Dr. Carlos Cury Jr.Ophthalmic Surgeon

A modern approach to cataract surgery

Cataract is the opacification of the crystalline lens and one of the leading causes of reversible vision loss worldwide. The surgical indication is clinical and considers the functional impact reported by the patient, not merely the examination findings.

Macro photograph of a human eye with a reflection on the crystalline lens
Illustrative image for educational purposes. It does not depict an identifiable patient.

Clinical explanation

Preoperative evaluation includes refraction, biomicroscopy, tonometry, retinal mapping and optical biometry for intraocular lens calculation. Corneal topography assists in the analysis of astigmatism.

Phacoemulsification is the reference technique: through small incisions, the opacified lens is fragmented and aspirated, followed by implantation of an intraocular lens within the capsular bag.

Lens selection takes into account the patient's lifestyle, corneal astigmatism, and the condition of the retina and optic nerve. Monofocal, toric and extended-depth-of-focus lenses have distinct indications, discussed on a case-by-case basis.

Clinical timeline

Stages of care

  1. 01

    Consultation and indication

    Assessment of the functional impact of the opacity and a complete ophthalmologic examination.

  2. 02

    Preoperative testing

    Optical biometry, corneal topography and macular OCT when associated retinal disease is suspected.

  3. 03

    Intraocular lens selection

    Discussion of the available options, with their advantages and limitations, aligned with the patient's expectations.

  4. 04

    Surgery and follow-up

    An outpatient procedure under topical anesthesia, with scheduled re-evaluations and a new refraction after stabilization.

Diagnostic imaging

Imaging documentation

  • Anterior segment image with detail of the cornea
    Corneal imaging

    Assessment of the anterior segment by topography, tomography and specular microscopy, as clinically indicated.

  • Optical coherence tomography showing a cross-section of the macular layers
    OCT

    Optical coherence tomography: a high-resolution cross-sectional image of the retinal layers, essential for macular assessment and quantitative follow-up.

  • Color fundus photograph showing the retina, macula and optic nerve
    Fundus photography

    Color documentation of the ocular fundus, used to record the state of the retina and compare its evolution throughout follow-up.

Discussion

Refractive predictability depends on the quality of the biometry and the calculation formula used; small residual variations are expected and described in the literature.

Posterior capsule opacification is a common late event that is treatable in the office with YAG laser capsulotomy.

Expected outcome

Removal of the opacity and visual rehabilitation consistent with the health of each patient's retina and optic nerve are expected. Associated ocular conditions may limit the visual gain achieved.

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