Bilateral cataract operation
La cataract is the opacification of the lens and the only definitive treatment is the cataract operation.
At present, thanks to the new surgical techniques, sanitary and intraoperative controls we have managed to standardize the bilateral cataract operation or better known as cataract surgery both eyes at once.
Bilateral cataract operation
La cataract is the opacification of the lens and the only definitive treatment is the cataract operation.
At present, thanks to the new surgical techniques, sanitary and intraoperative controls we have managed to standardize the bilateral cataract operation or better known as cataract surgery both eyes at once.
Bilateral cataract surgery
For many, the fact of operate both eyes in the same surgical act causing a state of pseudophakia in both eyes, it may seem negative or, at least, run an unnecessary risk, taking into account the possibility of an infection that could affect both eyes.
This statement, which until now would make a lot of sense, with the advances in the technologies we use in cataract surgery, prepared operating rooms and qualified surgeons, begins to stop making sense.
In fact, in many centers of international prestige, It is recommended as the first option.
Why operate both eyes cataract at the same time?
Basically because you get one faster and more effective vision recoveryis reduce the problems of entering an operating room twice y normal and work life is restored before.
We know that risk of surgical infections is reduced with the use of operating rooms that follow the “Good Clinical Practices” protocol for bilateral surgery, pre and postoperative care of patients and with micro-pulsed ultrasound microsurgery techniques, which implies a more sophisticated technology and surgeons experts in these techniques.
La Surgical technique microincisional for cataract surgery causes less tissue trauma, less inflammation, which is accompanied by lower risk of infections.
Advantages of operating both eyes at the same time
Once the pitfall of infection is saved, the negative aspect, let's go back to the Advantages of bilateral cataract operation. The advantages of operating both cataract eyes at the same time are:
- Shorter time off work.
- Much faster visual recovery.
- Lower surgical risk, especially in patients with associated pathology such as diabetes, coagulation disorders ...
- Greater comfort for the family, companion and patient when organizing cataract surgery.
- Less trauma for patients with fear of the operating room.
Every time we implant more lenses intraocular that they try not only to replace the diseased natural lens, the opaque lens (the cataract), but also to correct the need to wear glasses after the intervention, correct myopia, astigmatism or eyestrain that this patient could have before starting the cataract and that we corrected thanks to the toric and multifocal intraocular (IOL) lenses.
The use of this type of intraocular lenses is accompanied by a longer adaptation process than in conventional lenses. After the surgery you must produce a Neuro-adaptation process to see correctly, faster in women than in men, something similar to what happened in the laser surgery of myopia and that led to perform bilateral surgery, so that the visual recovery was more efficient and faster.
Based on this experience, it has been seen that in the falls, when we perform both eyes in the same session the advantages are: visual recovery is also much faster, getting the rehabilitation of the patient, his normal life, reading, computer use, etc., much faster that when we separated the surgeries from both eyes.
People with fear of the operating room
Finally, another compelling argument to indicate bilateral surgery is to avoid entering an operating room twice.
It seems silly but, let them tell you who is afraid of operating rooms. The anxiety it generates (in young and old), can cause serious problems.
Along with this that may seem anecdotal (and it is not), what is not so much is that, in those patients who must do a previous preparation, for being treated with drugs such as anticoagulants or diabetic patients, a single surgical act is much more advisable, since it reduces the preparation time and facilitates the control and return to the normal pattern prior to surgery, something that is also important for those who have to take care of these patients, generally family or in homes, where it is complicated and more so if It takes several weeks.
Conditions necessary to operate both eyes at the same time
Not all centers or specialists comply with the conditions necessary to perform bilateral cataract surgery.
The patient, when going to the specialized center, should ensure that the center and the surgeon meet the necessary conditions:
- Technology and experience to perform a good preliminary study of the patient and the calculation of the lenses to be implanted.
- Accredited surgical center and with Safety protocols for bilateral cataract surgery of both eyes.
- Surgeons with experience in microincisonal techniques with micropulsed ultrasound.
- Technology and experience for adjust the final visual result in each patient.
En Área Oftalmológica AvanzadaWe are committed to practicing bilateral cataract surgery to reduce risks and recover vision and normal life sooner.
Evidence in favor of operating both eyes at the same time
Most of the data can be found on the website of the International Society of Bilateral Cataract Surgeons (International Society of Bilateral Cataract Surgeons) https://isbcs.org/, a scientific society that endorses the advantages of this procedure and that I recommend to all those who want to know more about it.
Daniel S. Durrie in Cataract and Refractive Surgery Today, Vol 12, Nº4, 2012, points out the good results obtained with bilateral cataract surgery, with his patients expressing a high degree of satisfaction. As a result of these results, the percentage of these surgeries in their daily practice has increased and encourages other surgeons to gradually incorporate this surgery into their usual practice.
In the issue of Cataract and Refractive Surgery Today, Vol 12, Nº5, 2012, a review of this practice is made with some of the most representative surgeons in the international plane. Eric Donnenfeld highlights the advantages of bilateral surgery, highlighting four points:
- Benefits at the organizational level for the family.
- Less risk to the patient not having to enter the operating room twice.
- El economic savings.
- La rapidity in vision recovery.
Another author who manifests in favor of simultaneous cataract surgery is Karl G. Stonecipher, uses the same arguments as Donnenfeld and insists on the importance of reducing recovery time. In front of almost four weeks in conventional surgery, in bilateral surgery we passed 10 -14 days, much lower.
For Stephen A. Updegraff, the decision to perform bilateral surgery is to adopt the new protocols in the calculation of the intraocular lens, new technologies that allow a high accuracy and are very reproducible as well as having an operating room and an action protocol that minimizes the risk of infections, facts that are now available to most surgeons.
En Área Oftalmológica Avanzada we are experts in cataract surgery and in our opinion, we participate in the above arguments and have found that in the case of using multifocal intraocular lenses, the fact of operating both eyes in the same session, is key to improving vision, to reduce time that patients need to be "comfortable" at all distances.
