Cataratas


Una de las patologías más frecuentes a nivel ocular son las cataratas. En este post vamos a hablar sobre ello, para seguir leyendo pulse en el siguiente enlace.

¿QUÉ SON LAS CATARATAS?
Nuestros ojos tienen una lente natural llamada cristalino que se encuentra dentro del globo ocular. Ésta lente es trasparente y permite que pase la luz al ojo para permitirnos ver.
La catarata es una afectación ocular en la que una nubosidad u opacidad en el cristalino bloquea o modifica la entrada de luz y afecta la calidad de la visión.
 
¿A QUIÉN AFECTA?
Las cataratas son la causa prevenible de ceguera más frecuente del mundo. La mayor incidencia está en las personas entre los 65 y 75 años. El envejecimiento es la causa más común.
A partir de los 45 años, puede aparecer la presbicia o vista cansada que es la perdida de enfoque del cristalino y la dificultad de visión cercana. Posteriormente, se produce perdida de la transparencia, de forma progresiva y lenta que acabará formando cataratas.
 
¿EXISTEN FACTORES DE RIESGO PARA SU APARICIÓN?

  • Es más frecuente en personas de mayor edad.
  • En mujeres esta patología es más frecuente.
  • La diabetes aumenta el riesgo de desarrollar cualquiera de los tipos de catarata, particularmente cuando la enfermedad tiene una evolución mayor de 10 años.
  • La utilización de corticoides por vía sistémica durante períodos prolongados.
  • El tabaquismo está asociado con incremento de la catarata nuclear y subcapsular posterior. Al abandonar su uso disminuye este riesgo.
  • La exposición a radiaciones ultravioleta e infrarroja favorece esta patología. Esto ocurre tras haber pasado mucho tiempo bajo el sol, especialmente sin protección.
  • El aumento del índice de masa corporal.
  • Los antecedentes familiares de catarata.

 
¿QUE SÍNTOMAS TIENE?

  • La visión es borrosa, pudiendo existir distorsión de las imágenes (visión doble).
  • Afectación de los colores (visión menos intensa de ellos), o ser amarillenta.
  • Sensibilidad a la luz (fotofobia). Se pueden percibir deslumbramientos con los reflejos del sol sobre paredes blancas o las luces de los vehículos.
  • En algunos tipos de cataratas hay disminución de visión lejana y mejoría de la cercana, de hecho puede sentir que mejora la visión para leer que había perdido con la presbicia. En otras, se deteriora más la visión cercana que la lejana, y el deslumbramiento es mayor.


¿ES POSIBLE RETRASAR SU APARICIÓN?
La aparición  de las cataratas por el propio envejecimiento no podemos evitarlo, pero si atrasar su evolución. Estos son algunos consejos:

  • Proteger los ojos de la luz solar con gafas que tengan un filtro de rayos UV adecuado.
  • Adecuado control de niveles glucémicos en los diabéticos.
  • Mantener un peso adecuado.
  • Evitar el tabaquismo.

 
¿QUÉ SE PUEDE HACER?
Si presenta pérdida de visión progresiva con otros síntomas característicos de las cataratas deberá acudir a su médico de familia para una primera valoración de la agudeza visual evaluando la nitidez de su visión, y éste valorará la derivación a oftalmología para realizar su estudio. En el oftalmólogo se le realizará de nuevo una prueba de agudeza visual se examinarán las distintas partes oculares de forma más detallada.
 
¿CUÁL ES EL TRATAMIENTO DE LAS CATARATAS?
Las cataratas pueden extraerse sólo con cirugía.
Se sugiere la cirugía de cataratas cuando la visión de una persona ha disminuido de forma que interfiere con sus tareas diarias habituales.
¿En qué consiste la cirugía?
La cirugía de cataratas se realiza con anestesia local (gotas), y suele durar menos de una hora. Existen dos técnicas habituales.
1) Extracción del cristalino envejecido y su recambio por un lente intraocular. La recuperación del ojo puede durar unas semanas.
2) Facoemulsificación: Esta técnica tiene la ventaja de una recuperación más rápida. Consiste en  hacer una pequeña incisión, aspirar contenido opaco del cristalino y se coloca una lente intraocular. La intervención tiene más duración. Actualmente es la técnica más usada.
 
¿EXISTEN RIESGOS EN LA CIRUGÍA? ¿CUÁLES PUEDEN SER LOS RESULTADOS?
Como toda intervención quirúrgica, aunque son mínimos, los riesgos y complicaciones existen. Todo paciente debe firmar un consentimiento informado previamente a la intervención tras ser informado de todos ellos.  La recuperación y los resultados dependen del tipo de catarata, la técnica usada y si el paciente presenta o no patologías asociadas a su catarata. Se estima que el 90 % de los casos tiene un resultado satisfactorio, mejorando la agudeza visual y la percepción de colores respecto a la que tenía previamente.
Tras la intervención pueden aparecer cataratas secundarias por opacificación de cápsula posterior. Otras complicaciones de la intervención son infecciones, hemorragias, desprendimiento  de retina, edemas de córnea… En algunos casos aunque exista una clara mejoría en la visión, es necesario usar gafas para optimizar los resultados.
 


Dra Ana Claudia Farías Gorbea.
Médico de Familia. Centro de Laguna de Duero. Valladolid

REFERENCIAS

Revisión: febrero 2020.

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