Cataract

Before understanding what a cataract is, it’s important to address the most important biological properties of the eye lens, which are its transparency and flexibility. These properties are achieved through a complex cellular mechanism that allows for maintaining a constant amount of water within the lens.
Over the years, the natural lens in the eye loses its transparency and becomes cloudy. This cloudiness is known as “cataract” or “yarod” in Hebrew, and causes blurring and dimness of vision. The decrease in vision is gradual and usually occurs in both eyes, but not with the same severity and at the same rate.
Cataracts in the eyes, being a “fog screen,” can significantly impair the quality of life of patients. In third world countries, vision loss due to cataracts leads to blindness, and in fact, cataracts are the most common cause of blindness in the world that can be treated through surgery.

How are cataracts in the eye diagnosed?

Cataract diagnosis is done by an ophthalmologist in a simple clinical examination using a slit lamp after pupil dilation. In the cataract diagnostic examination, the physician measures the intraocular pressure, the optic nerve, and the center of vision.
Based on the clinical examination, the physician will know if cataract treatment needs to be combined with additional treatments.

What are the signs of a cataract?

• Decrease in visual acuity – one of the most common signs of the disease’s onset.
• Rapid change in vision and increase in prescription at an older age
• Decrease/distortion in color vision
• Blurriness in night driving
• Night glare
• Intraocular inflammation
• White pupil in newborns with congenital cataract
• Near vision may improve in certain types of cataracts.
• Cataracts in older age are the most common type, occurring as part of the body’s natural aging process and affecting about 70% of people aged 65 and above.
• Cataracts following eye trauma – such as injury.
• Cataracts as an associated condition – following a disease such as diabetes.
• Cataracts as a side effect – due to taking certain medications, such as steroids.
• Congenital cataracts – although the disease is common in adults, it is certainly possible for congenital cataracts to appear in newborns as a result of trauma during pregnancy or birth. Removal of congenital cataracts is possible through surgery.Despite different types of cataracts, it seems that the solution for all of them is the same – cataract removal surgery.

Treatment of cataracts in the eyes is performed in a common and relatively short surgery. During this procedure, the cloudy lens is removed from the patient and a transparent artificial lens is implanted in its place, which remains in the eye permanently.

Thanks to modern technology, cataract surgery is performed under local anaesthesia using anaesthetic eye drops. The procedure usually lasts about an hour, does not require hospitalization, and the patient is discharged home on the same day.

Traditional cataract treatment surgery

In most cases, cataract surgery is performed using the advanced “phacoemulsification” method. In this method, the cloudy lens is broken down and suctioned using an ultrasound device through a tiny 2 mm opening. Then, a new artificial lens is implanted, replacing the natural lens, and remains in the eye permanently.

The “phaco” method improves vision within a short time, significantly shortens the surgery, and allows for a very quick return to routine.
The success rate of the treatment using the “phacoemulsification” method for cataract cure is very high, thanks to the advanced technology and the extensive experience of the specialist physicians and the skilled team at the Dr. Levinger Group.

How is cataract surgery performed?

• The surgery is performed on one eye only under local anaesthesia using anaesthetic eye drops, without pain sensation.
• The lens capsule is cut and a tiny opening is created in the cornea, using a very fine knife.
• The cloudy lens is suctioned out using a tiny ultrasound device.
• A new artificial intraocular lens is inserted through the opening. Usually, stitches are not required.
• At the end of the surgery, a bandage or transparent shield is placed on the eye until the next day.

After follow-up that shows significant improvement in the eye without special complications, the second eye is operated on after a few weeks, subject to the surgeon’s instructions.

Why is it important to treat cataracts as early as possible?

There is a misconception that one can wait to perform cataract surgery until there is a significant deterioration in the condition. However, cataract surgery in an advanced state is a more complex procedure: alongside the use of higher ultrasound and/or laser powers, the recovery process from the surgery is longer, and the patient deals with more side effects or complications, such as edema.

In comparison to dental treatments, just as one doesn’t wait to treat a small hole in a tooth to avoid requiring complex root canal treatment, it is recommended to perform early diagnosis as possible and undergo cataract surgery without delay.

The Dr. Levinger Group is the first to bring laser cataract surgery technology to Israel and is the leading private medical group in the number of cataract surgeries and laser cataract surgeries performed in Israel.

Unlike the traditional surgery, where the incision in the lens capsule and cornea is done manually using a surgical scalpel, the incision in this innovative method is made using a precise laser, without human contact.

After making a tiny incision in the cornea, the cloudy eye lens is suctioned out and replaced with a highly precise artificial lens.

What are the advantages of laser cataract surgery?

• Maximum precision in cutting the lens capsule – ensures correct and precise positioning of the artificial lens.
• Maximum precision in creating the corneal opening according to the corneal curvature.
• Highest level of safety.
• For the first time, multiple treatments can be combined in a single surgery: cataract surgery, vision refraction correction (prescription) and astigmatism (cylinder) correction.
• Easy breakdown of the cloudy lens, alongside a significant reduction in damage to the endothelial cells in the cornea, reduces the risk of developing corneal edema after surgery.
• Fewer complications in cases of complex cataract surgeries due to the stages performed with the laser.
• The patient does not feel pain during the surgery.

Implantation of the world’s most advanced intraocular lenses in cataract surgeries

At the medical centers of the Dr. Levinger Group, cataract surgeries are performed using the most advanced method and with the most advanced lenses. These lenses allow patients to get rid of cataracts and significantly reduce dependence on glasses.
The implanted lens is chosen in coordination with the patient, from a variety of lenses produced with innovative technology and according to the specific vision impairment of each patient; with the aim of improving visual acuity and quality alongside cataract treatment.
The lenses are created based on precise calculation, using advanced equipment.

Types of artificial lenses for implantation in cataract surgery:

• Monofocal lenses – lenses with a single focus that correct vision for distance or near.
• Multifocal lenses – provide clear vision ability in each eye, for distance and near, and reduce dependence on reading glasses after surgery.
• Toric lenses (TORIC IOL) are designed to correct astigmatism (cylinder).
• Multifocal toric lenses – correct vision for distance and near and astigmatism.

What needs to be done before cataract surgery in the eyes?

You need to contact your family physician to obtain a summary letter including:

• Information about your health condition.
• List of regular medications.
• Confirmation that there is no contraindication to undergoing surgery under local anaesthesia.
• Results of general blood tests and an up-to-date ECG.
• The evening before surgery, it is recommended to wash your hair, as you cannot wash it for several days after surgery.
• Do not wear make-up 3 days before surgery.

What needs to be done on the day of cataract treatment surgery?

• Bring an identification document, the letter from your family physician mentioned above, blood test results and ECG, a means of payment, or Form 17 for surgery performed within the HMO services.
• Come with an adult escort aged 18 and above.
• Fast according to the surgeon’s instructions.

What actions need to be taken after cataract surgery?

• Instill cataract eye drops according to the physician’s instructions. It is important to note – these are not cataract treatment drops because, as we mentioned, they are not effective, but rather drops that help with recovery from the surgery.
• Come for a follow-up visit with the physician at a predetermined time.
• Follow all of the physician’s instructions for the first week after surgery.
• Avoid lifting heavy loads and physical exertion.

These instructions are general only and are not a substitute for the instructions of the physician and the medical staff.