At the examination, we determine visual acuity, measure intraocular pressure, examine the eye under a biomicroscope, and then the pupils are dilated to gain a detailed insight into the status of the lens/cataract, optic nerve, the macula and the entire retina.
The first test entails the calculation of the strength of the intraocular lens that is implanted in the eye using a device called IOL Master to determine the strength of the lens. This is the most accurate device that exists, and it is extremely important because precise determining of the strength of the lens can eliminate the patient's need for wearing glasses in certain situations, depending on the type of the lens which they selected. In the case of dense cataracts, we perform ultrasonic A scan that also accurately calculates the strength of the lens.
Then we perform corneal topography to accurately determine astigmatism and detect possible irregularities of the cornea which is especially important when implanting multifocal and toric lenses. The diagnosis of the yellow spot/macula and the optic nerve (OCT of the yellow spot/macula and the optic nerve) is extremely important to diagnose any related disease prior to surgery. This is important when implanting the multifocal lenses, but it is also important when it comes to the administration of certain drugs for diseases of the fundus before and during cataract surgery. Ultrasound of the eyeball can detect some diseases that are not visible, as is the case with extremely dense cataracts when the fundus cannot be analyzed through a dilated pupil. In this way we can detect retinal detachment, bleeding in the eye, ocular tumors, and the like. Measuring endothelial cells of the cornea before surgery is extremely important in order to additionally protect, during surgery, the cornea of patients who have a reduced number of these cells by applying a viscoelastic liquid, a thick liquid that protects the cornea during surgery. The endothelial cells are pumping out water from the cornea after surgery and allow recovery and clearing of the cornea after surgery. If the patient has a smaller number of these cells, there is a risk of prolonged recovery, corneal opacity, or even permanent damage to the cornea and vision.
We finish the examination by interviewing the patient in order to obtain all the necessary information and with the help of doctors decide on the type of the lens that will be implanted in the eye.
Before surgery, the patient needs to do a complete blood count (CBC), measurement of blood sugar (glucose), erythrocyte sedimentation rate (SE) and ECG.