Our medical director and experienced ophthalmic surgeon Dr. Zlatko Arnaudovski answers questions on Cataract surgery and Multifocal lenses.


  • What are the symptoms of cataracts?

Symptoms of cataracts include blurred vision, loss of contrast, and glare in bright light. A double image may appear, and problems with reading, watching TV, and driving are common. 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 (eg. Down syndrome).

  • Why and when should surgery be performed?

Cataract is one of the most common eye diseases in people in later years. Cataracts occur in about 70% of people over the age of 75. However, in recent years we have had a lot of younger patients where we have been diagnosed with cataracts. It is a consequence of the natural aging process which leads to blurring of the natural lens in the eye. 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.

  • How does advanced medicine affect the quality of life of patients in later years?

With the new methods we use in our hospital, there is no need to wait for the cataract to mature to the point of affecting the patient’s daily activities and normal life. This means that patients in later years do not have to be visually impaired for long. With quick and safe intervention, they can read, watch TV and drive well. Phacoemulsification is an ultrasound cataract surgery with a small 2.2 mm incision and implantation of a soft intraocular lens. The operation itself lasts 7-10 minutes per eye, and the postoperative period is also short and fast. Patients return to normal vision very soon after surgery. At Sistina Ophthalmology, we started with this intervention ten years ago. Now the method is widespread. In addition to a well-performed intervention, patient preparation is very important here. First of all, we talk about how he feels, and then we make accurate measurements: checking the fundus of the eye, accurate calculation of the diopter for precise definition of the lens. Sometimes it can mean a few examinations and measurements. Accurate diopter calculation of intraocular lenses is very important for acute postoperative vision, so we use the most modern computer device “IOL Master” to calculate the strength of the lens. Modern devices, for us, the doctors, give us complete control over the course of the operation, and the eye suffers minimal trauma.

  • Why multifocal lenses?

Classic intraocular lenses are monofocal lenses, which, as the name implies, have a single focus and allow you to see far and wide without glasses after surgery, but you must wear close-up glasses (or vice versa, depending on your vision). Multifocal intraocular lenses have two or three focuses, allowing the patient good vision at different distances without glasses. The latest generation of multifocal lenses are three-focal lenses, which not only give you good near and far vision but also provide good mid-range vision, which is very important for patients who spend a lot of time working on a computer. With the help of these lenses, patients see and function normally and without any aids. They can read, shave or put on make-up, look at the phone and TV, work on the computer, drive a car, play sports, and perform daily activities.

Dr. Zlatko Arnaudovski and Bojan Krizhaj

Who are ideal candidates?

People who are somewhere between the ages of 40 and 45, who have trouble reading, writing, or working nearby. If you avoid the text you are reading, you need more light and you feel tired or have a headache it is a sign that you have entered a period of presbyopia (aging diopters). It is a natural process of aging of the eye, especially when the natural lens of the eye loses its elasticity and finds it harder to focus on nearby objects. If you have not worn glasses before, you will start wearing reading glasses. If you have already worn glasses for far, now you get another pair for glasses for near. If you work on a computer and it is at a medium distance (between near and far), you will need a third pair of glasses, because the glasses for your proximity are strong, and for distance, you are weak for the same distance. In those moments, to avoid the inconvenience and wearing three pairs of glasses, you wonder what to do and what is the right solution for you? Then you are an ideal candidate for implanting multifocal lenses.