Submitted by wollson on Thu, 02/07/2019 - 15:54
  1. Cataract
  2. When is time to operate cataract
  3. Cataract surgery
  4. Implantation of multifocal intraocular lenses

Cataract is a changing of transparency of biological human lens, with opacities and therefore blurred vision, obstructing and decreasing visual function, starting from clouded vision to “temporary blindness”.

This “temporary blindness” occurs due to cataract maturing and because of delaying the surgery.

Therefore, early surgery, at the time of first disturbances started, will preserve the visual function.



Natural biological eye lens is transparent and biconvex. It refracts light rays on the way to retina and enables accommodation. Accommodation is an important physiological act, which enables the sharp near vision.

Approximately at the age of 45, accommodation is becoming weak, and in a little while, lost completely.

That means that near vision and ability to read becomes difficult, and therefore, reading glasses become a necessity. This is the age of presbyopia.



Because of numerous metabolic processes, lens in the eye loses transparency and changes color, most often with aging.

Cataract can occur at any age, from infants (congenital) – till the late age (senile), which is the most common.

Causes and factors are numerous: aging (senile cataract), hereditary, infections during the pregnancy (congenital cataract), metabolic diseases-diabetes e.g., radiation, smoking, alcohol, some medications, dehidration, diet and electrolitic disbalance, trauma (complicated traumatic cataract), high miopia,...

Often it is accompanying other eye diseases (uveitis, retinitis pigmentosa, metabolic diseases).

Congenital cataract can be joined with glaucoma which is not yet manifested, and for that reason children that underwent cataract surgery need to be followed-up regularly, after the surgery. Sometimes, cataract among children can point to existence of serious syndroms, in which some other organs are impaired. Once occured, the only treatment is surgical.


When is time to operate cataract?

Immediately when the disturbances start. This early operation is possible by phacoemulsification. Without waiting for cataract to mature, a lot of complications will be avoided and fast postoperative visual rehabilitation will be achieved. This is out-patient surgery.


Mature cataract is the ‘’temporary blindness’’ which leads to depression and social isolation with frequent injuries and fractures. 
Besides, maturing and melting of cataractous lens, which lasts long, may have persistent consequences, as uveitis, or secondary glaucoma, very complicated to treat, with severe visual defects. Behind dense cataract, it is not possible to check the posterior segment, fundus of the eye, especially in diabetes, glaucoma, or macular defects, and therefore as not visible, it is not possible to treat them (LFC, aVEGF,…).

In congenital cataract, operation is suggested as early as possible, especially in dense cataract or centrally located, so the child will have the possibilities to develop the vision.

Intraocular lens is implanted during the surgery.

Cataract surgery

Phacoemulsification is the operative procedure for cataract surgery.

We introduced this operation in the country many years ago with establishment of hospital. This phaco surgery means using the ultrasound to emulsify the cataractous lens and irrigate and aspirate it through small incision (2 mm). Artificial intraocular lens is implanted through the same incision. The procedure lasts 5-6 minutes. It is out-patient surgery.

Phacoemulsification in SVETI VID is at the highest point in technical skills and availability of the best quality, premium IOLs, owing to Prof. dr Pavel Rozsival who gave the great contribution to development of refractive lens surgery in the world of ophthalmology.

This remarkable surgeon is announced as one among the most honored persons for development of ophthalmology in XX and XXI centuries. He traced the way of further development of phacoemulsification in XXI century.

The surgery in SVETI VID gives maximum control and safety, which results in satisfied patients.

Phacoemulsification, as mini-invasive procedure, small incision, sutureless, painless, actually is refractive surgery for refractive error correction in presbyopic age.

IMMEDIATELY TOWARDS GOOD VISION Bilateral cataract surgery, in one act, simultaneously, painless, fast, in less than 10 minutes, sutureless, in local anesthesia (drops), gives comfort for the patient, visual function and binocular vision recovery in one-day, out-patient surgery. Cataractous lens, by ultrasound method of operation, is removed through small incision (2 mm) and small, foldable IOL, is implanted through the same incision. No suture, no pain. The vision is regained immediately after operation. You will choose the optimal IOL in discussion with your doctor, depending on what you need. If you do not want to depend on glasses for near, intermediate (computer) and far distance, then your choice should be multifocal/trifocal implant. Only rich experience in this field, as well as in solving complicated cases, gives maximum of safety and usage of new procedures that contemporary ophthalmology offers.

Implantation of multifocal intraocular lenses

With the new, high-quality intraocular lens, that can correct the preoperative refractive error, cataract surgery is nowadays crucial part of refractive surgery. The great opportunity for vision correction for different distances (near, intermediate and far), instead of dependency on many pairs of glasses, is implantation of multifocal/trifocal intraocular lens. In this way, multifocal implant will ’’immitate’’ lost accommodatiom.