March 28, 2015
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Cataracts: Causes, Prevention, Treatment
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Cataracts: Causes, Prevention, Treatment

What Surgery Is Like
There are two types of cataract surgery:
  1. Phacoemulsification: A small incision is made on the side of the cornea, the clear covering on the front of the eye. The surgeon inserts a tiny probe. The probe uses ultrasound waves to soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done this way.
  2. Extracapsular surgery: The surgeon makes a long incision on the side of the cornea and removes the cloudy core of the lens. The rest is removed by suction.
After the lens has been removed, it is usually replaced by an artificial lens, also known as an intraocular lens (IOL). An IOL is a clear, plastic lens that becomes a permanent part of your eye. You will not feel any difference between a healthy natural lens and an IOL. Some people cannot have an IOL, usually because of an unrelated eye disease. For them, a soft contact lens or high magnification glasses may be used instead.

Like any surgery, cataract surgery carries risks, such as infection and bleeding. After surgery, it is extremely important to keep your eye clean, wash your hands before touching your eye, and use prescribed medications to avoid infection. Serious infection can cause loss of vision or even blindness.

After surgery, it is extremely important to keep your eye clean, wash your hands before touching your eye, and use prescribed medications to avoid infection.

Cataract surgery slightly increases your risk of a detached retina. One sign of a detached retina is a sudden increase in what are called flashes (i.e., of light) or floaters. Floaters are small specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. If you think it might be a detached retina, go to an emergency service or hospital right away. Remember that a detached retina causes no pain. Speedy treatment is key in preventing permanent loss of vision.

Despite these risks, cataract surgery is one of the most common operations performed in the United States. It also is one of the safest and most effective. 90 percent of people who have cataract surgery will see improvement in their vision.

A cataract operation usually takes less than an hour and is virtually painless. Many people need little or no anesthesia, other than enough to numb the nerves in and around the eye.

After the operation, you will be watched for a few hours for bleeding or other problems. Most people who have cataract surgery go home the same day.

Secondary Cataracts
Sometimes, after people have had cataract surgery, new cataracts appear; these are called secondary cataracts. Modern cataract surgery is performed by cutting out the lens and implanting a clear plastic intraocular lens (IOL) into the remaining "capsular bag." Secondary cataracts occur when left-over lens cells move under the IOL and form a fibrous opaque layer.(29)(30)(31)(32)(33) Secondary cataracts develop in 5-15% of patients who undergo successful cataract surgery. Fortunately, they can be fairly easily corrected by laser treatment.

Can Cataracts Be Prevented?
Given the association between oxidative damage and age-related eye problems, it is not surprising that over 70 studies have attempted to relate lack of antioxidants in the diet to the risk of developing cataracts and other eye disorders. Many researchers believe that good nutrition and taking high doses of antioxidant supplements can reduce a person's risk for age-related cataracts. Observational studies suggest that a healthy lifestyle, with a diet containing foods rich in antioxidants, particularly lutein and zeaxanthin, (both found in green, leafy vegetables), as well as omega-3 fatty acids, (found in cold water, oily fish, flaxseed oil and other sources), appears to help prevent eye disorders, possibly including cataracts.(34)

However, even the most potent antioxidants cannot actually cure a cataract. And the science on the effectiveness of supplements is inconclusive. Recently, the FDA concluded that no firm proof exists for health claims about the intake of lutein or zeaxanthin.(35) Another study concluded that a multivitamin-multimineral supplement with a combination of vitamin C, vitamin E, beta-carotene and zinc (with cupric oxide) is effective in reducing the risk of cancer,(36) but does not recommend it for cataracts. On the other hand, there is certainly no down side to eating a healthy diet with lots of green vegetables.

So, what can we do if we are concerned about age-related cataracts? A healthy diet and common sense about sun exposure (wear sunglasses and a hat with a brim to block ultraviolet sunlight) seem to be the best bet to delay or prevent cataracts.(37)

We can expect to see better methods of cataract prevention and therapy in the near future as we learn more about how to protect the machinery of the lens from damage from oxidation, injury, toxicity and other factors and how to correct genetic defects. In the meantime, the best weapons we have today in the battle against cataracts are: taking antioxidants either in the form of antioxidant rich food or in the form of supplements; cautious use of steroids and other drugs; and improved eye surgery.
December 1, 2007
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