What is cataract?
Cataract is a very common pathology in Tunisia and worldwide, it is the first cause of blindness. It is characterized by a progressive degeneration of a lens placed inside the eye, the lens. The latter is transparent in the normal state, thus allowing the focusing of the image on the retina. The loss of transparency prevents light from passing through and the image becomes fuzzy.
Cataract results in a drop in vision from far and near which is not corrected by glasses.
What are the causes of cataracts?
Different studies have confirmed that the prevalence of cataracts increases with age. Indeed it is related to the aging of the lens. But other factors favor its appearance. As hereditary, nutritional, environmental factors (prolonged exposure to industrial pollution and UV rays) ...
The other etiologies are eye trauma, certain ophthalmological diseases (glaucoma, myopia and uveitis) and general diseases (diabetes, prolonged corticosteroid therapy, renal failure, hypocalcemia, magnesium deficiency ...).
Surgery: the only therapeutic strategy
In the absence of medical treatment, the only treatment for cataracts remains surgical. The operation should be done as soon as possible before the move to blindness. It is performed under local anesthesia in a sterile operating room. The ophthalmologist makes a small incision of the cornea, breaks the cataract into several fragments using an ultrasound instrument to extract the lens by a probe and replace it with an implant. The choice is discussed according to the anatomical characteristics of the eye. Thus there are several categories of implant; mono-focal, multifocal, accommodative and toric.
Femtosecond laser assisted surgery:
It is a major technological innovation in eye surgery. The principle of this technique is to deliver very precisely ultrashort pulses allowing the fragmentation of the lens in an automated way. This is a fundamental and delicate step of pretreatment to prepare the eye for surgery.
This femto cataract is nevertheless limited by its extra high cost for both the care structure and the patient, a longer operating time and a much more delicate surgery.
What are the complications of surgery?
A first consultation is always scheduled the day after surgery in search of acute complications, intraocular hyperpressure and postoperative infection. Two postoperative control visits one week and one month later should be performed and any abnormality felt including pain or redness. Anti-septic, anti-inflammatory or antibiotic eye drops may be prescribed by the surgeon.
Future of cataract treatment:
Lanosterol is a new molecule undergoing experimentation that has a physicochemical action to re-solubilize the opacified lens proteins. Experimental evidence remains to be demonstrated in humans. This treatment could become an alternative to surgery which the only effective treatment so far.
Last update : 26/08/2019