Questions & Answers

Cataract is the progressive opacification of the lens of the eye. The main symptom of cataract is a slowly progressing, painless vision loss.

If and when the cataract surgery is necessary can only be determined after a detailed profound examination of your eyes by an IROC ophthalmologist. Usually cataract surgery is advised if you are restricted in your everyday life (e.g. visual impairment/increased blinding/glare while driving).

No. Despite the high-quality standards, costs at IROC eye clinic in Zurich are the same as in a public swiss hospital. Thus, when choosing a standard artificial lens, the entire cataract surgery is covered by the standard swiss health insurance. These services are uniform throughout Switzerland for all outpatient treatments. However, we do not recommend the implantation of a standard artificial lens, but an aspherical blue-filter artificial lens. This enables better optical imaging on the retina and possible protection against macular degeneration. To determine the individual asphericity of this premium lens for your eye, an additional examination is performed that will be charged with 300,- CHF per eye prior to the surgery. These costs are not covered by the standard swiss health insurance.

Every intervention involves certain risks. These are, however, reduced to a minimum by using the most recent technologies and devices and by the long experience of our ophthalmologists and ocular surgeons. After a thorough pre-examination, you will be informed and advised in detail about general and individual risks regarding your eyes.

In most cases, cataract surgery is performed under local anesthesia. This can be done for example via a syringe injection, which is placed next to the eye. You won't feel this at all, because we let you sleep briefly for the time of the injection. Alternatively, the procedure can also be performed under topical anesthesia or rarely under general anesthesia.

Yes, blood-thinning medications such as Tiatral, Marcoumar, Sintrom, etc. should usually be stopped 7 days prior to the surgery, "new" blood-thinning medications like Xarelto at least 24-36 hours prior to the surgery. Do not stop taking these medications yourself but discuss this with your family physician first. If you have recurrent bruises or if you suffer from persistent bleeding after minor injuries, this is also taken into account during the planning of the surgery.

Yes, the high-precision femtosecond laser is used to produce the incision in the anterior surface of lens capsule because it increases safety compared to the manual technique. In addition, the actual cataract is also fragmented into small parts by the femtosecond laser, that are subsequently removed by an ultrasound pen.

Three hours in total. That includes the preparation time, the surgery and the follow-up time.

The operation is done on an outpatient basis. You can go home about 30 minutes after the end procedure.

This is recommended. Due to the bandage after surgery you only see with the fellow eye, which limits your spatial vision.

Strong pain after cataract surgery is rare. In case it occurs, you can find the provided painkillers in your post-surgery kit. If pain persists you should contact the surgeon. In general, many patients report foreign body sensation after the surgery. This is normal within the first days after cataract surgery.

During the first few days after cataract surgery a transient reduction in vision may occur. The surgeon will inform you about the expected healing course of your operated eye at the early-postoperative examination 1 day after the surgery.

By the rule, you are disabled to work for 1 week.

Keratoconus is the progressive thinning and conical protrusion of the cornea of the eye. In most cases it is a hereditary disease.

If you are diagnosed with keratoconus, be assured that our team of ophthalmologists is ready to take care of your case. In a preliminary examination, we want to get familiar with your personal situation and determine the next steps to offer you best-available therapy.

Crosslinking of the cornea is achieved by a combination of UV-irradiation with administration of riboflavin eye drops (vitamin B2). The intensity of the UV radiation is chosen so that structures posterior of the cornea are not damaged. The currently most efficient technique is customized crosslinking.

Together with the University Eye Hospital Dresden, we have the longest experience worldwide using this method. In the past years, further developments of the method were investigated by IROC. The IROC eye clinic in Zurich is currently the only provider of customized crosslinking, which has been demonstrated in international studies to be the most efficient and safest crosslinking approach in keratoconus.

Multiple studies from different research groups reported a significantly lower short- and long-term efficacy when using this technique. This is why we only don't use this technique.

In contrast to other countries (e.g. Italy, Norway, partly Germany), standard Swiss health insurances currently do not cover the costs for the crosslinking operation. In cooperation with a medical lawyer we have set the costs to CHF 2.300 as a lump sum for the operation.

IROC ophthalmologists will discuss possible risks and side effects together with you after the pre-examination. In general, the risks associated with this type of surgery are minimal if the pre-examination is carried out carefully. The complication rate is about 1%.

On the day of the customized crosslinking procedure, the eye is only anesthetized via topical anesthetic eye drops. The entire operation is completely painless.

During the crosslinking procedure, the superficial layer of the cornea, the epithelium, has to be removed. Bare corneal nerve endings induce pain, which is sometimes considerable strong within the first 48 hours after surgery. However, our ophthalmologists will provide painkillers to keep the discomfort on a minimum.

You should be in company, as your vision will be limited after surgery and the use of public transport may be a risk. You should also not drive a car yourself.

The inability to work is usually 7 to 10 days.

So far, results of 15 years of experience have been published in international studies, reporting god long-term outcome of crosslinking.

During the postoperative period (1-3 months) after the crosslinking you are much more sensitive to light (glare) and the visual acuity might be transiently reduced. Usually rigid contact lens can be used one month after the surgery again. Previously published studies report on an increased vision acuity after customized Crosslinking after 1 year.

You should come to IROC eye clinic about 1 to 1.5 hours prior the scheduled surgery time. The surgery usually lasts between 1 and 1.5 hours. The follow-up time is another 2 hours, after which an early postoperative examination is carried out.

If the early postoperative examination shows no abnormalities, you can leave the eye clinic when you are accompanied. However, on the day of the operation, you are not allowed to drive or use public transport without assistance.

Severe pain is rare after eyelid surgery. In case, you can find painkillers in the post-surgery kit. If pain persists you should contact the surgeon suing the provided phone number.

Within the first 2-3 days after the operation, you will notice a reduction in vision, because ointment is applied to protect the cornea, which can affect the vision.

Depending on the procedure, you will be unable to work between 2-7 days.

In most cases, eyelid surgery is performed under local anesthesia and you won't perceive any pain. Here, a syringe injection technique the so-called "fractional injection" is used, which is barely noticed by the patient.

Yes, blood-thinning medications, such as Tiatral, Marcoumar, Sintrom, etc. should usually be stopped 7 days prior to the surgery, "new" blood-thinning medications like Xarelto at least 24-36 hours prior to the surgery. Do not stop taking these medications yourself but discuss this with your family physician first. If you have recurrent bruises or if you suffer from persistent bleeding after minor injuries, this is also taken into account during the planning of the surgery.

The macula is located at the central retina in the posterior part of the human eye. It has the highest density of photoreceptors of the entire retina. The macula is responsible for sharp vision.

The most commonly diagnosed macular disease is age-related macular degeneration (AMD). The other diseases of the macula that are commonly diagnosed and treated are diabetic macular disease (diabetic maculopathy) and macular disease resulting from retinal venous occlusion (macular edema following venous occlusion). However, there are numerous less-frequent other types of macular diseases.

Numerous diseases of the macula can be successfully treated today. Whether the diseased macula will benefit from a possible treatment must be clarified in a profound examination. After the initial diagnosis, the cause, the type and the stage of the disease need to be determined. In many cases, previously reduced visual acuity can be gained again under therapy, or at least further deterioration can be prevented. The earlier and the more consistent the treatment is, the better the long-term outcome of the diseased macula will be.

Age-related macular degeneration (AMD) is the most commonly diagnosed macular disease. Beside hereditary cause, other factors like age of the patient play a crucial role in its development. In the course of getting older, the complicated metabolic mechanisms necessary for a good macular function can be disrupted. The layers that provide nutrients for the unrestricted function of the photoreceptor cells are not working appropriate and a consecutive accumulation of metabolic degradation products is causing tissue damage.

A distinction is made between "dry " and "wet" age-related macular degeneration (AMD).

Dry AMD very often has so-called "drusen" which are locally condensed accumulations of metabolic degradation products in the macular layers. In the context of further degenerative development, tissue atrophy can occur, including all layers of the macular structure. A late stage of dry AMD is characterized by an extensive tissue loss ("geographic atrophy"). In wet age-related macular degeneration (AMD), new vessels develop in the choroidal layer of the eye, which do not have the structure and characteristics of normal choroidal vessels. These new vessels can grow into retinal structures. They are permeable to fluid that may leak into the retina and they are prone to bleeding. If not treated appropriately, this exudative, wet form of AMD can lead to a fast-progressing loss of visual acuity.

Yes. The dry form of the AMD can change into a wet, exudative form. This transition is usually accompanied by symptoms like visual deterioration.

Affected patients often complain about severely distorted or blurred vision in the centre of the visual field. Straight lines are no longer perceived as straight. In late stages of wet macular degeneration, as well as in late stages of dry macular degeneration, the patient sees a central dark spot of various sizes.

Yes. This test is called Amsler test. The Amsler test is a very suitable test for the self-assessment of the macular situation of an eye. It is very simple, delivers quick results and yet is still surprisingly accurate. The Amsler grid is placed in reading distance (for example, about 30 cm). The test is done with reading glasses, unless you are able to read without glasses. The Amsler test is always performed separately for each eye (the fellow eye is covered), so that a conclusion about the macula of each eye can be made. For the test the eye has to fixate the black dot in the center of the panel. The test is conspicuous when the lines of the grid are not perceived straight but distorted or when line interruptions or whole area defects are noticed.

Not every macular disease has an evidence-based treatment option. In the wet form of age-related macular degeneration (AMD), diabetic macular disease, and in macular disease following venous occlusion, intravitreal injection therapy of vascular growth inhibitory factors ("anti-VEGF") into the vitreous humor of the eye is in most cases a very efficient therapy. In these cases, the current condition of the affected macula can be stabilized or even improved.

No. The adequate treatment requires repetitive intravitreal injections. Regular monitoring of the macula with OCT examinations makes it possible to customize the rhythm of the intravitreal injections for each patient individually.

No. Age-related macular degeneration (AMD) affects only the centre of the retina. In late stages of AMD, a central black sport of different sizes with the corresponding consequences for vision arises, including the loss of reading ability. The peripheral retina, which is responsible for the perception of the peripheral visual field, is preserved. This allows orientation of the affected patients in their spatial environment even in very advanced stages of macular degeneration.

We have put together a special brochure on macular therapy which informs you in detail about further steps. We are glad to answer all questions you may have about your macular problem after a profound macular examination.