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Cataract

I have a cataract and my vision is becoming increasingly blurred.

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01

What is a cataract?

A cataract is one of the most common eye conditions in older adults and occurs in 70% of people over 75 years of age.

It develops as a result of natural aging, when the eye’s lens gradually becomes clouded.

Although most commonly associated with aging, cataracts can also develop due to trauma, metabolic diseases (diabetes, galactosemia), medication use (e.g., corticosteroids), complications of other eye conditions (uveitis, glaucoma), or as part of certain syndromes (e.g., Down syndrome).

Krešimir Gabrić, MD

In the early stages, vision can sometimes be improved with glasses, but as the cataract progresses, surgery becomes the only effective solution.

The procedure involves removing the clouded lens and implanting an artificial intraocular lens, which:

Restores clear and sharp vision

Reduces glare and improves contrast

Facilitates reading, watching TV, and driving

Eliminates disturbances such as double vision

Provides a long-term solution to cataracts

For optimal results, we use advanced IOL Master technology for precise calculation of intraocular lens power.

02

Is this procedure for me?

If you notice that your vision is gradually deteriorating and that daily activities are becoming difficult despite wearing glasses, it is possible that a cataract is the cause of your symptoms. Surgery is a simple and effective way to regain clear vision and improve your quality of life.

Cataract surgery may be a good choice if:

Your vision is blurred and impairs daily activities

You have difficulty reading, driving, or watching TV

You notice glare, reduced contrast, or double vision

Glasses no longer provide satisfactory vision

Your vision is worse in low light or at night

You want a permanent solution for better and clearer vision

The examination for cataract surgery includes:

  • Assessment of visual acuity and intraocular pressure
  • Biomicroscopic examination of the eye
  • Pupil dilation for detailed analysis of the lens, optic nerve, macula, and retina
  • Calculation of intraocular lens power using the IOL Master, and if necessary, ultrasound A-scan
  • Corneal topography imaging for precise determination of astigmatism and any irregularities (especially important for multifocal and toric lens implantation)
  • OCT of the macula and optic nerve to detect hidden conditions
  • Ultrasound of the eyeball in cases of dense cataracts
  • Measurement of corneal endothelial cells to ensure surgical safety (this is important because endothelial cells help the cornea recover and clear after surgery; if there are too few, the procedure uses additional protection with a dense gel—viscoelastic—to avoid permanent vision damage)
  • Discussion with the patient about the type of intraocular lens to be implanted

Prof. Maja Bohač, MD, PhD

Dr. Krešimir Gabrić i dr.sc. Ante Barišić

Krešimir Gabrić, MD and Ante Barišić, MD, PhD

Preparation before surgery includes:

Complete blood count (CBC)

Blood glucose measurement

Erythrocyte sedimentation rate (ESR)

Electrocardiogram (ECG)

03

Types of intraocular lenses

Monofocal and toric intraocular lenses

Monofocal intraocular lenses have a single focus and provide the patient with good distance vision without glasses, but glasses are required for near vision (or vice versa if the patient prefers). If the patient had astigmatism before surgery (a refractive error caused by irregular corneal curvature), after surgery they will need to wear glasses with cylindrical lenses for both distance and near vision.

Implanting a toric monofocal lens during surgery in patients with astigmatism achieves good distance vision, while glasses are needed for reading. Monofocal lenses can be aspheric or spherical. Aspheric lenses correct spherical aberrations and provide patients with sharper vision in low-light conditions, especially for night driving, and are suitable for active patients.

Ante Barišić, MD, PhD

Multifocal intraocular lenses

With technological advances, multifocal intraocular lenses have been developed with 2 or 3 focal points, enabling patients to see well at different distances without glasses. Most multifocal lenses are bifocal. They provide good distance vision and good near vision, but slightly reduced vision at intermediate distances (80-100 cm).

The latest generation of multifocal lenses are trifocal lenses, which, in addition to good distance and near vision, also provide good intermediate vision, which is particularly important for patients who work extensively on computers. With this lens, patients can read newspapers and books, shave or apply makeup, look at their phone, work on a computer, watch TV, drive, engage in sports, and perform all other daily activities without glasses.

Krešimir Gabrić, MD

TECNIS PureSee™ IOL

TECNIS PureSee™ IOL is designed for patients who lead active lives and want clear vision at a range of distances – day and night, without depending on glasses.

It addresses the unmet demands of modern patients who lead active lives and require clear vision at various distances.

Svjetlost Eye Clinic is among the leading centers of ophthalmic excellence in the world for implanting PureSee lenses for reading correction, by Johnson & Johnson.

TECNIS PureSee™ IOL is an intraocular lens for presbyopia correction that provides high-quality vision day and night.

This lens uses advanced technology to ensure excellent distance and intermediate vision, with functional near vision, reducing dependence on glasses.

04

Procedure and recovery

What does the procedure involve?

Cataract surgery is today one of the safest and most frequently performed surgical procedures in the world.

Phacoemulsification lens extraction (PHACO) with intraocular lens (IOL) implantation is the gold standard in cataract surgery. It is a surgical procedure in which the clouded lens (cataract) is removed through an incision of 1.8-2.75 mm using an ultrasound probe, and a clear artificial lens is implanted. Thanks to the minimal incision, the wound heals quickly and does not require suturing.

Prof. Maja Bohač, MD, PhD

Cataract surgery is performed under local anesthesia using anesthetic drops.

It is painless and takes 10-15 minutes.

Cataract surgery carries no health risk and can be safely performed on elderly and ill patients.

The patient goes home 15 minutes after surgery. If cataracts are present in both eyes, surgery on both eyes can be performed on the same day.

What does recovery look like?

Approximately fifteen minutes after cataract surgery, the patient goes home and should avoid strenuous activity that day.

The first examination is the next day, followed by a follow-up examination after 7 days and after one month, when glasses are prescribed if needed. Just a few days after cataract surgery, the patient can return to work and normal life.

It is necessary to take the prescribed therapy (antibiotic/corticosteroid drops and ointment). Washing with tap water is prohibited for the first three days; avoid rubbing the eye, excessive bending, and lifting heavy objects for the first month. Exercise and similar activities can begin 2-3 weeks after surgery, depending on the patient’s age and exercise intensity.

Thanks to advances in technology and intraocular lens design, cataract surgery today, in the hands of an expert surgeon, is an effective, safe, fast, and painless procedure after which the patient can resume normal daily activities within 3-5 days.

05

Your medical team – our surgeons

Krešimir Gabrić, MD

Member of the Management Board

Prof. Nikica Gabrić, MD, PhD

Founder of Svjetlost Eye Clinic

06

Frequently Asked Questions

What is a cataract?

A cataract is one of the most common conditions affecting older adults. Cataracts occur in 70% of people over the age of 75. A cataract is the result of a natural aging process that causes clouding of the eye’s lens.

What are the symptoms of cataracts?

Symptoms of cataracts manifest as blurred vision, loss of contrast, glare in bright light, double vision, frequent problems with reading, watching TV, and driving.

Can cataracts develop as a consequence of certain diseases or medication use?

Yes, cataracts can also result from trauma, metabolic diseases (diabetes, galactosemia), medication use (corticosteroids), and complications of other eye diseases (uveitis, glaucoma), or they can occur as part of certain syndromes (e.g., Down syndrome).

Can I have an examination and cataract surgery on the same day?

No, pupils are dilated during the examination, while surgery is performed on a constricted pupil. Therefore, it is recommended to first undergo an examination to determine the best lens choice for you.

How long is the wait from examination to surgery?

At Svjetlost Eye Clinic, you can undergo cataract surgery within one week of your examination.

What preoperative tests do I need to have before surgery?

Before surgery, the patient should have a complete blood count (CBC), blood glucose level measurement, erythrocyte sedimentation rate (ESR), and an ECG recording.

How is the lens that will be implanted during cataract surgery determined?

The lens power calculation is determined using the most precise device called the IOL Master. In cases of dense cataracts, an ultrasound A-scan is also performed, which accurately calculates the lens power.

How is cataract surgery performed? Can it be treated with laser?

Phacoemulsification lens extraction (PHACO) with intraocular lens (IOL) implantation is the gold standard in cataract surgery. During the procedure, the surgeon makes a very small incision in the eye, through which the clouded natural lens is broken up using ultrasound and removed. A clear, artificial lens is then implanted in its place. Thanks to the minimal incision, the wound heals quickly and does not require sutures. Cataracts can be surgically removed using ultrasound or laser. Laser cataract surgery is considered the new gold standard for cataract operations, offering a less invasive, more individualized procedure with high precision.

Can I have cataract surgery without a lens implant?

When cataract surgery is performed, a lens implant is essential. The clouded natural lens is replaced with a new, clear lens.

How long should I keep my eye closed after cataract surgery?

After cataract surgery, the eye is usually kept closed until you arrive home. If both eyes are operated on, a protective lens is placed on the eye and the eye is not closed.

Is cataract surgery painful?

Cataract surgery is painless and is performed under local anesthesia using anesthetic drops.

How long does cataract surgery take?

Cataract surgery takes 10–15 minutes.

Is there any health risk for patients?

Cataract surgery carries no health risks and can be safely performed on elderly and ill patients.

When can I leave the hospital?

The patient goes home just 15 minutes after surgery. If cataracts are present in both eyes, surgery on both eyes can be performed on the same day.

What is the recovery like after cataract surgery?

Approximately fifteen minutes after cataract surgery, the patient goes home and should avoid strenuous activities that day. The first examination is performed the following day, followed by a check-up after seven days and after one month, when glasses are prescribed if needed. Just a few days after cataract surgery, the patient can return to work and normal life. It is necessary to take the prescribed therapy (antibiotic/corticosteroid drops and ointment), avoid washing with tap water for the first three days, rubbing the eye, excessive bending, and lifting heavy objects during the first month. Exercise and similar activities can begin 2–3 weeks after surgery, depending on the patient’s age and exercise intensity.

Who performs cataract surgery at Svjetlost Eye Clinic?

At Svjetlost Eye Clinic, cataract surgeries are performed by ophthalmologists: Prof. Nikica Gabrić, MD, PhD, Prof. Ratimir Lazić, MD, PhD,  Prof. Maja Bohač, MD, PhD,  Ante Barišić, MD, PhD and Krešimir Gabrić, MD.

What are the benefits of laser cataract surgery?

The benefits of laser cataract surgery include a personalized approach to each operation, a computer-guided surgical process, high precision, accuracy, and reproducibility of the procedure, as well as a less invasive procedure with reduced trauma to the eye.

What types of lenses do you offer at the Svjetlost Eye Clinic?

Svjetlost Eye Clinic offers monofocal, monofocal plus, premium intraocular lenses, and multifocal intraocular lenses.

Will I need to wear glasses after monofocal lens implantation?

Yes, monofocal intraocular lenses have a single focus and provide the patient with good distance vision without glasses, but glasses must be worn for near vision (or vice versa if the patient prefers). If the patient had astigmatism before surgery (a refractive error of the eye resulting from irregular corneal curvature), glasses with cylindrical lenses will need to be worn for both distance and near vision after surgery.

Do I need to wear glasses after multifocal lens implantation?

No, multifocal intraocular lenses, which have 2 or 3 foci, enable patients to achieve good vision at various distances without glasses. Bifocal multifocal lenses provide good distance vision and good near vision, but slightly weaker vision at intermediate distances (80 – 100 cm). Trifocal multifocal lenses, in addition to good distance and near vision, also provide good intermediate vision, which is particularly important for patients who frequently work on computers.

How long do intraocular lenses stay in the eye?

The intraocular lens is permanents and is designed to last a lifetime.

Do I need to remove contact lenses before the examination?

If you wear contact lenses, they must be removed before the examination: soft lenses at least 72 h beforehand, and (semi-)rigid lenses at least 14 days prior.

When can I come for an examination?

Examinations are available from Monday to Friday, in the morning and afternoon, depending on the doctor’s clinic.

Can both eyes be operated on simultaneously?

While it is possible to perform cataract surgery on both eyes on the same day, it is recommended to operate on one eye at a time, with a one-week interval.

Can cataracts return?

Cataracts cannot return, but sometimes the lens capsule can become cloudy after some time, reducing visual acuity (secondary cataract). This clouding can appear months or even years after cataract surgery. If this occurs, the clouding is removed with a YAG laser, performed as a painless outpatient procedure lasting only 5 to 10 minutes, with immediate visual rehabilitation.

Can I have an examination and YAG laser capsulotomy on the same day?

Yes, YAG laser capsulotomy can be performed on the same day as your examination.

I have floaters, can I have cataract surgery?

Yes, floaters are not a contraindication for cataract surgery.

What does the cost of cataract surgery depend on?

The cost of cataract surgery depends on the type of lens implanted in the eye after removal of the natural, clouded lens and on the method of performing the procedure (ultrasound or laser). Your doctor will recommend the choice of lens and method of performing the procedure during the examination, based on the health condition of your eye.

What diagnostics are performed as part of the cataract surgery examination?

The diagnostics include IOL Master, ultrasound + A-scan, corneal topography, endothelial microscopy, and OCT of the macula and optic nerve.

What is an IOL Master?

The IOL Master is a device that measures the power of the lens to be implanted in the eye during cataract surgery. Taking into account the axial length of the eye, keratometry values, anterior chamber depth, and a series of formulas, it calculates the power of the lens to be implanted.

How is the IOL Master performed?

The patient sits at the device, rests their head, and the device automatically records all necessary data. The examination is painless, takes half a minute, and the results are immediately printed.

What is ultrasound + A-scan?

Ultrasound + A-scan is an examination that provides insight into the interior of the eye and eye length.

How is ultrasound + A-scan performed?

The patient sits comfortably in a chair while the physician gently moves the ultrasound probe over the lower and upper eyelids and captures images. For the A-scan, the probe needs to be placed on the cornea of the previously anesthetized eye. The examination is painless, harmless, and takes several minutes.

What is corneal topography?

Corneal topography is an examination that provides insight into the curvature of the anterior surface of the cornea and determines the value of corneal astigmatism.

How is corneal topography performed?

The patient sits at the device, rests their head, and the device automatically records all necessary data. The examination is painless, lasts a few seconds, and the results are immediately printed.

What is an endothelial microscope?

An endothelial microscope is an examination that counts the number of endothelial cells in the cornea.

How is endothelial microscope performed?

The patient sits at the device, rests their head, and the device automatically captures all necessary data. The examination is painless, takes a few seconds, and the results are immediately printed.

What is OCT of the macula and optic nerve?

OCT of the macula and optic nerve is an examination that images the structure of the macula and optic nerve and detects possible disorders of these structures that are otherwise invisible during examination with a magnifying glass.

How is OCT of the macula and optic nerve performed?

The patient sits at the device, rests their head, and the device automatically records all necessary data. The examination is painless, lasts a few seconds, and the results are immediately printed.

What does a cataract look like?

A cataract is a consequence of the natural aging process that leads to clouding of the eye’s lens. A cataract (also known as gray cataract) most often appears as a grayish-white clouding in the pupil of the eye. Instead of being completely black, the pupil may appear milky, gray, or cloudy.

How to treat cataracts without surgery?

Cataracts cannot be treated with pills, ointments, or drops, but exclusively by surgery.

How to stop cataracts?

Cataracts cannot be stopped. The only permanent solution is surgery.

How long does recovery take after cataract surgery?

Patients can resume all daily activities within one week of the surgical procedure. Full stabilization of the eye is expected over several weeks, depending on the condition of the eye’s surface.

 

How much does cataract surgery cost?

Prices range from €1,500.00 to €2,400.00 per eye for ultrasound cataract surgery, while the price of laser cataract surgery ranges from €2,000.00 to €2,900.00 per eye.