Treatment of cataract

PHACOEMULSIFICATION

▫️The most technically advanced and commonly performed cataract surgery is phacoemulsification, which entails the fragmentation and removal of the opacified crystalline lens and its replacement with an intraocular lens (IOL).

​This technique is a quick, painless and minimally invasive surgery that lasts 10-12 minutes in day-hospital regime. During the preparation stage, the surface of the eye is treated with anaesthetic eye drops and slight sedation, to make the procedure more comfortable for both the patient and the surgeon.

Phacoemulsification surgery, performed with a microscope to magnify the eye details, starts with a small cut in the area between the cornea and the sclera (the white of the eye) to open the capsule containing the crystalline lens and to allow for the introduction of the phacoemulsificator, a device with a tip that vibrates at a speed of about 40,000-50,000 times per second and generates ultrasounds that break up the cataract. The same tip then removes the shattered pieces and clear the crystalline capsule.
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The next stage consists in inserting the artificial crystalline lens, called IOL, i.e. the intraocular lens. IOL is placed inside the capsular bag, where it unfolds and anchors itself, behind the iris and in front of the vitreous body.

The efficacy of IOL is estimated before surgery with an eye biometry. According to the data obtained during eye biometry we choose the best lens to correct the refractive errors of the eye.

▫️It is possible to correct both myopia and hyperopia and, only thanks to the latest-generation lenses, near and far vision simultaneously (multifocal IOL).

After surgery, the patient may need corrective glasses.

FEMTOSECOND CATARACT SURGERY

▫️The Femtosecond laser is the latest and most advanced laser technology used in eye microsurgery. The remarkable results achieved are made possible by the innovative features of this technology, which eliminates the need for a scalpel, causing minimal trauma to the eye tissues and ensuring faster healing.

▫️The Femtosecond laser acts on tissues by rapidly generating thousands of closely spaced impulses, producing incisions with an extremely precise geometry. This process involves a micro-explosion within the tissues, forming small air bubbles that act like a blade. Sophisticated computerized technology adjusts the technique to each individual case with extreme accuracy and safety.

▫️The Femtosecond laser simplifies and enhances the safety of the surgery, playing a role in various steps of the operation. It performs the corneal incision while monitoring its extension and depth, then cuts the front capsule to reach the central hard part of the cataract (nucleus). The final step involves the fragmentation and aspiration of the cataract.

Laser fragmentation is particularly advantageous for hard cataracts, where the crystalline emulsification by ultrasound may pose more risks of injury to nearby areas. After laser surgery, the surgeon removes the fragmented parts and implants an artificial crystalline lens.

▫️The Femtosecond Laser enables an accuracy impossible to achieve with human hands. For instance, the circular opening of the capsule is perfectly round and centered, a crucial factor in the post-surgery phase, allowing the surgeon to better center the artificial crystalline lens. This enhances the precision of the surgical operation compared to previous techniques.

Furthermore, the eye operated with the laser has the ideal conditions for receiving a complex artificial crystalline lens suitable for correcting visual disorders, such as astigmatism and presbyopia.