Cataract

Before cataract surgery, it is necessary to perform an electrocardiogram (EKG) and complete blood count (CBC), as well as check blood sugar levels (glucose) and urine analysis.

Cataract surgery is a painless surgical procedure. The eye is anesthetized with drops before the procedure, meaning local anesthesia is applied, and during the surgery, patients may feel slight pressure in the eye, which they are informed about. The patient is fully awake, conscious, and cooperative during the surgery.

At the time of the patient’s appointment, the preoperative examination and dilation of the pupils before the surgery begin. This process takes about 30 minutes. After that, the patient undergoes the surgery, which lasts about 10 minutes. Following the surgery, a short rest period is observed, and then the patient leaves our clinic.

Patients are briefed on all limitations during the preoperative preparation and the visit or check-up the morning after the surgery. It is necessary to adhere to the instructions for using the prescribed therapy. The operated eye should not be washed or rinsed for at least 7 days postoperatively, as tap water may contain impurities and microorganisms, and the eye is a fresh surgical wound. If necessary, the eye can be gently rinsed with artificial tears or saline solution. The eye should not be rubbed or touched with hands. For the first 7-10 days, it is necessary to protect the eye with darker sunglasses when going outside and avoid wind, smoke, dust, cooking fumes, and cleaning agents’ fumes. It is recommended not to lift heavy weights, avoid prolonged bending, avoid strenuous exercise, and avoid swimming pools, baths, and saunas, all within the first month after the procedure. After the first month, there are no restrictions.

Watching television, using a computer, driving, and reading are allowed when you feel comfortable and when nothing bothers, irritates, or burns your eye. You are the best judge of that.

In the past, cataracts were operated using the classic method, which involved removing the cataract through a large incision using instruments from the eye in one piece. Therefore, it was preferable for the cataract to be as hard and dense as possible. This was a significant trauma for the eye, and the surgery ended with placing a large stitch on the incision. The modern technology we use at the Special Hospital for Ophthalmology “Dr. Kozomara” allows for cataract removal using ultrasonic methods, which is minimally aggressive for the eye and implies faster visual recovery. An incision smaller than 3 mm (sometimes even 2 mm) is made on the eye, through which an ultrasonic probe enters, dissolving and aspirating the cataract from the eye, and an artificial lens is immediately implanted. The softer the cataract, the less ultrasonic power is needed, while the harder it is, the more ultrasonic power needs to be applied, which sometimes means a slightly slower recovery.

The desired outcome of visual acuity after cataract surgery is for the patient to see as well as possible at a distance without glasses. For this reason, precise calculations of the power of the intraocular lens implanted in the eye are performed. If the eye has astigmatism before surgery, it can be corrected during surgery with toric intraocular lenses. Glasses for reading and near work are typically prescribed 1 month after surgery. If a multifocal lens is implanted, glasses for reading or distance vision are usually not needed in 95% of cases. Some patients may occasionally need glasses for “intermediate distance,” specifically for computer use.

The patient’s age is not a limiting factor for this type of surgery. Besides cataracts, other eye conditions, primarily diseases of the macula (the yellow spot on the back of the eye), can occur with age. The expected outcome of vision after cataract removal is determined in accordance with the condition of other parts of the eye, which the patient is always informed about. In older patients, the quality of the corneal tissue (the transparent front part of the eye) usually decreases, which may cause some haziness during the surgery. Therefore, a slightly longer recovery time may be needed. The surgery is performed under local anesthesia (using anesthetic eye drops), so there is no fear of sedation or general anesthesia.

The first and mandatory check-up is the morning after the surgery. At that time, the eye’s condition is assessed, the recovery progress is evaluated, and the therapy is adjusted. The next check-up is usually scheduled for 5-7 days later, followed by another one in 3-4 weeks. Typically, the therapy is discontinued at this point, and appropriate glasses are prescribed if needed. After that, the operated eye is checked at 3-month intervals, then at 6 months, and thereafter as agreed upon with your ophthalmologist.

The intraocular lens provides a lifelong solution. It is made of materials that do not elicit a reaction from the body in terms of rejection.

As soon as it is determined that a child has a cataract, it should be removed as soon as possible. Cataract surgery in children should not be delayed because vision cannot develop under the cataract. Cataract surgery increases the chance of developing better vision. It is almost inevitable that some degree of amblyopia (lazy eye) remains, but the sooner the surgery is performed, the greater the chance of better vision development. Like in adults, after cataract removal, an intraocular lens is implanted to optimize vision development. There are different opinions on the type of lens implanted. It is possible to implant both standard acrylic and multifocal lenses. After lens implantation, treatment for amblyopia should continue. Due to the child’s growth, including eye growth, the need for glasses is expected. Sometimes, in adulthood, there may be a need to replace the intraocular lens due to differences in prescription resulting from growth and development. At the Special Hospital for Ophthalmology “Dr. Kozomara,” cataract surgeries are performed in children, and the operating room is fully equipped for these procedures, conducted by an experienced team of ophthalmologists.

The Special Hospital for Ophthalmology “Dr. Kozomara” Banja Luka offers certain payment options for surgical procedures. The surgery can be paid for in cash, with credit cards, or through installment payments (from 10 to 24 installments). Banks we have agreements with for installment payments via credit cards include: Unicredit Bank, Nova Banka, Sberbank, NLB Bank, and Addiko Bank. The Special Hospital for Ophthalmology “Dr. Kozomara” covers the costs of interest for installment payments. We also offer the option of payment in 36 interest-free installments through Ziraat Bank. For more information, call 0800 50 113.

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