Intraocular Lens Surgery: When Is It Necessary?

Most of the causes of decreased visual acuity involve the affection of one of the means of refraction. A good solution for these cases is intraocular lens surgery.
Intraocular Lens Surgery: When Is It Necessary?

Last update: 06 July, 2021

The human eye is an anatomical structure that has different means of refraction, and the crystalline lens the most important of them all. Many health issues can affect the ocular structures, so we must take corrective measures. One of the available treatments is intraocular lens surgery.

The main function of the refractive media is to make light rays hit a specific point on the retina to achieve maximum visual acuity. When there’s a problem with the cornea or the crystalline lens, light will hit the wrong spot, causing various vision problems in the affected person.

Intraocular lens surgery is the medical treatment of choice to solve refractive and cataract problems. The procedure consists of inserting a clear natural lens into the eye to correct or replace the entire crystalline lens. It’s a field in which many specialists have made many advances and innovations.

What can change the function of the lens?

The lens is the main structure focused on redirecting light to the retina. When the function of the lens is altered, people will have noticeable vision problems and other ocular symptoms.

Diseases of various kinds can affect this structure, cataracts being one of the most frequent. Cataracts are the presence of opacity in the crystalline lens of very variable magnitude.

It’s a health issue that’s associated with age, being more common in the elderly. Other diseases of the crystalline lens that affect its function are the following:

  • Presbyopia
  • Capsular opacity
  • Pseudoexfoliative syndrome

On the other hand, there are disorders that, although they don’t directly affect the lens, can alter its function. Among them, myopia, hyperopia and astigmatism stand out. All these conditions alter the point at which light strikes the retina, resulting in blurred vision.

An eye with cataracts.
Cataracts can lead to blindness and therefore surgery is suggested in advanced cases.

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When is intraocular lens surgery necessary?

Intraocular lens surgery is a technique that doctors have been using for many years to correct refractive problems and eliminate dependence on glasses or contact lenses. In the past, doctors only recommended this surgery in severe problems. However, in recent years they’ve also been using it to correct disorders of moderate intensity.

There are two characteristic conditions in which this treatment is used: refractive diseases and cataracts. In this sense, the lens used and the procedure, in general, may vary depending on the health issue.

Refractive problems

In general terms, specialists recommend this surgery for all those who have noticeable refractive problems. In addition, it’s also prescribed for patients who aren’t candidates for laser surgery on the superficial or deep layers of the cornea.

The lenses used in patients with refractive problems are phakic intraocular lenses. The specialist places this specific type in the anterior or posterior chamber of the eye without removing the crystalline lens. This way, the device will redirect the light and focus it on the point of highest visual acuity of the retina.

Cataracts

The presence of clouding in the lens will prevent light from passing through the lens, so a person with cataracts may experience blindness. According to the National Eye Institute, the use of glasses helps in the early stages, however, the treatments available in advanced cases are more invasive.

One of the most commonly used in cataract patients is intraocular lens surgery. In this case, doctors will use pseudophakic lenses to correct the problem, which involves the removal and replacement of the crystalline lens. This operation is also useful in patients over 45 with presbyopia.

What is intraocular lens surgery like?

The procedure is very quick and usually takes about 30 minutes if there aren’t any complications. Preparation for surgery begins a week before surgery, when the ophthalmologist makes small laser holes between the anterior chamber of the eye and the lens to prevent increased intraocular pressure.

It’s also possible that treatment with antibiotics and anti-inflammatory drugs may commence a few days before to avoid complications. Generally speaking, the intraocular lens surgery procedure is as follows:

    • The patient will lie on their back and the practitioner will apply a local anesthetic to inhibit the sensory innervation of the eye. They may administer sedatives in order to calm the patient.
    • The doctor will then remove any germs in the eye area and proceed to open the eyelids with a special instrument called an ophthalmic speculum.
    • They must place lubricant on the cornea to avoid injury. Subsequently, they’ll make a small incision in the eye and insert the intraocular lens.
    • Lastly, the specialist will remove the corneal lubricant and proceed to close the incision with very thin stitches.
    • Once the suture is finished, they’ll place lubricating oils on the ocular surface and close the eye with a patch.

Benefits of surgery

The greatest benefit patients point out is the considerable improvement in visual acuity after the device is in the eye. In addition, the lenses are so thin that the difference will be imperceptible and won’t represent any discomfort.

Other benefits of intraocular lens surgery are as follows:

  • It’s able to cure severe conditions that traditional lenses cannot improve
  • Significantly improves night vision
  • Eliminates dependence on glasses or contact lenses
  • They can be removed if necessary
  • Recovery is quick and there’s usually no ocular dryness
A patient undergoing ocular surgery.
Placing an intraocular lens is a task that doesn’t require a lot of time, but it does require prior preparation to avoid infections.

Possible risks and complications

As with all surgical treatments, intraocular lens surgery involves risks. However, the incidence of these risks is very low.

On the other hand, one of the most severe complications is the rotation of the lens inside the eye. Fortunately, this is very rare. Other complications include the following:

  • Corneal edema
  • Post-surgical infections
  • Glaucoma and loss of visual acuity
  • Retinal detachment

Another complication of surgery is the formation of posterior cataracts. However, its incidence is also low and isn’t associated with age. Studies found it in only 46 patients out of a total of 1653 cases studied.

Intraocular lens surgery: a low-risk solution

The surgical procedure in question is the treatment of choice in some cases of severe cataracts and refractive problems. It’s a minimally invasive technique, fast, with very few risks and complications. There are also few restrictions for patients and doctors can perform it on older adults.

One of the limitations of intraocular lens surgery is that patients must consult a specialist every 2 years to check the condition of the lens and the underlying health issue. However, this doesn’t seem to be a problem when we compare it to the benefits this quick surgery can provide.

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