Sustitución de lentes

Qué es la cirugía de reemplazo de lentes?

La sustitución del cristalino, también llamada implante de cristalino, es una intervención quirúrgica ocular cuyo objetivo es corregir trastornos visuales como la hipermetropía, la miopía y el astigmatismo. La sustitución del cristalino se utiliza cuando los trastornos visuales son demasiado graves para ser tratados mediante cirugía ocular LASIK o cuando el paciente no tiene una buena salud de la superficie ocular debido a la edad. La sustitución del cristalino consiste en sustituir el cristalino natural del paciente por un cristalino artificial. La sustitución del cristalino y la cirugía de cataratas son sinónimos, por lo que la cirugía de sustitución del cristalino trata y previene la formación de cataratas.

 

Por qué se realiza la cirugía de sustitución del cristalino?

Al igual que ocurre con la cirugía ocular LASIK, los defectos refractivos como la hipermetropía, la miopía, la presbicia y el astigmatismo que se producen debido al envejecimiento o a la inclinación genética pueden tratarse mediante la sustitución del cristalino. La sustitución de lentes es el tratamiento preferido para los defectos refractivos cuando el paciente no puede someterse a la cirugía ocular LASIK, a menudo debido a la edad. Las cataratas se tratan a menudo mediante la sustitución del cristalino y también se previene la formación de futuras cataratas.

 

Cuáles son las condiciones para la cirugía de sustitución del cristalino?

La cirugía de sustitución del cristalino está al alcance de muchos pacientes y sólo se aplica a pacientes que sufren defectos refractivos. El reemplazo de lentes sólo se recomienda a los siguientes pacientes:

  • Los pacientes mayores de 40 años.
  • Los pacientes menores de 40 años pero mayores de 21 que no reúnan los requisitos para someterse a la cirugía ocular LASIK.
  • Las pacientes que no estén embarazadas.
  • Los pacientes que no tienen un desgarro en la cápsula en la que se encuentra la lente del cristalino.

 

Cuáles son los tipos de cirugía de Reemplazo de Lentes?

 

Los pacientes mayores de 40 años:

Para los pacientes mayores de 40 años, existen tres tipos de lentes: trifocales, bifocales y monofocales. La lente Trifocal mejora la visión para ver mejor los objetos de lejos, de cerca y a media distancia. Las lentes bifocales, en cambio, sólo mejoran la visión de lejos y de cerca. A diferencia de las dos primeras, la Monofocal sólo mejora la visión de lejos, de cerca o intermedia, pero puede mejorar cualquiera de ellas. Se extrae por completo el cristalino del paciente y se le coloca la lente inteligente.

 

Los pacientes menores de 40 años:

Si los defectos refractivos como la hipermetropía, la miopía y el astigmatismo son demasiado elevados para ser corregidos con el tratamiento LASIK o si el grosor de la córnea no es suficiente para el tratamiento LASIK, se aplica la sustitución del cristalino para tratar los defectos refractivos mediante la inserción de la lente intraocular fáquica delante o detrás del iris.

 

Qué hay que tener en cuenta antes del reemplazo de lentes?

Cuando el paciente llega al hospital, se le realizan pruebas preoperatorias exhaustivas y consulta con el oftalmólogo que le atiende. Se determina el método de tratamiento específico para el paciente y se le proporciona información sobre el proceso y los posibles riesgos. Una vez que el paciente ha recibido la información necesaria sobre la intervención, se toma su consentimiento informado.

 

Cómo se realiza el cambio de lentes?

Antes de la intervención se administra anestesia general o sedación local para aliviar cualquier posible dolor. Se realizan tres pequeñas incisiones en la córnea, la mayor de las cuales tiene una anchura de 3,2 mm.

 

Los pacientes mayores de 40 años:

Se extrae el cristalino a través de las incisiones y se introduce la lente intraocular en el ojo a través de una incisión en forma de túnel.

 

Los pacientes menores de 40 años:

La lente intraocular fáquica se coloca delante o detrás del iris, y el cristalino natural del ojo no se interfiere durante la intervención.

 

La operación dura, por término medio, 15 minutos por ojo. El paciente no puede ver a través del ojo operado durante aproximadamente 24 horas, por lo que cada lente se sustituye en días diferentes para que el paciente pueda ver en todo momento.

 

Qué hay que tener en cuenta después de la cirugía de reemplazo de lentes?

El paciente se somete a un seguimiento al día siguiente de la cirugía en el que se realizan las comprobaciones necesarias para asegurar que el ojo está cicatrizando correctamente. Se recomienda al paciente que se aplique el colirio antibiótico proporcionado según las instrucciones de su oftalmólogo. Además, durante la primera semana después de la cirugía se recomienda al paciente lo siguiente:

  • No ejercer presión física sobre los ojos ni frotárselos.
  • Lavarse el pelo con la cabeza inclinada, como en la peluquería, para evitar que entre agua o jabón en los ojos.
  • Tener cuidado al aplicarse loción o maquillaje y no hacerlo en la zona cercana a los ojos.
  • Llevar gafas de sol cuando se está al aire libre.
  • Evitar ejercicios extenuantes como nadar, levantar peso o montar en bicicleta.

 

El paciente puede volver a su rutina diaria a partir de la 2ª semana, pero se le aconseja que no se frote los ojos enérgicamente durante al menos otra semana.

 

Cuáles son los riesgos del reemplazo de lentes?

Los riesgos del reemplazo de lentes incluyen, entre otros, los siguientes:

  • Hemorragia intraocular
  • Hemorragia en los párpados
  • Hemorragia del iris
  • Formación de edema en la córnea.
  • Desplazamiento de la lente colocada en el ojo.
  • Presión intraocular elevada, glaucoma
  • Infección ocular
  • Desgarro o desprendimiento de retina
  • Macular, mancha amarilla, edema.

 

Aunque la mayoría de estos efectos desaparecen por sí solos, algunos pueden requerir atención médica inmediata. Se aconseja al paciente que se ponga en contacto con su Coordinador de Pacientes si presenta alguno de estos efectos secundarios.

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