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Multifocal Cataract

What is a cataract?

A cataract is a condition which causes clouding of the lens in the eye, resulting in blurry vision. The lens is situated behind the iris, the dark portion of the eye, and is not visible. The lens is mostly made up of water and proteins. These specific proteins provide the lens its transparent structure.  Any structural change in these proteins can alter the clarity of the lens and negatively impact vision. The lens becomes cloudy when a cataract occurs and is seen as a white cloudy ball in the center of the iris. Cataracts are classified based on their location in the eye. They include:

  • Nuclear cataract: Cloudiness is present in the center of the lens.
  • Cortical cataract: Cloudiness is seen in the outer peripheral or cortical region of the lens.  
  • Subcapsular cataract: Occurs at the back of the lens capsule or subcapsular region.  This develops faster than the nuclear and cortical cataracts.

The development of a cataract is common in aged individuals due to related changes that occur in the structure of the lens proteins. Cataracts can also be inherited or can develop in infants as a result of infections in the mother during pregnancy. They can form as a complication of other diseases such as glaucoma and diabetes, or can develop after certain injuries. Prolonged use of corticosteroid inhalers and eye drops, and excessive exposure to UV rays, X-rays and other radiation during radiotherapy, can increase the risk of cataract formation.

To assess the impact of the cataract on your vision your doctor will perform a Visual Acuity Test where the patient reads an eye chart from a particular distance with one eye at a time. The doctor then examines the cornea, iris, and lens to detect any abnormalities.

Treatment

Multifocal lens implantation is one of the best available treatments for cataracts.

Multifocal Lens Implantation – Procedure

Multifocal lens implant surgery is performed on an outpatient basis under local anesthesia. Eye drops will be placed in your eyes to dilate your pupil. Your surgeon will make a small incision in the cornea (transparent dome-shaped surface of the eye), break up the defective lens using a probe that passes ultrasound waves, and remove its fragments (phacoemulsification). Sometimes, when you have certain other complications with your eyes, your surgeon may suggest extracapsular cataract extraction, during which a larger incision is made and the front portion of the lens is removed, leaving the back portion intact. However, this procedure is not done very often.

Following either of these methods, an artificial multifocal lens will be implanted in place of the defective lens, which will become a permanent part of your eye. You may or may not require stitches for closure depending on the size of the incision on the cornea.

The procedure is done on one eye at a time. The other eye is corrected only after the first has healed.

Postoperative Care

After a multifocal lens implantation, your vision will begin to improve gradually. You will be provided with instructions on eye care. Some mild itching and discomfort may be present for the first few days. You should avoid rubbing or applying pressure on your eyes. You will be prescribed medications and eye drops to reduce your discomfort and to prevent infections. Your doctor may advise you to use a patch over your eye at night until healing occurs. Complete healing will occur within eight weeks. But, some patients may have problems with night vision (viewing rings around lights at night time) until the brain adjusts to the new multifocal intraocular implant. You will need to follow up with your eye doctor in one or two days.

Risks

Complications after multifocal lens implantation are fairly uncommon and occur mostly if you have some other serious medical condition or eye disease. Some of these possible complications include:

  • Inflammation
  • Bleeding
  • Infection
  • Retinal detachment
  • Loss of vision

Benefits

The benefits of multifocal lens implantation include:

  • Excellent vision at various distances (near, intermediate, and far)
  • Reduced dependence on reading glasses and contact lenses
  • Greater independence with improved self-confidence

Conclusion

Multifocal lens implantation is a widely known and fairly safe procedure, which can result in improved vision and better quality of life. Your candidacy will depend on your overall health and the condition of your eyes, and your eye doctor will be the best person to advise you on the procedure.