Laser Eye Surgery

For many years, cataract surgeries have been performed with the method called FAKO. It is a needle-free, seamless and painless surgery.

Laser Eye Surgery

For many years, cataract surgeries have been performed with a method called FAKO. It is a needle-free, seamless and painless surgery.

The patient’s eye to be operated on is anaesthetised with a drop and a small incision of 2.2-2.4 mm is made in the eye. In the surgery, where all procedures are performed by entering through this small incision, first a round piece is peeled from the front part of the membrane surrounding the cataract lens. Then, with the help of a device called a Phaco and working with ultrasonic sound waves, the cataract lens is divided into small pieces. Then, these small parts are sucked and cleaned again with the phaco device. An artificial intraocular lens suitable for the patient’s eye is placed in the pocket consisting of a membrane, which is completely cleaned inside. At the end of the surgery, antibiotics are injected into the eye. Finally, the incision site is closed seamlessly.

  • The most recent method that has developed and rapidly became widespread in recent years is “Femtosecond Laser Cataract Surgery”.

Thanks to the use of lasers in cataract surgeries, cataract surgeries can now be performed in a much safer, more comfortable manner and with minimised risk of complications compared to the classical Phaco method.

In the laser method, the patient’s eye is anaesthetised with drops. First of all, the patient’s eye, which is taken under the laser device, is made to create an incision, open a window in the anterior capsule and disassemble the cataract lens (approximately 30-45 seconds) with the help of computer-controlled laser, in a way that the patient cannot feel. Later, the patient is taken under the operating microscope. Here, it is entered through the incision created by the laser (without a knife), and the parts of the lens that are torn by the laser are absorbed with the Phaco device and cleaned in a short time. Then, an artificial intraocular lens is placed, antibiotics are injected into the eye and the operation is terminated.

What are cataracts? How does it occur?

A lens that is not normally seen is naturally found just behind the coloured part of our eye and since this lens is transparent, we see the pupil as black.
The lens provides a clear image by dropping the rays coming into the eye to the nerve layer. In order for the light to pass through the lens and reach the nerve layer, the lens must be clear (transparent). If this transparent lens becomes cloudy for various reasons, it is called cataract. This blurring can occur anywhere or on the entire lens.

Is cataract an old age disease? Is it seen in young people?

It can be seen in people of all ages, including babies. It is rare in middle age. Its frequency increases with age. Approximately half of those between the ages of 50-59 and almost all of those over 80 years of age have some density. However, this density does not always affect vision significantly.

What are the causes of cataracts?

The most important cause of cataracts in adults is the changes in the lens that occur with aging. In children, metabolic diseases, consanguineous marriage, diseases in the womb, drug use during pregnancy, microbial conditions and injuries are effective. In addition, eye injuries (trauma), diabetes, intraocular inflammation (uveitis), kidney disease, glaucoma, radiation, high blood pressure (hypertension), and long-term use of cortisone drugs can cause cataracts.

Can cataracts be treated with medication?

There is no treatment for cataracts other than surgery. Although there are some drugs currently being tried, no successful results have been reported yet. So we can say that the treatment of cataracts can be performed surgically.

  • Increasingly painless blurred vision
  • Dazzling or reduced sensitivity to light
  • Frequent change of glasses numbers
  • The need to wipe the glasses frequently
  • Difficulty while driving
  • Reduced night vision and scattering of lights
  • Needing strong light for reading
  • Double vision with one eye
  • Colours fading or yellowing

In which situations is cataract surgery inevitable?

  • Surgery is recommended if the patient is faced with any of the following conditions.
  • Does not meet the daily needs of the patient visually
  • Creates a disturbance such as cataracts eye inflammation
  • If you are upgrading a cataract patient’s eye pressure

What are the Advantages of Femtosecond Laser Cataract Surgery to Classical Phaco Method?

  • Without a blade (the incision is opened with a laser)
  • Performed under computer control (margin of error is close to zero)
  • During surgery, the duration of stay in the eye is very short and therefore the tissues are preserved.
  • Thanks to laser opening of the membrane in front of the cataract lens, the risk of tearing is eliminated.
  • The cataract lenses can be divided into small pieces as much as desired by the laser within seconds, while preventing damage to the surrounding tissues.
  • Incision opening, cataract lens breaking operations can be done within seconds and without damaging the eye. However, all these stages are the stages with the risk of complications in the classical phaco method and success depends on the skill and experience of the surgeon.
  • One of its most important advantages is  that the membrane from which the lens with cataract is removed is cut very smoothly by laser, and therefore the artificial lens to be placed inside can stand very smoothly in this membrane. In the classical phaco method, since all the steps are performed by the surgeon, this membrane may not always be opened with the same smoothness and as a result, the artificial lens placed inside may not be at the exact center. This creates a situation that adversely affects the patient’s vision quality even if the best quality lens is attached.
  • Femtosecond lasers have been developed to increase the success of the surgery and to provide maximum performance from the lenses, especially in patients who choose multifocal, trifocal, toric intraocular lenses and want to remain without glasses. “Femtosecond Laser” method should be preferred especially for patients who choose special intraocular lens.

What should be the characteristics of intraocular lenses placed in surgery?

The lenses to be used are usually single-focus, that is, far or near clear.

It is a type that is produced to show. After wearing this type of lens, the patient may need to wear glasses and contact lenses to see both far and near clearly. “Multifocal lenses”, which have recently been introduced to the market and in order to ensure that the patient can see both the distance and the near after the surgery, have also started to be used. These types of lenses are used in situations where the patient and the physician will decide jointly.

What is done before cataract surgery?

Before the surgery, various examinations can be performed in cases deemed necessary according to the age of the patient, other diseases, medications used, and the type of surgery to be performed. In particular, inform your doctor about all the medications you use and follow his recommendations according to the type of drugs. Some medications can be administered orally, on the arm or buttocks after being taken into the operating room or taken when coming to the surgery, you should not eat or drink anything for at least 6 hours before. It may be good to have a companion with you to assist you. You will need to remove your makeup and jewellery. As some drops will be dropped into your eyes, your pupil may be enlarged and red in the eye.

Is anesthesia done in surgery?

General (completely anesthetized) anesthesia is generally preferred in children in cataract surgery. Another preference is to apply (local) anesthesia by injecting around the eye. It is also possible to anesthetize the eye with drops without a needle (topical anesthesia). This anesthesia is applied in cases where the patient’s compliance is good.

How is cataract surgery performed?

After the eye is anesthetized for surgery, the anterior membrane of the lens is opened first by entering the eye according to the method chosen, and the cataract part is removed either as a whole or by breaking it up. Only the membrane of the lens is left inside. Again, lens placement can be performed according to the age of the patient, the condition of the eye and the type of surgery.
In some cases (such as children under 1 year old) the lens may not be placed. Sometimes, the lens may not be placed due to the course of the surgery and the condition of the eye, or it may be delayed until a second operation. In some cases, it may be necessary to use different types of lenses (requiring stitching on the eye wall, attached to the coloured part) other than the planned type. When these situations occur, the physician performing the operation will decide according to the most suitable option for you.

Is post-operative care required?

After the operation, the eye is usually covered with a bandage. This bandage should remain on the eye for as long as your doctor will recommend. You should not put pressure or rub the eyes after the surgery. It will inform you of your hospital stay. If you are going to be sent from the hospital, do not drive yourself. You can start taking food and medicine according to the recommendations of clinical nurses and doctors. Do things such as washing your face, bathing, carrying items, praying, doing sports, starting work, swimming in the sea and the pool, in consultation with your doctor. Drugs to be given after surgery (drops, pomade, tablets, syrup, etc.) should be used as and for the time recommended by your doctor. Do not change, reduce or stop your medication without consulting your doctor. Before using the drops and pomades given, the person applying them to the eyes should definitely wash their hands with soap. While applying the drugs, the tip of the dropper or pomade box should not touch the places such as eyelid, eyelash, skin, hand, paper, napkin. Controls are made on the 1st day, 1st week and 1st month after the operation. During this time, eye drops are used to heal the eye and protect it against infection. Take the warnings of your physician about the postoperative follow-up period and things to do.

Does reading after surgery harm the eye?

Reading does not hurt the eyes. For reading, you can use your old glasses if they are available and help you read . But there may be eye discomfort and fatigue immediately after surgery. Watching TV is less tiring and not harmful to the eyes. Full distance and near glasses are adjusted after the operation at a time deemed appropriate by your physician. What changes will happen in the lives of people who have undergone cataract surgery? It is also wondered whether cataract surgery creates limitations on some issues. After surgery, people who obtain the vision specified in the law can get a driver’s license and drive a car. They can do sports that do not require contact. 

Does cataracts recur?

Cataract does not occur again in those who have cataract surgery. With the operation, the membrane in which the lens is placed may become denser over time. Although it is called “secondary cataract” among the people, it is not actually a cataract. This formation can usually be easily treated with laser. In children or in rare cases where the membrane becomes very thick, it may be necessary to clean it surgically .

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