Cataract is a clouding of the natural lens that can only be treated with surgery.

Although cataracts can be the cause of vision loss, it can be removed with a one-day procedure. With modern surgery, in addition to cataracts, diopters are also removed.

In some cases, in the initial cataract, vision can be improved with glasses because the protrusion of the lens causes myopia (minus diopter), but over time and as the lens blurs, the glasses are no longer useful and the only solution is surgery of cataract (curtain).

Cataract surgery is one of the most common surgeries performed in our hospital.

Phacoemulsification extraction of the lens is performed and intraocular lens are implanted.

The operation is performed with an ultrasound probe, making an incision of 1.8 to 2.75 mm replacing the blurred natural lens with a new intraocular lens that is lifelong and biocompatible. Due to the minimal incision, the wound heals quickly and suturing is not required.

The operation is performed under local anesthesia – anesthetic drops. It is completely painless and safe and lasts about 10-15 minutes on each eye. The patient is conscious and communicative with the ophthalmologist.

Intraocular lenses are divided into monofocal lenses and multifocal lenses. With monofocal lenses patients receive vision at a certain distance, usually being prescribed short range glasses after surgery. With multifocal lenses patients receive vision of two or three distances and there is no need for glasses.

• Symptoms

The symptoms of cataracts are manifested by:

• blurred vision;
• loss of contrast;
• glare in bright light;
• double image;
• Problems reading, watching TV and driving.

Cataracts can be a consequence of trauma, metabolic diseases (diabetes, galactosemia), drugs (corticosteroids), and can occur as a complication of other eye diseases (uveitis, glaucoma) and occur together with other syndromes (e.g. Down syndrome).

Cataracts occur in about 70% of people over the age of 75. Cataracts can also be congenital.

Cataract surgery can be performed on both children and adults.

Cataract surgery poses no risk for healthy people and can be done without any obstacles in people who are older, as well as people with other health problems: high blood pressure; diabetes; dialysis, etc.

The preoperative examination for cataracts contains the following examinations required for the operation:

• Refraction;
• Determining visual acuity;
• Measurement of intraocular pressure;
• Bottom view;
• Echo;
• Biometrics;
• IOL master.

Preparation for the examination begins with the nurse. The examination continues with the ophthalmologist, and if necessary with an optometrist.

The advantage of our clinic is that the examination and the operation can be done on the same day. No special preparations are required by the patient before the examination.

Echo / biometrics – Optical biometrics is a precise and accurate non-invasive method that measures the anatomical features of the eyes. This method calculates the strength of the intraocular lens, which is needed before cataract surgery. Accurate calculation of intraocular lens diopters is very important for acute postoperative vision, i.e. for the patient to see clearly after the operation.

IOL master – Included in measuring the diopter strength we use the most modern computer device “IOL Master”.

OCT (Optical Coherence Tomography) – records the structure of the macula and the optic nerve to detect any defects in the structure that are invisible on magnifying glass. This diagnosis is made if the ophthalmic surgeon deems it necessary. It is usually done before cataract surgery by inserting multifocal lenses as well as if there is a need to give therapy for retinal eye condition before and during cataract surgery.

All diagnostic tests are painless and are performed in collaboration with the patient.

Preoperative preparation takes about 20 minutes. Patients with chronic diseases, depending on the therapy they receive, have special preparations for which they are informed on the day of scheduling cataract surgery.

The preparation is started by the nurse, during which the vision, tone and refractive measurement are taken again.

The patient is then transferred to the preoperative block and a history is taken. Blood pressure and blood sugar are checked. Then, in consultation with the ophthalmologist, if necessary, additional diagnostics are made and the preparation ends with dilation of the pupils.

Once the patient is fully prepared, they are admitted to the operating room.

The patient is placed on the operating chair where anesthetic drops are instilled. The operation can take up to a maximum of 20 minutes.

Cataract surgery can be done on both eyes on the same day. First the cataract of one eye is removed and an intraocular lens is implanted. The procedure then continues on the other eye.

During the operation, the patient is awake and communicative with the surgeon and feels no pain.

After the operation, the patient is taken to an apartment. About half an hour after the operation the patient is checked out of hospital (one-day surgery) without bandages, except at the request of the patient.

The patient also receives written guidance on limitations and postoperative care.

Due to the advanced technology and design of intraocular lenses, cataract surgery when performed by experienced surgeons is a successful, safe, fast and painless operation.

Restrictions after the intervention are temporary and do not last long and are always in accordance with the recommendation of the surgeon.

In the first 3 days after the intervention, the patient should avoid washing their face with plain water and rubbing their eye and in the first month the patient should avoid heavy labor as well as lifting heavy objects. It is especially important to use the prescribed therapy regularly and correctly.

Sports activities are usually allowed 2-3 weeks after the operation, depending on the patient’s age and the intensity of the exercises.

Medical staff are available 24/7 for any consultation required after the intervention.

YAG capsulotomy is a special laser treatment used to improve vision after cataract surgery in the event of a secondary cataract.

Secondary cataracts occur when residual proteins adhere to the intraocular lens implanted in the eye after cataract surgery.

Because of this the vision is reduced, but it is not damaged. This condition is reversible, i.e. it is easily removed and no complications occur.

The procedure with YAG capsulotomy takes place in a special outpatient room. First, the pupils are dilated and anesthetic drops are instilled so that the patient does not feel pain.

The procedure takes about 20 minutes. After the laser treatment, the patient stays in the hospital for a while and their eye pressure is checked. The ophthalmologist then prescribes a report and drops to be used after treatment.

Cataract operation is covered by the Health Insurance Fund of RNM.

For more information contact us by phone 02 3097 000 or electronically at contact@sistinaoftalmologija.mk.

The package includes: intervention with local anesthesia, preoperative preparation and two follow-ups.

The operation through the Health Fund includes participation and one free follow-up.

There is an opportunity to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.