Cataracts

Cataract is the opacification of the lens of the eye, a very slow phenomenon that takes place during the course of life. From a biological point of view, we know that cataracts result from the activation of an enzyme, kynurenineamino transferase. This enzyme, which is induced in humans at around 20 to 23 years of age, oxidises the lens and causes increasing diffraction of light, which leads to glare. Some of the consequences of this diffraction are well known to all of us, such as difficulties in driving at night in the rain from the age of about 35 and glare.

Modern medical treatment of cataracts

The natural rate of progression of cataracts can be accelerated by the use of certain drugs such as tobacco or the abuse of other products such as alcohol. It can also progress more rapidly with certain diseases such as diabetes, high blood pressure or severe nutritional deficiencies. Although a healthy diet, reasonable use of antioxidants and good protection against ultraviolet light probably slows the rate of progression of cataracts, there is a lack of independent scientific evidence to support this.

At present there is no medical treatment for cataracts.

Surgical treatment of cataracts

When the patient is sufficiently affected by the cataract, the treatment consists of replacing the clouded natural lens with an artificial lens (intraocular implant) made of a synthetic material. This very delicate and sophisticated surgical operation must be performed in an operating room under sterile conditions and with the help of a microscope. The operation is performed as an outpatient procedure under topical anaesthesia, i.e. without injections, is usually painless and the patient remains awake throughout the procedure. The patient leaves the surgical centre within an hour of the operation and returns to the doctor's surgery for a check-up.

Intraocular implants

Cataract surgery has undergone significant technological development and so has the manufacture of intraocular implants. Since the 1970s, techniques have been developed and these procedures are considered safe and effective. Most implants contain a filter that blocks much of the sun's ultraviolet radiation that is harmful to the eye. They are injected into the eye through the small 2mm incision and unfold in the eye. These implants remain in the eye for life and do not need to be changed. The aim is to give the patient a better quality of vision and maximum independence from glasses. These implants can correct vision disorders such as myopia, hyperopia or astigmatism. The most suitable lens for each patient is selected after a thorough examination in which the exact curvature of the cornea and the length of the eye are measured. This examination is of vital importance in determining the power of the intraocular implant.

Our ophthalmology centre offers you the opportunity to benefit from specific implants with the aim of significantly improving your vision. Here are the different types of intraocular implants:

  • Aspheric monofocal implant

By choosing the right implant power according to the calculation, it is possible to correct pre-existing myopia or hyperopia. Due to the characteristics of its optics, this traditional implant offers an excellent quality of vision and improves contrast. Depending on the patient's choice, it is possible to optimise distance or near vision or to opt for the "monovision" solution. The latter consists of combining clear distance vision in the dominant eye with clear vision at reading distance in the other eye. In this way, both eyes work together and provide independence from glasses in most daily activities. Before choosing this option, a special test is carried out, possibly with contact lenses, to ensure that the visual system can accept this difference in focus and that the patient is comfortable.

  • Toric monofocal implant

A toric implant allows the correction and reduction of astigmatism, generated by the cornea. However, it requires a rigorous positioning in the eye. This implant will therefore correct the patient's myopia or hyperopia as well as their astigmatism. It will therefore be possible, after the operation, to have optimal vision at close range or at a distance without glasses (depending on the patient's choice). The option of monovision is also possible with toric implants.

  • EDOF Implant

Unlike a standard monofocal intraocular lens, the EDOF implant allows for an extended depth of field: this means clear vision at distance and mid-distance without glasses, which is not the case with a monofocal implant. For close-up vision, however, a corrective device will be necessary. In addition, this implant's technology is also available for astigmatic eyes (toric EDOF) to correct all types of visual defects.

  • Multifocal/trifocal implant

These implants are designed to reduce dependence on glasses for distance, intermediate and near vision. The technology of these implants varies from one manufacturer to another but all agree that the implant has several focal lengths (Far, Intermediate, Near) to give a clear image at all distances. They can correct myopia, hyperopia, astigmatism and presbyopia. However, some visual discomfort may be experienced such as glare, perception of light halos, and reduced contrast perception in about 20% of patients.

The various implants detailed above are not covered by the health insurance funds. Part of the costs will therefore be borne by the patient