Cataract surgery with implantation of an artificial lens

Abstract

Background: Cataract surgery, the most frequently performed operative procedure worldwide, typically concludes with the implantation of an artificial intraocular lens (IOL) to correct aphakia (absence of the crystalline lens).

Method: Selective literature review including current regulations, guidelines and recommendations for cataract surgery.

Results: The main symptom of cataract is loss of visual acuity, which usually progresses slowly. It can arise in one eye or both. There is a basic distinction between congenital and acquired cataracts. The probability of developing a cataract rises with age because of biochemical aging processes. The development of a cataract becomes highly likely from the sixth decade of life onward.

Conclusions: As no effective medications for cataract are available at present, its current standard treatment is the removal of the clouded lens. In industrialized countries, this is usually done with ultrasound (phacoemulsification), followed by the implantation of an IOL.

Keywords: artificial lens; cataract; minimally invasive treatment; ophthalmic surgery; visual acuity.

Figure 1

Age-related (senile) cataract

Figure 2

Measurement of incision size (2.0 mm) after phacoemulsification and microincisional implantation of a one-piece, aspherical acrylate intraocular lens (e17)

Figure 3

Phacoemulsification of the natural ocular lens

Figure 4

Three-piece spherical blue light-filtering intraocular lens (with standard optics), with C-loop haptics

Figure 5

Multifocal aspherical intraocular lens after implantation into the capsular bag (shown with retroillumination and with the pupil dilated). One can see the diffractive ring segments, which project two different foci onto the retina, one for near vision and one for distant vision.

Figure 6

Accommodative aspherical intraocular lens (shown with retroillumination and with the pupil dilated). The photograph shows the special haptics, which are able to bend at a particular position (flexible bending spot) to provide anterior-posterior displacement of the lens as the ciliary muscle contracts and relaxes

Figure 7

Cystoid macular edema, as revealed by optical coherence tomography

Figure 8

Posterior capsule opacification after implantation of a silicon intraocular lens (shown with retroillumination and with the pupil dilated).