designed to reduce the dependence on reading glasses as a result of presbyopia.

Toric IOLs are designed to correct astigmatism, potentially reducing the need for glasses.


Conventional cataract surgery


Modern cataract surgery is performed using ultrasound energy to fragment the lens. The small fragtments are then aspirated through a circular opening in the capsular bag that is created by the surgeon. It is very important that this rhexis is perfectly round and centered, to allow for proper placement of the IOL.




Femtolaser-assisted cataract surgery (Femtophaco)


Either type of procedure (conventional can be effective when performed by a skilled surgeon, but laser-assisted cataract surgery procedures are generally more predictable and precise. Laser-assisted cataract surgery technology can automate certain steps during the procedure with laser precision.

Femtocataract surgery is a high-tech procedure, and we are proud to have access, as one of the first in Switzerland, to this technology. The femtocataract laser is used in addition to conventional surgery, and is currently not covered by health insurance.

See a real-time surgery here. It takes approximately 10 minutes, and was one of the first femtocataract cases perfomed in 2012. We use the swiss Z8 femtosecond laser by Ziemer Technologies, a world leader in femtosecond technology.






FAQ

Before the procedure


People often believe that a cataract must be in a highly advanced stage to be removed, but this isn’t true. When your eye care specialist sees signs of a cataract and you start to experience visual symptoms, you should ask about your options so that the cataract doesn’t infringe on your lifestyle.

If left untreated, the clouded area in your lens will continue to grow. The speed at which cataracts develop varies, but eventually your entire lens can become clouded, causing blindness.

The replacement lenses, known as intraocular lenses (IOLs), that you receive during cataract surgery depend on your lifestyle and your visual needs. Your surgeon will make a recommendation, but it’s a good idea to familiarize yourself with multifocal lenses, astigmatism-correcting lenses, and monofocal lenses so you can have an informed discussion about your options.

Yes. Your surgeon will offer you medication to help you relax and take steps to make sure you don’t feel any pain.

The procedure typically lasts between 15 and 30 minutes, though it may be two to three hours from when you check in until you leave your surgeon’s office.

Eye make-up can contain particles and bacteria (particularly eyeliner and mascara) so we stop them three days prior to surgery and week after.

Continue all eye medications through the day before your surgery. Do not use eye medications in the eye to be operated on the day of surgery. Eye drops for the fellow eye should be continued as usual.