Cataract2021-02-05T15:49:18+01:00

Cataracts is the clouding of the normally clear lens of your eye

You can treat this common condition with cataract surgery
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Cataracts is the clouding of the normally clear lens of your eye

You can treat this common condition with cataract surgery
TAKE SUITABILITY TEST
Book an appointment

Reclaim your vision and experience more colour and clarity

In this video, Dr. David Donate explains how cataract surgery transforms our patients’ daily lives

Fix your cataracts and restore your vision

In the toggles below, we have provided everything you need to know about cataract and how we can treat it

Cataracts are the number one cause of blindness in the world. In France, it affects more than 20% of the population over 65, and 60% of those over 85. Its prevalence is constantly increasing due to longer life spans.

In the absence of surgical treatment, a patient with cataracts may experience a total or partial clouding of the lens, which causes a gradual and irreversible reduction in vision. In rare cases, it may appear in only one eye (unilateral cataract), but it generally affects both eyes (bilateral cataract). The visual discomfort it causes depends on both the intensity and location of the clouding of the lens.

What do we mean by lens?

The lens is situated behind the iris and is completely transparent. It is elastic and biconvex in shape. This form, or shape, depends on the ciliary muscle, which differs from person to person. It changes shape to allow vision at varying distances, and it is this that brings focus to the retina.

The lens is composed of a central core of protein fibres which is surrounded by a transparent and elastic envelope: the capsule. In this small “pouch”, there are two parts which we can identify anatomically: the anterior capsule and the posterior capsule.

In a patient with cataracts, the lens loses its transparency and flexibility and also changes colour according to its severity (brown, red, white, etc.). Light can no longer be transmitted effectively to the retina; therefore, the image produced is no longer clear. When the cataract is large, it can be seen by the naked eye, in the pupil.

Cataract symptoms

Symptoms most often appear with age, although cataracts can occur at any time of life. Cataracts are painless and are characterized by purely visual symptoms, the main one being a gradual decrease in vision, sometimes over several years, despite an appropriate correction with glasses or lenses.

Progressive clouding of the lens can manifest as:

  • Blurred vision
  • A decrease in visual acuity
  • Impaired colour vision (yellowing, or difficulty distinguishing close colours)
  • Glare, halos around light sources which can make driving at night difficult
  • Optical aberrations
  • A decrease in the vision of contrasts
  • The need to increase the light sources for certain activities (reading, sewing…)

The impact of these symptoms on daily activities can become significant and very bothersome.

Cataract screening is typically done by :

  • A visual acuity test
  • A slit-lamp examination (biomicroscope)

At the Donate Vision Clinic, we specialize in cataract screening, we don’t just test visual acuity, but we also take visual quality into account.

To do this, we assess the sensitivity to contrasts at all spatial frequencies as well as the absorption and scattering of light by the lens using the “Visiometrix HD Analyzer”. We check the density of the lens using OCT imaging, and we also evaluate aberrometric changes related to cataracts.

During the proposed preoperative assessment, we will also verify that the other anatomical and physiological structures of the eye are healthy to optimize the results of the surgery and reduce complications.

We will check:

  • The condition of the lens zonules (fibres that hold the capsular bag)
  • The state of the retina
  • The state of the optic nerve
  • The state of the Meibomius glands
  • The state of the tear film and the regularity of the corneal surface
  • The corneal topography
  • The condition of the corneal endothelial cells

Lastly, we will perform an eye biometry, which collects the dimensions of the eye to accurately calculate the power of the custom-made implant, which will replace your lens and give you perfect vision without glasses.

The purpose of this comprehensive assessment (which lasts approximately 2 hours) is to operate under the best possible safety conditions and to offer you the best possible visual result.

The only treatment for cataract is surgery. It is the most widely performed procedure in France with nearly 700 000 procedures per year.

When the beginning of a cataract is detected, simple ophthalmological monitoring is necessary. It is entirely the patient’s decision as to when they feel their quality of vision has deteriorated to a level that they no longer wish to tolerate. At this point, you may want to consider surgery.

The surgical treatment aims to:

  • Clean the clouded lens
  • Insert an artificial lens (intraocular implant made of synthetic material), while retaining its natural envelope (capsule) which will serve as a support for the implant.

This operation is definitive, and the implant is made to last for life.

Are there different types of cataract?

Yes. We will classify the different types of cataracts according to the anatomical zone of the lens in which the cataract appears.

Nuclear cataract : the opacities are located in the nucleus of the lens. Its evolution leads to growing myopia and sometimes the splitting of images.

Cortical cataract : the opacities are located at the periphery, on the cortex of the lens.

Cortico-nuclear cataract : all the layers of the lens are more or less equally clouded. It is the most common form of senile cataract. The patients feel they need more light to see.

Subcapsular cataract : the opacities are located under the posterior or anterior capsule of the lens. This cataract gives the sensation of having a veil before the eyes and of being dazzled.

The different forms of cataracts are also named according to their cause of occurence.

Senile cataract : it is the most common cataract. It appears with ageing, at around 65/70 years old, although it can affect much younger individuals. The nucleus and cortex are opacified (cortoco-nuclear cataract). It often affects far vision first before interfering with near vision.

Traumatic cataract : it often occurs in young people and children following a force trauma (e.g. a punch, champagne cork, ball sports : watch out for badminton and squash!). It is typically posterior subcapsular. It can also follow an eyeball injury or the introduction of a foreign body into the eye. It can sometimes appear long after being hit.

Pathological cataract : they include cataracts alongside another ocular pathology : strong myopia, chronic uveitis (they are called “complicated cataracts”) or to a general metabolic pathology such as insulin-dependent diabetes (posterior subcapsular cataracts) for example. There may be iatrogenic cataracts due to prolonged use of certain drugs (corticosteroids) or in the aftermath of radiation therapy.

Congenital cataract : it can be present from birth (0,03% of births) and requires early management to avoid amblyopia.

Secondary cataract or capsular fibrosis : it occurs frequently after cataract surgery. It is not considered a complication of the first operation. It is due to the clouding of the lens envelope within a few months or years after the primary procedure. It is easily diagnosed with a slit lamp examination and treated at once with the YAG laser (capsulotomy).

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Frequently asked questions about cataracts

There is no recommended age for having the operation. You have to think about the operation as soon as you are significantly hampered in your daily activities. Do not wait until the lens is too hard and too opaque. If the average age of the cataract operation is between 60 and 70 years in France, some people are embarrassed much earlier. In addition, the indication will also depend on the type of cataract you have. An active patient with cataracts will have surgery quickly.

When should you operate for cataracts?

As soon as you feel visually impaired and your eyesight drops despite an appropriate correction.

I have been diagnosed with cataracts, do I need an emergency operation?

Apart from very rare exceptions, there is no urgency to operate. Once again, it is your feelings that will lead you to consult for an intervention.

There is no obligation to be operated. Some elderly people whose daily life does not require very good eyesight cope very well with this pathology. On the other hand, if cataracts prevent you from leading a normal life (driving, reading, etc.) or restrict your leisure activities (reading, sewing, etc.), you should not hesitate to consult.

What are the side effects of cataracts?

The side effects of cataract surgery are mainly related to eye drops (drops) that you will need to put in your eyes after surgery: allergies or irritation. Fortunately, not all patients will suffer from this kind of discomfort, but sometimes some people have dry eyes before the operation. This pathology, which is commonly called “dry eye”, is due to a dystrophy of the meibomus glands, small glands located along the eyelids which ensure the quality of the tear film. This may result in a feeling of eye irritation, glare or fluctuating vision. These symptoms improve if you treat this dry eye before / during and after treatment for cataracts. If a patient were to have dry eye, it would in any case be diagnosed during the very complete assessment which is systematically performed at the Donate Vision Clinic. Eye drops, however, remain essential after each operation because they reduce the risk of inflammation and postoperative infection.

What are the consequences of a cataract operation?

They are very simple and brief. You have to take a little rest and, above all, stay in a clean environment for the days following the operation. The goal is to avoid any infection and any “sudden” contact with the recently operated eye.

Strictly speaking, cataracts cannot be avoided since it is a natural phenomenon linked to the aging of the eye. The only “preventable” cataract is related to direct trauma to the eye (traumatic cataract). On the other hand, as in many general pathologies, a healthy lifestyle can help you preserve your eyes for longer:

  • Protect your eyes from UV rays with sunglasses
  • Avoid tobacco and alcohol
  • Control your blood sugar in case of diabetes
  • Have your doctor check the long-term intake of certain medications (corticosteroids, etc.)

Can cataracts be treated naturally?

Unfortunately, there is no treatment other than surgical treatment for this pathology. But as seen previously, a varied quality diet and a healthy lifestyle are good natural methods against aging of the eye and aging in general.

Can you drive after cataract surgery?

You will not be able to drive immediately after your operation and someone will need to accompany you. On the other hand, you will see the surgeon the day after the operation and only he can give you the green light for driving. It is usually possible two to three days later.

You can resume sport 15 days after the operation. But time being the best ally of your healing, still remain cautious with contact sports the following weeks.

What is a secondary cataract?

It is a very frequent result of the operation for cataracts. During the first operation, the surgeon keeps the patient’s capsule intact since it serves as a support for the implant which is inserted into the eye. Over time, in a very variable but systematic way, this capsule also loses its transparency, disturbs the patient’s vision and suggests that the cataract has returned. This is not the case. The treatment of this secondary cataract is very simple and painless. You will go to your surgeon’s office as a simple consultation and after instillation of a few drops of anesthetic eye drops, the doctor will make a central opening of the capsule using a laser called Laser YAG. This gesture lasts a few minutes, is perfectly painless and you will definitely find a clear view. You can come unaccompanied and resume your activities immediately after the treatment. The only discomfort you may experience will be the dilation of the pupil for a few hours.

Is the result of the operation final?

Yes. The implant inserted into your eye will remain transparent throughout your life and will not require replacement.

No. Implants placed today are very durable and designed to last a lifetime.

Is there a maximum age for cataract surgery?

No, you can have the operation at any age as long as you are embarrassed. If your general condition allows it, there is no contraindication to having the operation.

Is it possible to have cataracts and other related pathology?

Yes. The very complete examinations that you will have taken beforehand will allow a complete check-up of your eyes and if there were to be another associated ocular pathology, it would be detected and treated as well.

Age-Related Macular Degeneration is an aging-related disease of the central area of ​​the retina (called the macula). It results in a progressive loss of central vision. If there is a cataract associated with AMD, this will require special treatment but there is no contraindication. Often times, treatment for cataracts can improve the diagnosis and treatment of AMD. Contrary to a commonly heard misconception, cataract surgery does not change AMD if the management is well done.

Will I still have glasses after the procedure?

We now have implants that allow, in addition to replacing the functions of your old lens, to correct other visual defects. If you wish, you can request to have implants that will allow you to see far and near without glasses.

How long after the procedure will I see clearly?

Very often you will see very well the very next day. Sometimes it will take a few days if there is ever a small, transient corneal edema.

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This doctor operated on me in 2009. Multifocal implants …. having “bionic” eyes when you have had glasses at the bottom of bottles for 50 years is great. .. do not dream of having these eyes there, it is the thousand and one nuances of the green colour of the trees which surround the clinic of the pardieu ….. in 2020 I have 12.6 for my right eye and only 10 for l left eye I had at least fifteen diopters before my operation ….. it is not beautiful life?

Camille M.

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Thanks to the advice and great skills of Doctor David Donate, I opted for multifocal implants, and now I work and live without glasses and with great comfort.

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I followed the advice of a friend and had a consultation with Dr Donate. I now have 10/10 sight in each eye. Thank you to the team for your professionalism. I recommend them to all… they’re innovative, rigorous and cutting edge.

Antoinette T.

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The intervention (PRELEX) was done under general anaesthesia at the outpatient clinic. I had no pain. The results were breathtaking the next day. No more glasses to drive or work. I forgot about my eye problems. Thank you to Dr Donate’s team for their kindness and professionalism.

Dr Yves L.

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While I have worn glasses all my life, since this intervention, I do not wear glasses for either near or far. I am very satisfied with the result. Thank you to you and your team.

Pierre G.

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What a joy it is to open your eyes in the morning and see what is going on around you without first having to look for your glasses. It is liberating to have independence from this unattractive exogenous transplant. I should have done this earlier! So don’t hesitate, take the plunge.

Professor Devouassoux M.

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After years of wandering from ophthalmologist to ophthalmologist, I finally found Doctor Donate and his team. They listened and gave me real therapeutic responses. I will recommend to my friends!

Jean-Alex C.

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After multi-focal implants, I can now see very well, even on the computer. Doctor Donate is very professional and listened to my needs.

Farid R.

We have replaced the images of real patients who provided these testimonials to protect their privacy.

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Links to authoritative resources on refractive cataract surgery

Follow the links below for more information on refractive cataract surgery

Sometime after age 50, most of us are likely to hear our eye doctor say, “You have cataracts.” A cataract is a clouding of the lens inside the eye, causing vision loss that cannot be corrected with glasses, contact lenses or corneal refractive surgery like LASIK. Click here to read more.

Cataract surgery outcomes have greatly improved due to advancements in surgical technique, intraocular lens (IOL) technology, and preoperative testing and calculations. With the improvements has come increased expectations from patients regarding postoperative visual acuity and independence from spectacle correction. Click here to read more.

Cataract surgery has evolved to become a refractive surgery in this modern era. The demand for a better quality of life with the best possible vision is constantly requested by our patients. How to best satisfy this demand thus becomes the utmost priority for eye surgeons. Click here to read more.

Dr. David Donate

Ophthalmologist – Refractive surgery specialist

20 years’ experience and 20000 successful vision correction treatments

With over 20 years of experience performing more than 20000 successful eye procedures, and a repertoire of academic publications and research, Dr. David Donate has earned himself an international reputation.

At his state-of-the-art clinic in Lyon, Dr. Donate follows a specialised method called, The Donate Method, to ensure his patients feel confident about their vision correction journey. Combined with the highest quality pre-op and post-op appointments, expert precision solutions and top technology, Dr. Donate is perfectly positioned to deliver the best possible outcome for his patients.

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