Mr Vincenzo Maurino, Consultant Ophthalmic Surgeon in Cornea and Refractive Surgery and Service Director for Cataracts at Moorfields talks to Angela Smith about cataract surgery and explains the importance of the Biometry Machine that Friends purchased for the hospital last July.
There are two lenses in the eye; the first is the cornea and the second one is the crystalline lens. As part of the natural aging process, the crystalline lens can become opaque and cloudy and of course the sight is then damaged looking throughout a cloudy lens. When this happens it is a bit like taking a picture with a camera that has an opaque lens; the picture is not good! Age related cataracts are very common, with one in three people over 65 requiring cataract surgery.
Cataracts are not just caused by age, there are also genetic and medical causes. We see cataracts in young children and babies. At Moorfields the Paediatric Service performs cataract surgery on babies who are just a few weeks old
Currently the only treatment for cataracts is surgery. Cataract surgery has been around since Egyptian and Roman times, but this was a very primitive and crude form of surgery as it involved simply pushing the cataract deep into the eye so the patient could see without looking through the opaque lens.
More recently cataract surgery has been refined and it was in London that the first ever replacement artificial lens was implanted at the time of the removal of the crystalline opaque lens (the cataract); that was a momentous breakthrough! In the past few decades cataract surgery has been perfected. Modern cataract surgery involves just a small corneal incision with the lens sliced into pieces and then removed from the inside of the eye using ultrasound energy and a complex infusion aspiration system and then an artificial clear lens is inserted in the eye. In the past few years Moorfields has introduced femtosecond laser assisted cataract surgery. Here the first 30% of the procedure is carried out in an automated robotic way and the lens is split in small pieces from the outside without the patient needing to be in the operating room. This really demonstrates the evolution of cataract surgery, which is the most successful type of surgery that can be performed on the human body. The rate of complications is less than 1%.
Biometry is measuring the eye using special laser machines and applied mathematical formulas. We can then decide the specific implant power for individual patients to correct any need for glasses. The IOL master 700 is the most advanced biometry machine and can take precise measurements even if the patient moves, or has unusual shaped eyes. We are very thankful to Friends for purchasing this, it has been a big acquisition for Moorfields and will help us to continue to get better and better outcomes for our patients.”
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