Les évolutions dans le traitement de la cataracte

Cataract is an opacity of the crystalline lens. It is the leading cause of blindness in the world. Its surgical removal is the only treatment, and currently accounts for more than 600,000 surgeries per year in France. The history of cataract surgery began in Antiquity with the ancient technique of “couching”, which consisted in pushing down the lens into the vitreous cavity using a needle. From the mid-18th century to the 1980s, the surgical techniques of intracapsular and extracapsular extraction had their heyday. Nowadays, cataract removal is usually performed through a 2- or 3-mm incision using vibrational energy to fragment the lens; the technique is called phacoemulsification and is usually accompanied by intraocular artificial lens implantation. This surgical evolution is still relevant, as shown, a few years ago, by the development of femtosecond laser-assisted cataract surgery. More recently, it has been demonstrated that lanosterol could prevent or treat cataract by preventing the aggregation of the lens intracellular proteins, called crystallines and involved in lens transparency. The results are still experimental. However, if the effectiveness of this cataract treatment was confirmed, it would be a socioeconomic and a medical revolution in this age-related pathology.